The Relationship between Perfectionism and Anger in Adolescents.

BACKGROUND: As a contribution to the dimensional classification of mental disorders, which in the next edition of the American Psychiatric Association (APA) could dominate over the categorical, and in general, due to the impact of anger on the behavior of individuals in our society, it seems important to examine and analyze dimensions that represent risk factors for occurrence and development of anger disorders. Aim, to examine gender differences in the expression of the adaptive and maladaptive dimensions of perfectionism and anger (state and trait, as well as the anger expression and control) and to examine whether the dimensions of perfectionism are statistically significant predictors of anger. SUBJECTS AND METHODS: This study included a total of 600 primary and secondary school students (305 girls and 295 boys), 12 to 18 years old. Data were collected using a Socio-demographic Features Questionnaire for general information onto the Adaptive/ Maladaptive Perfectionism Scale (AMPS), Child-Adolescent Perfectionism Scale (CAPS), and State-Trait Anger Expression Inventory-2 Child and Adolescent (STAXI-2 C/A). RESULTS: Statistically significant gender differences were found in the expression of the adaptive and maladaptive dimensions of perfectionism and anger. For aspects of anger, girls have been found to control their anger more often than boys. Multiple regression analysis indicates the important contribution of the dimensions of perfectionism in the explanation of anger in adolescents. CONCLUSION: Given the results obtained, our research represents a contribution to the definition of a dimensional diagnostic system to prevent comorbidity of mental disorders and provide more clinically relevant information about each individual. The instrument which is used to measure anger in this study (STAXI-2 C/A; Brunner & Spielberger 2009) was for the first time applied in Bosnia and Herzegovina. The results of this research are a contribution to its validation.

ATTITUDES TOWARDS AND HABITS IN ORAL HEALTH OF ADOLESCENTS IN HERZEGOVINA.

The aim of the study was to determine attitudes towards and habits in oral health of adolescents in Herzegovina, as well as to evaluate the possible differences in habits among individuals of different adolescent categories. The study included 120 participants (35 male and 85 female) divided into three adolescent categories, as follows: early (11-14 years of age), middle (15-18 years) and late (19-21 years) adolescence, from the Herzegovina-Neretva Canton, who presented for dental examination. All participants completed the socio-demographic questionnaire and standardized Hiroshima University Dental Behavioral Inventory (HU-DBI). The answers provided by study adolescents in the HU-DBI showed statistically significant differences among particular age groups, i.e. between early and middle adolescence in items 7 (p=0.046) and 15 (p=0.007); between middle and late adolescence in items 8 (p=0.021), 11 (p=0.04) and 12 (p=0.027); and between middle and late adolescence in item 11 (p=0.032). Respondents in middle adolescence had poorer oral hygiene attitudes than those in early and late adolescence. In order to improve the oral hygiene habits of adolescents in Herzegovina, it is necessary to put emphasis on continuous education about oral hygiene habits during their secondary education.

Humanism influencing the organization of the health care system and the ethics of medical relations in the society of Bosnia-Herzegovina.

Every successful health care system should be based on some general humanistic ideals. However, the nationally organized health care systems of most European countries usually suffer from a deficiency in common ethical values based on universal human principles. When transitional societies, such as that of Bosnia-Herzegovina are concerned, health care organizational models are even more dysfunctional. The sources of a dysfunction in medical care system of Bosnia-Herzegovina are manifold and mutually controversial, including a lack of shared principles, an inappropriate involvement of politicians in medical care and practice, administrative difficulties arising from superficial communication systems, as well as economic limits concerned with the financing of health care. The deficiency of a moral culture of medicine, which is correlated to a general collapse of morality is also responsible for many problems affecting various aspects of life including medical care. Hence, medical ethics from a virtue perspective is becoming an important ingredient of any improvement deigned to provide better-quality medical care.The aim of this paper is to underline the influence of humanism on the organization of health care systems and the ethics of medical interrelations in the society of Bosnia-Herzegovina. It is not intended to diagnose or resolve the problems, but to analyze them. It is also a critique of specific socio-political-economic influences on this health care system, inquiring if well-educated individuals in the virtues, which are involved in medical practice and education, would counteract them.In conclusion, humanism creates a universal ethical structure, which is based on human values such as fidelity, trust, benevolence, intellectual honesty, courage, compassion and truthfulness. These values should represent the standard around which medical care is organized. Since the health care system in Bosnia-Herzegovina is not entirely founded upon humanistic ideals, addressing the socio-political-economic conditions that constantly undermine those values is a prerequisite for any much-needed improvements of the medical care.

