According to their own statements, 57% of the patients were nonadherent, while 84% exhibited some form of nonadherence on the Morisky scale. The patients reported a mean pain intensity of 6.6 ± 2.2 on a visual analog scale. The most common deviation from the prescribed therapy was self-adjustment of the dose and medical regimen based on the severity of pain. Polymedication correlated positively with nonadherence. Nonsteroidal anti-inflammatory drugs were the most frequently prescribed medications. The majority of the participants (59%) believed that higher pain intensity indicates progression of the disease, and half of the participants believed that one can easily become addicted to pain medications. Nonadherence was associated with patient attitudes about addiction to analgesics and ability of analgesics to control pain. CONCLUSION.: High pain intensity and nonadherence found in this study suggest that physicians should monitor older patients with chronic nonmalignant pain more closely and pay more attention to patients' beliefs regarding analgesics to ensure better adherence to pharmacological therapy.

Aim To compare the prevalence and characteristics of bullying between two towns in Bosnia and Herzegovina -Stolac, which was exposed to firearm conflict during the 1992-1995 war in Bosnia and Herzegovina, and Posušje, which was outside of the active combat zone. MethodsIn this cross-sectional study, we included 484 primary school pupils attending 4th-8th grade of elementary school, 217 (44.8%) of them from Stolac and 267 (55.2%) from Posušje. The pupils were interviewed using a standardized questionnaire on the experience of bullying.Results Every sixth pupil (16.4%) experienced at least one form of bullying almost every day, while 34 (7.0%) pupils constantly bullied other children. Sixth-eighth graders were more often bullies than 4th-5th graders (P = 0.044). Girls were most often victims of bullying, while boys were most often bullies (P = 0.036). The expected difference in bullying between the two towns was not observed, except for older pupils in Posušje, who were more violent than their peers in Stolac (P = 0.044). Among the analyzed variables of sex, age, town, and school achievement, only male sex was significant predictor of bullying (P = 0.010), increasing the relative risk by 3.005 times.Conclusion Bullying among primary school pupils did not differ between areas that experienced war activities in 1992-1995. Our results could be useful in the introduction of specific prevention measures against bullying in postwar situation.

In our study, we aimed to establish expression of cytotoxic CD8+ T cells in the decidua basalis and the maternal peripheral blood (mPBL) of severe and mild preeclampsia (PE) and compare to healthy pregnancies. Decidual tissue and mPBL of 10 women with mild PE, 10 women with severe PE, and 20 age-matched healthy pregnancy controls were analyzed by double immunofluorescence and qPCR, respectively. By double immunofluorescence staining, we found a decreased total number of cells/mm2 in decidua basalis of granulysin (GNLY)+ (p ˂ 0.0001), granzyme B (GzB)+(p ˂ 0.0001), GzB+CD8+(p ˂ 0.0001), perforin (PRF1)+ (p ˂ 0.0001), and PRF1+CD8+ (p ˂ 0.01) in the severe PE compared to control group. Additionally, we noticed the trend of lower mRNA expression for GNLY, granzyme A (GZMA), GzB, and PRF1 in CD8+ T cells of mPBL in mild and severe PE, with the latter marker statistically decreased in severe PE (p ˂ 0.001). Forkhead box P3 (FOXP3) mRNA in CD8+ T cells mPBL was increased in mild PE (p ˂ 0.001) compared to controls. In conclusion, severe PE is characterized by altered expression of cytotoxic CD8+ T cells in decidua and mPBL, suggesting their role in pathophysiology of PE and fetal-maternal immune tolerance.

Content on communication training is rare in teaching. Practicing communication skills will empower the doctor - patient therapeutic relationship.

Department of Family medicine has been formed in academic year 2002/2003, few years later after the foundation of the School of Medicine University of Mostar. The formal members of department are professor and assistants who lecture and lead seminars. In addition, physicians in rural practices contribute to teaching of family medicine. Clinical teaching of family medicine at Mostar School of Medicine is organized in the summer semester of sixth year of the study. It lasts six weeks and contains lectures, seminars and practices. Every student has right and obligation to evaluate educational process at the end of the course in a form of questionnaire and essay. Family medicine continuously receives high marks by students, especially practices. Evaluation of teaching by students is good way of giving feedback about teaching. We believe that student opinion can revise and improve teaching practice. Our good experience and good marks may prompt the changing our educational curriculum to include family medicine at each study year of medical program.