ISSN 1512-6994 D EFEKTOLOGIJA Defectology Časopis za defektološka, pedagoško-psihološka i sociomedicinska pitanja teorije i prakse rada sa djecom, omladinom i odraslim osobama ometenim u razvoju Journal of defectology, Defektologija 2011; 17 (1): 1-83 educational-psychological and socio-medical issues of theory and practice of work with children, youth and adults with development disorders IZDAVAČKI SAVJET ČASOPISA / INTERNATIONAL EDITORIAL BOARD prof.dr.sc. Behlul Brestovci (Sveučilište u Zagrebu), prof.dr.sc. Fuad Brkić (Univerzitet u Tuzli), prof.dr.sc. Andrea Canevaro (Italija), prof.dr.sc. Carolyn Wiles Higdon (The University of Mississippi), prof.dr.sc. Berit Johnsen (University of Oslo), prof.dr.sc. Milko Mejovšek (Sveučilište u Zagrebu), prof.dr.sc. Mira Oberman-Babić (Sveučilište u Zagrebu), prof.dr.sc. Borislav Petrović (Univerzitet u Sarajevu), prof.dr. sc.Nevzeta Salihović (Univerzitet u Tuzli), prof.dr.sc. Dževdet Sarajlić (Univerzitet u Tuzli), prof.dr.sc. Osman Sinanović (Univerzitet u Tuzli), prof.dr.sc. Mujo Slatina (Univerzitet u Sarajevu), prof.dr.sc. Husref Tahirović (Univerzitet u Tuzli), prof.dr.sc. Sadeta Zečić (Univerzitet u Tuzli) REDAKCIJSKI ODBOR / EDITORIAL BOARD prof.dr.sc. Fuad Brkić, prof.dr.sc. Behija Ćišić, doc.dr.sc. Mirela Duranović, dr.sc. Zamir Mrkonjić, doc.dr.sc. Husnija Hasanbegović, doc.dr.sc. Fata Ibralić, doc.dr.sc. Ranko Kovačević, prof.dr.sc.Nevzeta Salihović, prof.dr.sc. Dževdet Sarajlić, doc.dr.sc. Mirzeta Suljkić, doc.dr.sc. Ruža Tomić, doc.dr.sc. Medina Vantić-Tajić GLAVNI UREDNIK / EDITOR IN CHIEF prof.dr.sc. Dževdet Sarajlić (e-mail: casopis.defektologija@yahoo.com) IZVRŠNI UREDNIK / EXECUTIVE EDITOR prof.dr.sc. Nevzeta Salihović IZDAVAČ / PUBLISHER Univerzitet u Tuzli, Edukacijsko-rehabilitacijski fakultet/ University of Tuzla, Faculty of Education and Rehabilitation Edukacijsko-rehabilitacijski fakultet, Univerzitetska br. 1, 75000,Tuzla, Bosna i Hercegovina Kontakt osoba/ Contact person: dr.sc. Alma Huremović, e-mail: alma.huremovic@untz.ba, tel.: +387 35 320 665; fax: +387 35 320 660 Copyright © 2011, University of Tuzla ŠTAMPA / PRINT Ulica Otokara Keršovanija 116, 75000 Tuzla, Bosna i Hercegovina Tel/Fax: +387 35 282 022 e-mail: off_set@bih.net.ba Časopis izlazi dva puta u godini / The Journal is published twice a year Štampano na beskiselinskom papiru / Printed on acid-free paper Časopis je indeksiran u Index Copernicus (www.indexcopernicus.com) / Journal is indexed in Index Copernicus (www.indexcopernicus.com) Časopis DEFEKTOLOGIJA je upisan u evidenciju javnih glasila Ministarstva obrazovanja, nauke, kulture i sporta RBiH broj 08-265-4/95 (20.05.1995.)