Study of depression and anxiety in patients with asthma and chronic obstructive pulmonary disease.

BACKGROUND: Suggested treatment of patients with COPD and astma requires promotion and psychological dimensions of patients. AIM: Primary objective of this study was to determine frequency of developing anxiety and depression in patients with asthma and chronic obstructive pulmonary disease (COPD) in relation to gender, age and socioeconomic status and to evaluate possible differences between patients with and without high level of anxiety and depression and to find correlation between psychological aspects and disease itself. SUBJECTS AND METHODS: This study included a total of 120 subjects: 60 patients with asthma and 60 patients with COPD. Data were collected using a socio-demographic questionnaire for general information on subjects, standardized Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). RESULTS: Significant difference was found in the anxiety level in these two groups. Average value for the patients with COPD was 43 (15) and for the patients with asthma 37.5 (15.7). Statistically significant difference was also reported for the depression level among females. In female patients with COPD that level was 13.5 (14.7) and in female patients with asthma 7.5 (11). There is a correlation between anxiety and depression in patients with COPD and asthma, especially among women. CONCLUSION: This study suggests that asthma and COPD are a significant stressor with a risk of developing anxiety and depression.

PANDEMIC INFLUENZA A (H1N1) 2009 PRESENTING AS A MILD DISEASE IN CHILDREN IN A CROATIAN CLINICAL CENTRE.

Pandemic influenza A virus (H1N1) 2009 causes a disease that is epidemiologically and clinically not significantly different from seasonal influenza, but there are differences. The aim of the study was to display and compare epidemiological and clinical characteristics of pandemic influenza in children. At Dr. Fran Mihaljevic University Hospital for Infectious Diseases in Zagreb, in the first two seasons, the incidence of pandemic influenza virus A (H1N1) in particular was exhaustively analyzed only in patients with laboratory-confirmed pandemic influenza A virus (H1N1) 2009. In hospitalized children with documented influenza pandemic, moderate form of the disease predominated, which ultimately meant shorter hospital stay and fewer complications. Otitis media was the rarest complication in children in both seasons. In conclusion, children younger than 5 years, especially boys, were vulnerable groups for pandemic influenza, presenting as a mild disease with low mortality and few complications. Most of the affected children with influenza did not have important risk factors such as asthma and obesity, highlighted by other authors as significant risk factors.

Prognostic value of lactates in relation to gas analysis and acid-base status in patients with pulmonary embolism.

AIM: To assess the prognostic value of lactate level for mortality in patients with pulmonary embolism (PE) and Pulmonary Embolism Severity Index (PESI) I-III and its independence of gas-analysis parameters and acid-base status. METHODS: This prospective observational study was conducted at the University Clinical Hospital Mostar from 2013 to 2017. On the first day after PE diagnosis, 1.5 mL of arterial blood was collected from 103 patients with PE. Partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, blood pH value, concentration of bicarbonates in arterial blood (HCO3-), base deficit, and oxygen saturation were analyzed. Lactate levels were assessed using blood samples taken from the cubital vein. Logistic regression analysis was used to assess the predictive value of gas-analysis variables, lactate level, PESI score, age, and sex for in-hospital death due to PE. RESULTS: The mortality in the group of PE patients was 19.1% (18 of 103 patients). Lactate level was an independent predictor of mortality (P=0.002, odds ratio 0.06). HCO3- was also found to be a significant predictor (P=0.022, odds ratio 2.4). Lactates were independent of other variables. Other gas-analysis parameters were not significant predictors of mortality. CONCLUSION: In PE patients at low-intermediate risk of mortality (PESI I-III), lactate level was associated with a short-term mortality, independently of other gas-analytic parameters. Oxford Centre for Evidence-based Medicine level of evidence: 2.

