The Bosnian version of the international self-report measure of posttraumatic stress disorder, the Posttraumatic Stress Diagnostic Scale, is reliable and valid in a variety of different adult samples affected by war.
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BACKGROUND: The aim of the present study was to assess the internal consistency and discriminant and convergent validity of the Bosnian version of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Stress Diagnostic Scale (PTDS). The PTDS yields both a PTSD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and a measure of symptom severity. METHODS: 812 people living in Sarajevo or in Banja Luka in Bosnia-Herzegovina, of whom the majority had experienced a high number of traumatic war events, were administered the PTDS and other measures of trauma-related psychopathology. The psychometric properties of the instrument were assessed using Cronbach's alpha and principal components analysis, and its construct validity was assessed via Spearman correlation coefficients with the other instruments. RESULTS: The PTDS and its subscales demonstrated high internal consistency. The principal components revealed by an exploratory analysis are broadly consistent with the DSM-IV subscales except that they reproduce some previously reported difficulties with the "numbing" items from the avoidance subscale. The construct validity of the PTDS was supported by appropriate correlations with other relevant measures of trauma related psychopathology. CONCLUSION: The Bosnian version of the PTDS thus appears to be a time-economic and psychometrically sound measure for screening and assessing current PTSD. This self-report measure awaits further validation by interview methods. (+info)
Acculturation and psychological problems of adolescents from Bosnia and Herzegovina during exile and repatriation.
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AIM: To estimate the frequency, type, and severity of psychological trauma among Bosnian refugee adolescents during the process of repatriation after the 1992-1995 war in Bosnia and Herzegovina. METHODS: A sample of 239 pupils (120 girls and 119 boys), with a mean age (+/-standard deviation) of 15.2+/-2.1 years were assessed for war traumatic events, acculturation and repatriation maladjustments, school behavioral problems, and presence of post-traumatic stress disorder (PTSD). The sample consisted of adolescents who were in the process of repatriation after exile in a foreign country (n=120) and internally displaced adolescents (n=119). RESULTS: Adolescents who had been exposed to severe psychological war trauma still had high level of trauma more than three years after the end of war. The level of recalling traumas they experienced (mean+/-standard deviation=3.9+/-1.2 on a scale from 0 to 5) and frequency of PTSD symptoms (1.5+/-1.0 on a scale from 0-5) were significantly lower among repatriated than internally displaced adolescents (4.4+/-0.7 and 2.2+/-1.1, respectively; P<0.001). The prevalence of PTSD did not differ between repatriated (56.7%) and internally displaced adolescents (68.1%). Returnees with more acculturation problems reported more functional and relational problems after return but less psycho-emotional dysfunctions. Those who adapted to the culture in the exile country had difficulties in adapting back to the culture in the home country. CONCLUSIONS: PTSD was still very frequent among Bosnian refugee adolescents 3.5 years after the end of war. Adolescents who had spent more than five years as refugees in foreign countries had significantly lower level of experienced trauma recall and frequency of PTSD symptoms, as well as less anxious/depressed and withdrawn/depressed behavioral problems, and somatic complaints. Returnees who had more acculturation problems in exile reported more functional and relational problems but less psycho-emotional problems after repatriation. Schools and other institutions involved in the education of adolescents should develop programs to address these issues. (+info)
Gene analysis of steroid 5 alpha-reductase 1 in hyperandrogenic women.
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AIM: To examine the gene encoding for 5alpha-reductase type 1 in hyperandrogenic women, and assess the association of its eventual mutations or polymorphisms with the development of the hyperandrogenic female pattern. METHODS: Sixteen hyperandrogenic women were included in the study. Single-stranded conformation polymorphism analysis (SSCP) and DNA sequencing were performed after polymerase chain reaction amplification of each of the 5 exons of the SRD5A1 gene in both hyperandrogenic and control group (16 participants). RESULTS: Sequence analysis identified the existence of many polymorphisms; in codon 24 of exon 1, GGC (Gly) into GAC (Asp); in codon 30 of exon 1, CGG (Arg) into CGC (Arg); in exon 3 codon 169, ACA to ACG (both encoding for threonine); in exon 5, AGA to AGG (both encoding for arginine, codon 260); and T/C polymorphism in intron 2. Polymorphisms were found in both groups. CONCLUSION: Polymorphisms of SRD5A1 gene were the same in both hyperandrogenic and healthy women, indicating no significant associations of genetic polymorphisms/variations of SRD5A1 gene with clinical manifestations of hyperandrogenic disorders in women. (+info)
Managing occupational safety and health in aluminum production: case study of aluminum production factory, Mostar, Bosnia and Herzegovina.