/ Registration at Ministry of Education, Culture and Sport RBiH No. 08-265-4/95 (20.05.1995.) Datum štampanja / Date of print Juni 2011. / June 2011. Tiraž / Circulation 100 DEFEKTOLOGIJA / DEFECTOLOGY GODINA 2011 / VOLUMEN 17 / BROJ 1 YEAR 2011 / VOLUME 17/ No 1 SADRŽAJ / CONTENTS LEARNING GAMES AND THE FUTURE OF LITERACY ASSESSMENTS FOR THE DYSLEXIA INDIVIDUAL 1 Ian SMYTHE INTERVENTION STRATEGIES FOR CHILDREN WITH FLUENCY DISORDERS IN LITHUANIA 7 Darius GERULAITIS, Vilma MAKAUSKIENE, Regina IVOSKUVIENE, Daiva KAIRIENE PREVALENCA TEŠKOĆA ČITANJA U DJECE OSNOVNOŠKOLSKE DOBI PREVALENCE OF READING DISABILITIES IN PRIMARY SCHOOL CHILDREN 12 Mirela DURANOVIĆ, Amela IBRAHIMAGIĆ, Jasmina BAJRAMOVIĆ, Nermin TOROMANOVIĆ AKUSTIČKA ANALIZA GLASA KOD PARCIJALNIH LARINGEKTOMIJA ACOUSTIC VOICE ANALYSIS AT PARTIAL LARYNGECTOMY 17 Mila BUNIJEVAC, Mirjana PETROVIĆ–LAZIĆ, Siniša MAKSIMOVIĆ POREMEĆAJI PRILAGOĐAVANJA U ADOLESCENCIJI ADJUSTMENT DISORDER IN ADOLESCENCE 21 Vesna ŽUNIĆ-PAVLOVIĆ, Ranko KOVAČEVIĆ, Meliha BIJEDIĆ INDIVIDUALNO/KLINIČKI FAKTORI RIZIKA NASILNIČKOG PONAŠANJA UČENIKA OSNOVNIH I SREDNJIH ŠKOLA INDIVIDUAL/CLINICAL FACTORS OF VIOLENT BEHAVIOR OF STUDENTS IN PRIMARY AND SECONDARY SCHOOLS 26 Edin MUFTIĆ, Lejla KURALIĆ-ĆIŠIĆ POVEZANOST STAVOVA O OBRASCIMA PONAŠANJA U SOCIJALNIM SUKOBIMA S RAZINAMA POREMEĆAJA U PONAŠANJU KOD ADOLESCENATA RELATIONSHIP OF ATTITUDES ABOUT PATTERNS OF BEHAVIOR IN SOCIAL CONFLICTS WITH THE LEVELS OF BEHAVIORAL DESORDERS IN ADOLESCENTS 30 Nataša VLAH, Edina VEJO, Meliha BIJEDIĆ, Edin MUFTIĆ PROCESSES OF SOCIAL INCLUSION IN LITHUANIAN NGO’s FOR PEOPLE WITH DISABILITIES RELATIONSHIP OF ATTITUDES ABOUT PATTERNS OF BEHAVIOR IN SOCIAL CONFLICTS WITH THE LEVELS OF BEHAVIORAL DESORDERS IN ADOLESCENTS 35 Darius GERULAITIS, Liuda RADZEVIČIENĖ, Benas GUDINAVIČIUS POVEZANOST STAVOVA O OBRASCIMA PONAŠANJA U SOCIJALNIM SUKOBIMA S RAZINAMA POREMEĆAJA U PONAŠANJU KOD ADOLESCENATA RELATIONSHIP OF ATTITUDES ABOUT PATTERNS OF BEHAVIOR IN SOCIAL CONFLICTS WITH THE LEVELS OF BEHAVIORAL DESORDERS IN ADOLESCENTS 41 Alma DIZDAREVIĆ, Milena NIKOLIĆ, Medina VANTIĆ-TANJIĆ, Bahira DEMIROVIĆ, Zinaida ČOLIĆ ĆATIĆ, Arnela BOROVAC-BEKAJ STAVOVI O DRUŠTVENOM STATUSU GLUHIH U BOSNI I HERCEGOVINI ATTITUDES ABOUT THE SOCIAL STATUS OF THE DEAF IN BOSNIA AND HERZEGOVINA 49 Sadik AHMETOVIĆ UČESTALOST DEFICITA PAŽNJE I HIPERAKTIVNOG POREMEĆAJA KOD GLUHE I NAGLUHE DJECE FREQUENCY OF ATTENTION DEFICIT AND HYPERACTIVITY DISORDER WITHIN CHILDREN AFFECTED BY HEARING DISABILITY 53 Meliha POVLAKIĆ HADŽIEFENDIĆ, Elvira ČEKIĆ SPOLNA DISTRIBUCIJA AFAZIJA NAKON MOŽDANOG UDARA THE FREQUENCY OF APHASIC DISORDERS AFTER A STROKE Jasmina KLEBIĆ, Nevzeta SALIHOVIĆ, Aida ŠEHANOVIĆ, Rusmir SOFTIĆ 57 VRSTA I UČESTALOST INFEKCIJA U DJECE SA PRIMARNIM IMUNODEFICIJENCIJAMA TYPE AND FREQUENCE OF INFECTIONS IN CHILDREN WITH PRIMARY IMMUNODEFICIENSES 62 Belkisa ČOLIĆ-HADŽIĆ, Maida JAHIĆ, Almira ĆOSIĆKIĆ DENTALNI STRAH, DENTALNA ANKSIOZNOST I FOBIJA: BIHEVIORALNI PRISTUP DENTAL FEAR, DENTAL ANXIETY AND PHOBIA: BEHAVIORAL APPROACH 67 Pavla RAKOVEC, Nurka PRANJIĆ UTJECAJ KIRURŠKE PROCEDURE NA EMOTIVNO SOCIJALNI RAZVOJ DJETETA THE INFLUENCE OF SURGERY PROCEDURE ON THE EMOTIOSOCYAL DEVELOPMENT OF THE CHILD 72 Elvira KONJIĆ, Nada MLADINA, Devleta HADŽIĆ, Belkisa HADŽIĆ-ČOLIĆ UTICAJ FIZIKALNE TERAPIJE NA PROMJENU INTENZITETA BOLA, JUTARNJE UKOČENOSTI I FUNKCONALNE SPOSOBNOSTI U BOLESNIKA SA REUMATOIDNIM