Prevalence of Intellectual Disabilities and Epilepsy in Different Forms of Spastic Cerebral Palsy in Adults.

BACKGROUND: Spastic cerebral palsy may be interconnected with other neurodevelopmental disorders such as intellectual disabilities, and epilepsy. Brain synaptic plasticity and successful restorative rehabilitation may also contribute to diminish neurological deficit of patients having cerebral palsy. The aim of this study was to investigate the prevalence of intellectual disabilities and epilepsy in adult patients with different forms of spastic cerebral palsy and to find out correlation between the severity level of intellectual disabilities and epilepsy. SUBJECTS AND METHODS: Adults diagnosed with different forms of spastic cerebral palsy were analyzed during a three-month period. The investigated features were: gender and age; form of cerebral palsy; the prevalence of intellectual disabilities and epilepsy. Intellectual disabilities were divided into 4 severity levels. The correlation between the severity level of intellectual disabilities and epilepsy was statistically analyzed. RESULTS: Intellectual disability was present in 55% of patients diagnosed with spastic cerebral palsy. Epilepsy was present in 36% of such patients. It was recorded in 51.1% of quadriplegic, 21.9% of diplegic, and 19.2% of hemiplegic patients. Intellectual disability was present in 73.8% of quadriplegic, 31.3% of diplegic, and 53.8% of hemiplegic patients. The statistically significant correlation existed between the severe intellectual disability and epilepsy. CONCLUSIONS: Intellectual disabilities and epilepsy most frequently occurred in patients with most severe forms of spastic cerebral palsy. Epilepsy is strongly correlated to the severity level of intellectual disability. Such patients require additional special modes of treatment and restorative rehabilitation to improve the functional outcome.

Parental Socioeconomic Status as a Predictor of Physical and Mental Health Outcomes in Children - Literature Review.

Parental socioeconomic status is a multidimensional concept of special importance for the growth, development, health outcomes and education of children. Its definition generally refers to the amount of parents' income, their employment status and level of education. Hence, lack of economic resources and poverty of parents affect all aspects of the child's life, health outcomes and education, as well as his/her social inclusion. Accordingly, the consequences of a reduced parental socioeconomic status leave long-term effects on their children. Therefore, in order to create interventional programs for children of parents with low income and lower socioeconomic status, as well as with lower level of education, it is important to address the direct aspects of poverty. This review contributes to the evidence indicating that the parental socioeconomic status is highly influential in determining the child's physical and mental health and future outcomes including his/her academic achievements and education, as well as the parameters of his/her physical abilities, cognitive function and fundamental neurobiology affecting brain development.

APPEARANCE OF NEURODEVELOPMENTAL DISORDERS IN CHILDREN DELIVERED POST-TERM: A CROSS-SECTION STUDY.

GOAL: To analyze the appearance of neurodevelopmental disorders in children delivered post-term and to find out whether prolonged pregnancy may be a cause of such disorders in a selected group participants. PATIENTS AND METHODS: This study included a cohort of 34 children born post-term suffering from neurodevelopmental disorders who were treated at the Service for psycho-physiological and speaking disorders in Mostar, Bosnia and Herzegovina during an 18-year period. RESULTS: There were 59.4% of male and 40.6% female patients (P=0.002). The most common neurodevelopmental disorder in the sample was intellectual disability (38.2%), followed by epilepsy (26.4%), delayed psychomotor development (14.7%), and cerebral palsy (11.7%) (P<0.001). The correlation between mothers' parity and post-term delivery was found (P=0.016). CONCLUSION: Post-term delivery may be the cause of neurodevelopmental disorders. The most common disorder among them were intellectual difficulties.