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AIM: To assess the effect of modernization of the aluminium production on physical and chemical health hazards at work environment in the Aluminium Mostar factory. The modernization included introduction of automatic equipment, computerized management, and rationalized coke manipulation in Anoda, Electrolysis, and Cast House plants. METHOD: Periodical measurements of chemical (gas concentrations and aerosols) and physical (microclimatic factors, noise, and illumination) factors were performed at the same workplaces by the same methods of measurements before (1982-1988) and after the modernization (2004). The measured values were compared with the recommended Occupational Safety and Health Standards of Bosnia and Herzegovina. RESULTS: The number of workplaces with a high noise level was reduced from 65.0% (89/137) in 1982-1988 to 28.7% (51/178) in 2004. The best results were achieved in Cast House plant. The illumination of the workplace was partly improved. Values of microclimatic factors did not considerably change; they deviated from the recommended values at nearly all the workplaces in the factory. The concentrations of chemical agents were above the recommended standards in 56.3% (196/348) of the samples in 1982-1988, and in only 15.4% (99/645) of the samples tested in 2004. High concentrations of hydrogen fluoride have remained the primary pollutant in Electrolysis plant. CONCLUSION: The modernization of the factory has considerably reduced the amount of harmful substances at work environment in the Aluminum Mostar. However, the exposure to unfavorable physical factors has been only partly reduced. (+info)
Psychological consequences of rape on women in 1991-1995 war in Croatia and Bosnia and Herzegovina.
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AIM: To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina. METHODS: The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to retrospectively obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9-/+2.4 after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders. RESULTS: The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n=65) were accompanied by physical torture. The most frequent psychological symptoms felt immediately after the rape were depressiveness (n=58), avoidance of thoughts or conversations associated with the trauma (n=40), and suicidal ideas (n=25). Although none of the women had a psychiatric history before the rape, at the time of study 52 suffered from depression, 51 from social phobia, 21 from posttraumatic stress disorder (PTSD), and 17 had sexual dysfunctions. These disorders were often comorbid. Out of 29 women who got pregnant after rape, 17 had artificial abortion. The decision to have an abortion was strongly predicted by suicidal thoughts and impulses (odds ratio, 25.8; 95% confidence interval, 2.53-263.2). CONCLUSION: War-time rapes had deep immediate and long-term consequences on the mental health of women victims of rapes and their social and interpersonal functioning. (+info)
Psychological disturbances of war-traumatized children from different foster and family settings in Bosnia and Herzegovina.