ARTRITISOM THE EFFECTS OF PHYSICAL THERAPY ON CHANGES IN PAIN INTENSITY, MORNING STIFFNESS AND FUNCTIONAL CAPACITY OF PATIENTS WITH RHEUMATOID ARTHRITIS Šahza KIKANOVIĆ, Nedima KAPIDŽIĆ-BAŠIĆ, Asja HOTIĆ-HADŽIEFENDIĆ,Dževad DŽANANOVIĆ 78 LEARNING GAMES AND THE FUTURE OF LITERACY ASSESSMENTS FOR THE DYSLEXIA INDIVIDUAL Ian SMYTHE School of Education, University of Wales Newport, UK 34 Collingwood Road, Sutton, Surrey, SM1 2RZ, United Kingdom Stručni rad Proffesional articles Rad primljen / Received: 03.05.2011. Rad prihvaćen / Accepted: 01.06.2011. ABSTRACT Testing for dyslexia traditionally uses one-to-one testing methods to identify those with difficulties and provide an outline of their learning needs. A shortage of assessors, costs and a reluctance to accept reports means that support is, at best, variable. This paper outline an alternative process that, through re-alignment of the objectives will provide a fairer, quicker, cheaper alternative which will not only enable the needs of all dyslexic individual to be identified but also to provide a motivating environment that combines assessment with the learning process. Key words: dyslexia, testing, alternative process. INTERVENTION STRATEGIES FOR CHILDREN WITH FLUENCY DISORDERS IN LITHUANIA Darius GERULAITIS, Vilma MAKAUSKIENE, Regina IVOSKUVIENE, Daiva KAIRIENE Siauliai University Visinskio st. 25, Siauliai, Lithuania Originalan naučni rad Original scientific articles Rad primljen / Received: 18.03.2011. Rad prihvaćen / Accepted: 12.05.2011. ABSTRACT The paper presents theoretical and empirical analysis of features typical for the children with fluent speech disorders on the data of the survey of speech therapists (N=101) in Lithuania. The research also reveals distinctive features between stuttering and cluttering. On the basis of the authentic research data, the intervention strategies of speech therapy, by including school and family community members in the education process of children with fluent speech disorders, are reflected upon. Key words: cluttering, stuttering, fluent speech disorders, speech therapy. PREVALENCA TEŠKOĆA ČITANJA U DJECE OSNOVNOŠKOLSKE DOBI PREVALENCE OF READING DISABILITIES IN PRIMARY SCHOOL CHILDREN Mirela DURANOVIĆ1, Amela IBRAHIMAGIĆ1, Jasmina BAJRAMOVIĆ2, Nermin TOROMANOVIĆ3 1 Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75000 Tuzla, Bosna i Hercegovina 2 BOSNAFARM d.o.o. Tuzla Albina Herljevića 14, 75 000 Tuzla, Bosna i Hercegovina 3 JZU Dom zdravlja Cazin Indire Pjanić 28, 77220, Cazin, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 20.04.2011. Rad prihvaćen / Accepted: 20.05.2011. APSTRAKT Istraživanje je provedeno s ciljem da se utvrdi prevalenca teškoća čitanja u djece koja pohađaju redovnu osnovnu školu. Istraživanje je obuhvatilo 1364 djece od trećeg do sedmog razreda. Za procjenu sposobnosti čitanja korišten je Jednominutni ispit glasnog čitanja (Furlan, 1965) i Lista sa serijama riječi za ispitivanje čitanja (Matanović-Mamužić1982). Na osnovu dobivenih rezultata možemo zaključiti