[DIFFERENCE IN THE PREVALENCE OF BURNOUT SYNDROME IN PRECLINICAL AND CLINICAL TEACHING DOCTORS OF MOSTAR SCHOOL OF MEDICINE]. / RAZLIKE U UCESTALOSTI POJAVE SINDROMA IZGARANJA U NASTAVNIKA PRETKLINICARA I KLINICARA MEDICINSKOG FAKULTETA U MOSTARU.

AIM: The aim of this study was to determine the difference in the prevalence of burnout syndrome in preclinical and clinical teaching doctors of Mostar School of Medicine in the academic year 2011/2012. Special attention was also focused on finding out the possible difference between the syndrome incidence that was correlated to gender and years of service. The main hypothesis was that the probability of burnout syndrome incidence was higher in the group of female clinical teaching doctors having more years of service. SUBJECTS AND METHODS: The study involved 62 people with high academic education employed at Mostar School of Medicine who were surveyed during a randomly selected consecutive 3-month period (February to May) of the academic year 2011/2012. The data were prospectively collected through a standardized questionnaire survey. The studied parameters were gender, years of work experience and the engagement in preclinical or clinical departments of the Medical School. RESULTS: The survey showed that 43 out of 62 (69.4%) respondents did not suffer the burnout syndrome, while moderate syndrome was recodred in 19 (30.6%) of them. No person had serious symptoms of the syndrome. The difference between the respondents who suffered the syndrome and those who did not was not statistically significant (P=0.002). Considering the gender of respondents, statistically significant differences were not confirmed (P=0.444). Considering the years of service, the highest incidence of the syndrome was found in people with more work experience (in the group of 21-25 years), but the difference between the groups was not statistically significant (P=0.271). Observing the work in preclinical and clinical departments, because of the limited number of patients we could not confirm the hypothesis. The syndrome had affected 13 (21%) clinical teaching doctors and 6 (9,7%) preclinical doctors, while the differenece between them was not statistically significant (P=0.054). CONCLUSION: Considering the results of this research, it has not been proven that the burnout syndrome occurred more frequently in doctors who were involved in clinical teaching than in doctors who tought in preclinical departments. Also, there was no difference in the appearance of the syndrome that was related to gender and years of service.

The Influence of Serum Cortisol Level Onto Perceptive Experience of Optimism in Patients with Newly Diagnosed Cancer.

THE AIM: The aim of this study is to investigate the correlation between the morning level of serum cortisol and perceptive experience of optimism in a selected group of 60 patients with newly diagnosed cancer who were treated at Mostar University Clinical Hospital during a one-month period. PATIENTS AND METHODS: The morning level of serum cortisol was measured in all patients following the verification of oncological disease. The patients also filled out a questionnaire of socio-demographic data, as well as the scales for optimism/pessimism assessment. RESULTS: The average morning serum cortisol level was within the reference values in the majority of patients, independently of their perceptive experience of optimism/pessimism. There was no significant difference in the morning level of serum cortisol among the subgroups of patients high and low on the scale of optimism, as well as the scale of pessimism. No correlation existed between the serum cortisol morning level and expressed optimism/pessimism, as well. The great majority of respondents had secondary and lower education, was retired or unemployed, and suffered lower socio-economic conditions of life. Therefore, their access to medical information and their knowledge of cancer modern treatment options and possibilities were restricted, what may also have an influence onto perceptive experience of optimism/pessimism. CONCLUSION: The results concerned with the perceptive experience of optimism/pessimism assessment were not a consequence of stress reaction but they were more correlated to general personal characteristics, the level of education, and socio-economic status of patients. The results do not confirm the impact of morning serum cortisol level onto physiological reactions to stressful conditions and situations in selected group of patients with de novo carcinoma.

