Прегледај по Аутор "Racic, Maja"
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- СтавкаAssessment of hypertension chronic care model: Pacic application in Bosnia and Herzegovina(PLOS, 2018) Pilipovic-Broceta, Natasa; Vasiljevic, Nadja; Marinkovic, Jelena; Todorovic, Nevena; Jankovic, Janko; Ostric, Irena; Kalimanovska-Ostric, Dimitra; Racic, MajaThe objectives of this study were to evaluate patients’ attitudes towards hypertension treatment according to the chronic care model and to assess the implementation of hypertension clinical guidelines in family medicine. The cross-sectional study was carried out in two randomly selected primary health care centers (Bijeljina and Prijedor), respectively in Bosnia and Herzegovina, covering the period between March and April 2016. This study sample consists of 791 respondents with hypertension purposing to measure specific actions and quality of care for hypertensive patients. The Patient Assessment of Chronic Illness Care (PACIC) was used. Treatment for the indicators of hypertension was assessed by analyzing patients' medical charts according to the recommendations of clinical guidelines. More than half of the evaluated indicators of treatment for hypertension were documented in medical charts of 84.07% patients. The average overall PACIC score was 4.18 (SD 0.59), being an average of the separate scores of 4.19 (SD 0.57) in men and 4.17 (SD 0.60) in women. Subscale means of PACIC were as follows: patient activation 4.33, delivery system design 4.36; goal setting 4.03; problem solving 4.51; follow-up and co-ordination 3.67. No statistically significant correlations in the overall score and subscale scores were found by demographic characteristics. Non-smokers had a significantly higher overall score compared to smokers (p = 0.001). As implementation of the guidelines became stronger, the reported PACIC scores rose. Continuing the education of patients in order to achieve better health care outcomes is imperative.
- СтавкаDistribution of EGFR SNPs -191C/A and 181946G/A in patients with lung cancer depending on smoking status in the Republic of Srpska, Bosnia and Herzegovina(Balkan Union of Oncology, 2018) Elez-Burnjakovic, Nikolina; Ugrin, Milena; Obradovic, Jasmina; Miletic, Natasa; Racic, Maja; Kulic, Milan; Pavlovic, Sonja; Jurisic, VladimirPurpose: To analyze the frequencies of two single nucleotide polymorphisms (SNPs) of EGFR gene, -191C/A and 181946G/A, among lung cancer patients from the Republic of Srpska, Bosnia and Hercegovina, as well as to assess the association of SNP genotypes with the cancer type and other demographic characteristics of patients, particularly with the smoking status. Methods: This study enrolled 41 lung cancer patients from the territory of Republic Srpska, Bosnia and Herzegovina. Detection EGFR SNPs was performed using PCR-RFLP methodology. PCR was performed on 2720 Thermal Cycler (Applied Biosystems, United States). PCR, as well as RFLP products, were detected by gel electrophoresis. SPSS-17 software (SPSS, Inc.) was used for statistical analyses. Results: There was significantly more male than female smokers in our cohort (p=0.006). In addition, the proportion of smokers was higher among patients with adenocarcinoma in comparison to patients with other lung cancer types (p=0.044). Adenocarcinoma was less common in patients older than 64 years (p=0.035). The wild type homozygous genotype of both SNPs was the most frequent genotype in all the tested demographic groups. Using dominant genetic model for -191C/A SNP, we observed statistically significant association of -191CC genotype and adenocarcinoma (p=0.043) in the subgroup of patients younger than 64 years. Namely, patients younger than 64 years and carriers of -191CC genotype had higher risk (odds ratio/OR=9.6; 95% confidence interval/CI= 0.8477 to 108.7214) for adenocarcinoma than the ones carrying -191CA or -191AA genotype. Conclusions: Patients younger than 64 years and carriers of -191CC genotype have significantly higher risk for adenocarcinoma than carriers of -191CA or -191AA genotype. Further studies on larger cohorts are necessary to evaluate -191C/A SNP as a potential biomarker.
- СтавкаFactors influencing health profession students’ willingness to practice in rural regions of Bosnia and Herzegovina: a cross-sectional study(2019) Racic, Maja; Ivkovic, Nedeljka; Pavlovic, Jelena; Zuza, Aleksandra; Hadzivukovic, Natalija; Bozovic, Djordje; Pekez-Pavlisko, TanjaIntroduction: 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.
- СтавкаHealth Literacy: Current Status and Challenges in the Work of Family Doctors in Bosnia and Herzegovina(MDPI, 2019) Todorovic, Nevena; Jovic-Vranes, Aleksandra; Djikanovic, Bosiljka; Pilipovic-Broceta, Natasa; Natasa, Nadja; Racic, MajaHealth literacy (HL) has become an important area of research. The aim of this study was to evaluate the HL of primary healthcare patients in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify socioeconomic and health factors associated with HL. This cross-sectional study among 768 patients was conducted in two healthcare centres between March and May 2017, using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Analysis was done using descriptive and inferential statistics (a chi-squared test and logistic regression). Inadequate and marginal HL was found in 34,6% of respondents. Socioeconomic and self-reported health factors were significantly related to HL. An age of 55 years and over (OR 1.02), living in a rural environment (OR 2.25), being divorced (OR 3.32), being insufficiently physically active (OR 1.29), having poor income (OR 1.96), having more than three chronic diseases (OR 1.94), and poor health (OR 1.59) were significantly corelated with inadequate and marginal HL. The results of our study indicate that a low level of HL is related to the elderly, having a divorce, having a rural residence, poor income, having more than three chronic diseases, poor health, and insufficient physical activity. Further evaluation, monitoring, and activities to improve HL are of great importance for patients’ health outcomes.
- СтавкаPrevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina(Wiley, 2019) Zuza, Aleksandra; Racic, Maja; Ivkovic, Nedeljka; Krunic, Jelena; Stojanovic, Nikola; Bozovic, Djordje; Bankovic-Lazarevic, Dusica; Vujaskovic, MirjanaIntroduction: 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.
- СтавкаReversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma(Sociedad Medica de Santiago, Chile, 2016) Miric, Mirjana; Ristic, Sinisa; Joksimovic, Bojan N.; Medenica, Snezana; Racic, Maja; Ristic, Slavica; Joksimovic, Vedrana R.; Skipina, MirjanaBackground: Benzodiazepines have a direct bronchodilatory effect. Methacholine is a non-selective muscarinic receptor agonist causing bronchoconstriction. Aim: To examine the effects of inhaled benzodiazepines, modulating bronchoconstriction induced by methacholine in patients with asthma. Patients and Methods: Twelve patients with well controlled asthma were studied. On the first day, after determining the initial values of pulmonary function, a dose response curve was carried out with progressive doses of methacholine. After the last dose, when at least a 20% drop of the initial forced expiratory volume in the first second (FEV1) was achieved, vital capacity (VC) and FEV1 were measured at 7, 15 and 30 minutes after provocation. On the second day a diazepam aerosol was inhaled by the patients prior to the same protocol with methacholine. Results: In the first day of testing, methacholine inhalation (6 mg/mL) led to a significant drop in FEV1 from 2.98 to 1.69 L. On the second day of study, in the same patients, previous inhalation with diazepam reduced the changes of FEV1 after inhalation of methacholine. This parameter decreased from 2.48 to 2.21 L. Conclusions: Inhalation of benzodiazepines reduce bronchoconstriction after a methacholine challenge in patients with asthma.