da prevalenca teškoća čitanja iznosi 3.23%, te da su teškoće učestalije kod učenika muškog spola. Ključne riječi: teškoće čitanja, prevalenca. ABSTRACT This research has been made with aim to establish prevalence of reading disabilities in children from regular elementary schools. A study was carried out on a group of 1364 children from third to seventh grade. One minute test of reading aloud (Furlan, 1965) and List with the series of word for testing reading (Matanović-Mamužić-1982) were used for evaluation of reading ability. On the basis of the results we can conclude that prevalence of reading disabilities Matanović-Mamužić-1982) is 3.23%, and that this disability is more frequent in male students. Key words: reading disabilities, prevalence. AKUSTIČKA ANALIZA GLASA KOD PARCIJALNIH LARINGEKTOMIJA ACOUSTIC VOICE ANALYSIS AT PARTIAL LARYNGECTOMY Mila BUNIJEVAC1, Mirjana PETROVIĆ–LAZIĆ2, Siniša MAKSIMOVIĆ3 KBC „Zvezdara”, ORL klinika Dimitrija Tucovica 161, 11 000 Beograd, Srbija 2 Fakultet za specijalnu edukaciju i rehabilitaciju, Univerzitet u Beograd Visokog Stevana 2, 11 000 Beograd, Srbija 3 Opšta bolnica „Sveti Vračevi” Srpske vojske 53, 76 300 Bijeljina, Bosna i Hercegovina 1 Originalan naučni rad Original scientific articles Rad primljen / Received: 31.03.2011. Rad prihvaćen / Accepted: 27.05.2011. APSTRAKT Cilj istraživanja je bio da se izvrši analiza akustičke strukture vokala (e) pre i posle vokalne terapije glasa kod ispitanika sa parcijalnom laringektomijom i da se proveri da li je tromesečna vokalna terapija dala zadovoljavajuće rezultate u popravljanju akustičke strukture glasa. Primenom kompjuterske multidimenzionalne analize glasa biće omogućena kvantitativna verifikacija uspeha vokalne terapije. Ova analiza ima za cilj da obezbedi objektivne podatke i služi kao podrška subjektivnoj proceni glasa. Omogućava komparaciju podataka i koristi se kao pomoć dijagnostici i rehabilitaciji. Ključne riječi: akustička analiza, glas, parcijalna laringektomija. ABSTRACT The aim of the study was to analyse acoustic voice structure of vowel (e) before and after vocal therapy in patients with partial laryngectomy, as well as to see whether a three-month therapy gave satisfying results in improving acoustic voice structure. The Quantitative verification of vocal therapy success will be possible by the use of multidimensional computer voice analysis. The aim of this analysis is to gather objective information and to support subjective voice assessment. It enables comparing and contrasting the data and it is used to help with diagnostics and rehabilitation. Key words: acoustic analysis, voice, partial laryngectomy. POREMEĆAJI PRILAGOĐAVANJA U ADOLESCENCIJI ADJUSTMENT DISORDER IN ADOLESCENCE Vesna ŽUNIĆ-PAVLOVIĆ1, Ranko KOVAČEVIĆ2, Meliha BIJEDIĆ2 1 Fakultet za specijalnu edukaciju i rehabilitaciju, Univerzitet u Beogradu Visokog Stevana 2, 11000 Beograd, Srbija 2 Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75000 Tuzla, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 