Epidemiological characteristics of children born with Down syndrome in western Herzegovina in the period of the last twenty years (1994-2013).

BACKGROUND: Children with Down syndrome (DS) are an everyday casuistry of pediatric clinical medicine. The prevalence of DS is dependent on socio-demographic and cultural conditions of a community. Antenatal screening is not carried out mainly due to religious views, and the prevalence of DS in our region is really considered a "natural phenomenon". The aim of the study was to analyze some epidemiological characteristics of infants with Down syndrome in the western region of Herzegovina in the period between year 1994-2013. SUBJECTS AND METHODS: We performed a retrospective analysis of hospital records of children who were supervised and treated at Children's Hospital through the twenty-year period. RESULTS: In this period there were 44,100 liveborn infants. Down syndrome was detected in 78 children (54 male and 24 female). The prevalence is estimated at 1.8/1,000 of live births. Aborted fetuses and stillbirths were not analyzed. 37 (47%) of the parent couples were over 35 years of age. Out of that 65 cytogenetic analysis, a regular type of trisomy 21 was found in 94% of cases, and the translocation in 6%. From major malformations (MM) heart failure was more often present (47%), then the anomaly of the gastrointestinal and genitourinary systems. Ten children (12%) died, most often in the early period of infancy due to complications of the cardiovascular system. CONCLUSION: The prevalence of DS throughout these two decades has been uniform in the region of western Herzegovina. Improvement in perinatal care in recent years caused higher survival and a better quality of life for the children with DS and thus their families. DS is less a desirable family tragedy, and increasingly a tolerable family fate.

Metabolic risk factors, coping with stress, and psychological well-being in patients with age-related macular degeneration.

The aim of this study was to determine the relationship between the risk factors (age, obesity, hypertension, hyperlipidemia, smoking, consumption of alchohol and drugs, positive family history, and exposure to sunlight), coping with stress, psychological well-being and age-related macular degeneration (ARMD). Forty patients with ARMD (case group) and 63 presbyopes (control group) participated in the study. Patient data were collected through general information questionnaire including patient habits, the COPE questionnaire that showed the way the patients handling stress, and the GHQ that analyzed the psychological aspects of their quality of life. These questionnaires were administered to the patients during ophthalmologic examination. The study involved 46 (44.66%) men and 57 (55.33%) women. Statistical analysis showed that the major risks for the development of ARMD were elevated cholesterol, triglycerides and LDL cholesterol in plasma. A significantly higher number ofARMD patients had a positive family history when compared with presbyopes. This study showed presbyopes to cope with emotional problems significantly better and to have a lower level of social dysfunction when compared with ARMD patients. However, it is necessary to conduct further studies in a large number of patients to determine more accurately the pathophysiological mechanisms of metabolic factors as well as the impact of the disease on the quality of life in patients with ARMD.

[The frequency of burnout syndrome in physicians in Mostar University Hospital]. / Ucestalost sindroma burnout kod lijecnika u Sveucilisnoj klinickoj bolnici Mostar.