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AIM: To assess the psychological health of war-traumatized children in different foster settings and compare them with children living with one or both parents, 7 years after the 1992-1995 war in Bosnia and Herzegovina. METHOD: The study was carried out in Tuzla, Bosnia and Herzegovina, in March 2002. We assessed 186 (93 girls and 93 boys) elementary school children aged 12.7-/+1.8 years for war trauma, presence of posttraumatic stress disorder (PTSD), and depression. There were 38 (14 girls) children from the government orphanage, 48 (24 girls) children from the non-governmental organization (NGO) SOS Children's Village, 50 (24 girls) children who lost a parent in the war but lived with the surviving parent, and 50 (31 girls) children who lived with both parents. For data collection, we used Children's Posttraumatic Stress Reaction Index and Children's Depression Inventory. Basic sociodemographic data were also collected. RESULTS: Of 186 children, 90 (48.4%) had been forced into refuge because of the war. Loss of a family member was most frequent among children in the SOS Children's Village, who also experienced the highest number of other types of trauma. PTSD was present in 51.6% of 186 children, with the highest prevalence among children in the SOS Children's Village (39/48). PTSD prevalence was higher among children who lost a parent but lived with the surviving parent (29/50) then among children in the orphanage (15/38) or children living with both parents (13/50) (chi(2)(3)=33.075, P<0.001). Depression was present in 42 of 186 (22.6%) children, but with no statistical difference among the groups (chi(2)(3)=6.337, P=0.096). The prevalence of PTSD and depression was similar in boys and girls. Loss of a parent was associated with higher frequency of PTSD and depression. The loss of both parents was associated with high prevalence of PTSD, but not depression. Prevalence of PTSD was positively correlated with the prevalence of depression (Spearman's rho=0.188; P=0.01). CONCLUSIONS: All children experienced war trauma and many had psychological consequences. The highest prevalence of PTSD, often comorbid with depression, was found among children who lost one or both parents. The children with the lowest rate of psychological disturbances were those living with both parents. (+info)
Cardiovascular risk factors in the Federation of Bosnia and Herzegovina.
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BACKGROUND: Federation of Bosnia and Herzegovina (FBiH) has high cardiovascular disease mortality as other countries in Eastern Europe and situation has even deteriorated in the post war period. Reliable information on risk factor levels and patterns needed in prevention planning and disease management has been lacking. METHODS: A cross sectional population survey was conducted in the FBiH in autumn 2002. A random sample of population, aged 25-64 years, was taken using a three stage stratified sampling methodology. Altogether, 2750 persons participated in the survey (1121 men and 1629 women). The survey was done according to internationally established standards and protocols. RESULTS: The mean systolic blood pressure was 132 mmHg among men and 135 mmHg among women. The mean diastolic blood pressure was 84 mmHg in both genders. Almost 40% of the participants were recognized as hypertensive (blood pressure level over 140/90 mmHg). The prevalence of hypertension among men was 36% and among women 45%. The mean Body Mass Index (BMI) was 26.5 kg/m(2) among males and 27.0 kg/m(2) among females. About 75% of both men and women were overweight (BMI > 25 kg/m(2)) and 16% of men and 20% of women were obese (BMI > 30 kg/m(2)). About 50% of men and 30% of women reported to be daily smokers. CONCLUSIONS: As a whole the non-communicable disease risk factor levels in the FBiH seems to be relatively high. The data can be utilized in health promotion planning and as a baseline for future monitoring activities with possibility of international comparison of results. (+info)
The new face of refugee resettlement in Wisconsin: what it means for physicians and policy makers.
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BACKGROUND: Historically, Wisconsin has received refugees from 3 large geographic areas: Southeast Asia, the Former Soviet Union, and the former Republic of Yugoslavia. However, recent trends demonstrate a dramatic increase in the number of countries from which current refugees originate. Further, state migration patterns show that most counties in Wisconsin have sizable per capita refugee populations and can expect more. OBJECTIVE: This paper describes past and current refugee resettlement trends and their ramifications on health care delivery, health policy, and social development in Wisconsin. METHODS: Statistical data on national, regional, and state refugee resettlement trends was obtained from the US Department of Health and Human Services' Office of Refugee Resettlement and the Wisconsin Department of Workforce Development. Additional data was obtained from Milwaukee-based refugee service agencies. Further, discussions were held with health officials in Barron County and around the Midwest. FINDINGS: Beginning in the 1980s, with the influx of Laotian Hmong refugees, and continuing through the late 1990s with the end of the Balkan Wars, Wisconsin has provided safe refuge for thousands of refugees. Over the last 5 years the diversity of refugees being resettled in Wisconsin has accelerated to include an array of countries. This phenomenon has led to an increase in the range of health behaviors and health needs characteristic of these populations. The new face of refugee immigration has profound implications on Wisconsin's health landscape, not only in terms of clinical disease, but also in health policy, planning, and social development. (+info)