12.04.2011. Rad prihvaćen / Accepted: 05.05.2010. APSTRAKT Cilj ovog rada bio je ispitati prilagođenost adolescenata kako bi se utvrdile kritične oblasti na koje bi se moglo pravovremeno djelovati. Istraživanje je provedeno u deset srednjih škola na području općine Tuzla, na uzorku od 829 ispitanika oba spola. Uzorkom je obuhvaćeno po jedno odjeljenje od I do IV razreda. Za procjenu prilagođenosti adolescenata primijenjen je instrument RAASI (Reynolds Adolescent Adjustment Screening Inventory) kojim se procjenjuju eksternalizirani i internalizirani problemi (antisocijalno ponašanje, problemi kontrole bijesa, emocionalne teškoće, nivo samopoštovanja i socijalna inhibicija). Podaci su obrađeni pomoću SPSS paketa 16.0, korištena je deskriptivna statistika i t-test. Hipoteza kojom smo pretpostavili da će se adolescenti razlikovati u manifestiranju problema prilagođavanja u odnosu na spol je potvrđena. Između ispitanika različitog spola otkrivene su statistički značajne razlike u skorovima na dvije podskale. U odnosu na dječake, djevojčice su imale veće skorove na skali koja mjeri emocionalne teškoće i manje skorove na skali koja mjeri antisocijalno ponašanje. Rad upućuje na potrebu za kvalitetnim socijalnopedagoškim dijagnosticiranjem kako bi se utvrdile i prepoznale potrebe i područja za prognoziranje, projekciju i planiranje intervencija u cilju preveniranja socijalne isključenosti mladih. Ključne riječi: procjena, prilagođenost, adolescenti, spol. ABSTRACT The aim of this study was to examine the adjustment of adolescents to determine the critical areas that could be time to act. The study was conducted in ten secondary schools in the municipality of Tuzla, on a sample of 829 respondents of both sexes. The sample was covered by a one division from I to IV grade. To assess adolescents' adaptation applied instrument RAASI (Reynolds Adolescent Adjustment Screening Inventory), this evaluated and outsourced internalised problems (antisocial behaviour, anger control problems, emotional difficulties, self-esteem and social inhibition). Data were analyzed using SPSS 16.0 package, was used statistic descriptive and t-test. The hypothesis that we have assumed that the adolescent different manifesting adjustment problems in relation to sex were confirmed. Between subjects of different sexes were detected statistically significant differences in the two score of subscale. Compared to boys, girls had higher scores on a scale that measures emotional problems and lower scores on a scale that measure antisocial behaviour. Work suggests the need for quality socio-pedagogical diagnosis in order to determine and identify needs and areas of forecasting, projection and planning of interventions aimed at prevention of social exclusion of young people. Key words: assesment, adjustment, adolescents, sex INDIVIDUALNO/KLINIČKI FAKTORI RIZIKA NASILNIČKOG PONAŠANJA UČENIKA OSNOVNIH I SREDNJIH ŠKOLA INDIVIDUAL/CLINICAL FACTORS OF VIOLENT BEHAVIOR OF STUDENTS IN PRIMARY AND SECONDARY SCHOOLS Edin MUFTIĆ, Lejla