AIM: To determine the prevalence of burnout syndrome in clinical physicians in Mostar University Hospital. SUBJECTS AND METHODS: The study included 94 subjects who were familiar with the purpose of research and were classified into three specialty groups. The first consisted of doctors in the Department of Internal Medicine and Department of Pediatrics, the second group of doctors in the Department of Surgery and Department of Gynecology and Obstetrics, while the third group (CL-specialization) were doctors of the Clinic of Dermatology and Venereal Diseases, Department of Otorhinolaryngology and Department of Ophthalmology. All subjects were handed anonymous questionnaire to assess burnout. The questionnaire consisted of 18 statements with numbers from 1 to 3, 1 meaning rarely, 2 often and 3 always The task was to circle an appropriate number depending on how the statement described them. Along with these statements the questionnaire contained information on the place of employment, years of work experience and gender. RESULTS: In the studied sample of respondents most (n = 81, 86.2%) didn't have symptoms of burnout syndrome. As for the people who had these symptoms, they all belonged to the moderate intensity (chi2 test = 49.19, df = 1, P < 0.001), while none had severe symptoms of this syndrome. The intensity of the symptoms in the subjects was not significantly different between males and females (chi2 test = 0.85, df = 1, P = 0.355). Also, the intensity of symptoms in the subjects did not differ significantly depending on the number of working years (exact test, P = 0.888). After the formation of three groups from seven departments involved in the research of so far perceived intensity of stress, no significant differences in the intensity of the symptoms of burnout were found between them (exact test, P = 0.536). Regarding the individual items in the overall survey sample, in five items high intensity symptoms of burnout were most often circled. The most frequently reported high intensity of the symptoms was the sense of inability to change something at work (chi2 test = 78.04, df = 14, P < 0.001) CONCLUSION: The majority of respondents did not have symptoms of burnout syndrome, and those who had them were in the moderate stage of burnout. No statistically significant differences in the incidence of burnout syndrome between the groups of specialties were found.

[Anxiety and depression in oncology patients in the Mostar University Clinical Hospital]. / Anksioznost i depresivnost kod onkoloskih bolesnika u Sveucilisnoj Klinickoj Bolnici Mostar.

OBJECTIVE: To determine the degree of anxiety and depression in patients hospitalized at the Department of Oncology of the Mostar University Clinical Hospital and the relationship between the degree of anxiety and depression, sex, marital status, age, and education of the patients. PATIENTS AND METHODS: The study included 160 patients who were divided into two groups: a test and a control group. A patient from the test group was assigned a patient from the control group according to his/her age, gender, education level and marital status. The study population consisted of 80 patients who were treated at the Department of Oncology of the Mostar University Clinical Hospital from January 1, 2010 to March 31, 2010. The control group consisted of 80 patients who were admitted via the Family Medicine Office of the Mostar Community Health Center from March 1, 2010 to March 31, 2010. The Beck's Anxiety and Depression scale was used. The appropriate statistical methods were used to test the collected data. RESULTS: Patients hospitalized at the Department of Oncology had a greater degree of depression than the control group (exact test, P<0.001). A significant difference in the level of anxiety between the test and control groups was not found (exact test, P=0.143). A mild degree of anxiety was found in the cancer patients older than 60 and a high level of anxiety in the group aged 25-40 (exact test, P<0.001) and in highly educated patients (exact test, P=0.024). The research showed that the cancer patients from the younger age group had higher levels of depression (exact test, P<0.001). By comparing the degree of anxiety to the age in the control group, statistically significant difference was not found, so the highest level of anxiety was found in the patients aged between 41 and 60 (exact test, P<0.001). It was determined that a higher percentage of women (exact test, P=0.034) and patients over 60 years old (exact test, P=0.006) in the control group were more depressed. CONCLUSION: Although a statistically higher level of depression was determined for the test group patients, a statistically significant difference in the levels of anxiety between test and control groups was not found.

[Psychological adjustment to chronic stress in parents of children with intellectual disability]. / Psiholoska prilagodba na kronicni stres roditelja djece s intelektualnim teskocama.

AIM: To investigate whether mothers and fathers of children with intellectual disability differ when it comes to resistance factors (deailing with stress, marital quality, personality traits) and adjustement (psychical symptoms and subjective health complaints, pleasant and unpleasant mood). SUBJECTS AND METHODS: The researchencompassed 30 married couples, 30 mathers and 30 fathers, all of wich are parents of children whit intellectual disability who treat in Service for psychophysical and speech difficulties in Mostar, Centre for special needs "Mary our hope" in Siroki Brijeg and Centre "Nazareth" in Mostar. Materials are delivered to parents on arrival at chech-in to special education. The research was conducted from Semptebre 2010 to May 2011. The study used a survey that consisted of five questionnaires: the Standardizerd questionaire of coping with stress, Standardizerd questionaire severity of subjective health symptoms, Standardizerd questionaire of quality of marriage, Standardizerd questionaire of a mood and Standardizerd questionaire of five-factor model of personality. The survey was anonymus. The collected dana was tested with corresponding statistical methods. RESULTS: Mothers frequently (P = 0,005) and intense (P = 0,005) perceived subjective health symptoms as compered to fathers. Mothers frequently (P = 0,043) and intense (P = 0,033) experienced gastrointestinal symptoms compared to fathers. They also more frequent (P = 0,000) and more intense (P = 0,001) experienced pseudoneurological symptoms. Flu symptoms are more frequent (P = 0,008) and more intense (P = 0,005) in mothers. There is not statistically significant difference in the frequency and intensity of muscle and allergic symptoms. Fathers are emotionally stable than mothers (P = 0,000). In other protective factors we adid not find statistically significant differences in measures of adjustment. CONCLUSION: With regard to measures to adjustment, mothers and fathers of children with intellectual disability differ in overall frequency and intensity of subjective health symptoms. Here we hightlight the gastointestinal, pseudoneurological and flu symptoms. In termes of protective facrors fathers are emotionally stable than the mothers.

Early detection and recognition of children with ADHD (attention deficit hiperactivity disorder) symptoms.

Aim of this study was to determine the probability of occurrence of Attention Deficit/Hyperactivity Disorder- ADHD in children of preschool age and early school age, and to identify differences in the assessment of children identified with high probability for the disorder with regard to assessment by parents and teachers, and with respect on age and sex of children. Total of 107 children were included in the study: 51 girls and 56 boys. The study employed two questionnaires: Questionnaire for Analysis at School for teachers and Questionnaire for Analysis at Home for parents. Both questionnaires contained 39 statements which covered three dimensions of child's behavior needed for ADHD diagnosis. Raw data in each questionnaire were converted according to the standard norms of Guide to Standard Scores (SS) and Total Standard Scores (TSS) and as such were used for statistical analysis. It was found that a considerable number of children demonstrated high probability for ADHD disorder in assessments done by both parents and teachers. Parents recognize probability of ADHD presence more frequently among male children, while teachers recognize this probability more often among female children. Research shows that a significant percentage of children from the entire sample have been labeled with significant ADHD symptoms. Given the age of the child both parents and teachers recognize similar levels of high ADHD probability. Future studies should be directed toward early detection and recognition of children with ADHD syndrome, and clinical evaluation as a first step toward successful treatment and prevention of additional psychological and other problems in an adult.

Risk factors associated with cerebral palsy in newborns.

The aim of this study was to investigate the risk factors associated with cerebral palsy (CP). For this purpose, a total of 55 newborns were investigated in the case control design study, with a total of 55 additional newborns that were matched to the cases. All patients were recruited in University Clinical Hospital Mostar and other institutions in the region between 1997-2005. The comparison of the Apgar score did not seem to show significant differences between cases and controls (odds ratio [OR] = 1.15, 95% confidence intervals [CI] 0.36-3.69). Hypoxia was more common in the CP group (36.3% vs. 5.4% in the control group; p < 0.001). Additionally, cases were more frequently exposed to the infections (p < 0.001), intracranial hemorrhage (p = 0.002), premature delivery, before the 28th gestation week ( p = 0.027), as well as the premature delivery during the 28-34 gestation week ( p = 0.001), and 34-38 gestation week ( p = 0.018). Accordingly, small birth weight was associated with cases more often than controls (p = 0.003). Bleeding during pregnancy was also more common in cases than controls (p = 0.032), while the breech presentation, emergency cesarean section, hydrocephalus, placenta disorders and pre-eclampsia were not associated with CP. The results suggest that CP cases were more commonly exposed to numerous risks, which all seem to contribute to the increased chances of PF. Traditional indicator, poor Apgar score was not found to be significantly associated with the CP.