KURALIĆ-ĆIŠIĆ Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75 000 Tuzla, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 18.05.2011. Rad prihvaćen / Accepted: 02.06.2011. APSTRAKT Cilj istraživanja je utvrditi nivo faktora rizika i sagledati postojanje razlika individualno/kliničkih faktora rizika učenika osnovnih i srednjih škola. Ovim istraživanjem je obuhvaćeno 1209 učenika osnovnih i srednjih škola na području 5 kantona Federacije Bosne i Hercegovine uzrasta 13-17 godina. Analizom rezultata su utvrđeni nivoi individualno/kliničkih faktora rizika učenika osnovnih i srednjih škola kao i postojanje razlike u odnosu na uzrast. Rezultati istraživanja su pokazali da su učenici srednjoškolskog uzrasta u višem nivou rizika od učenika osnovnoškolskog uzrasta. Ovi učenici više konzumiraju alkohol, probali su drogu i imaju pozitivnije stavove prema osobama koje koriste drogu, teže kontrolišu ljutnju. Ključne riječi: nasilje, rizični faktori, procjena rizika ABSTRACT The research aims to determine the level of risk factors and examine the existence of individual differences / clinical risk factors for primary and secondary schools. This survey included 1209 students in elementary and secondary schools in the five cantons of the Federation of Bosnia and Herzegovina, ages 13-17 years. The analysis results were determined levels of individual / clinical risk factors for primary and secondary schools as well as the existence of differences in relation to age. Survey results showed that students of secondary school age are in higher risk levels of primary school pupils. These students consumed more alcohol, tried drugs and have more positive attitudes towards people who use drugs more difficult to control anger. Keywords: violence, risk factors, risk assessment POVEZANOST STAVOVA O OBRASCIMA PONAŠANJA U SOCIJALNIM SUKOBIMA S RAZINAMA POREMEĆAJA U PONAŠANJU KOD ADOLESCENATA RELATIONSHIP OF ATTITUDES ABOUT PATTERNS OF BEHAVIOR IN SOCIAL CONFLICTS WITH THE LEVELS OF BEHAVIORAL DESORDERS IN ADOLESCENTS Nataša VLAH1, Edina VEJO2, Meliha BIJEDIĆ3, Edin MUFTIĆ3 Učiteljski fakultet, Sveučilište u Rijeci Slavka Krautzeka bb, 51 000 Rijeka, Republika Hrvatska 2 Islamski pedagoški fakultet, Univerzitet u Zenici Fakultetska 3, 72 000 Zenica, Bosna i Hercegovina 3 Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75 000 Tuzla, Bosna i Hercegovina 1 Originalan naučni rad Original scientific articles Rad primljen / Received: 31.05.2011. Rad prihvaćen / Accepted: 07.06.2011. APSTRAKT Cilj istraživanja je bio utvrditi povezanost između razina poremećaja u ponašanju adolescenata i njihovih stavova prema obrascima ponašanju u socijalnim sukobima. Uzorak ispitanika činilo je 489 učenika Srednje obrtničke škole u Zenici. Podaci su prikupljani školske 2009./2010. godine. U obradi podataka je pored deskriptivne statistike provedena univarijatna analiza varijance i dvije diskriminacijske analize. Rezultati su pokazali da adolescenti koji su prepoznati od svojih razrednika kao rizični, imaju društveno najnepoželjnije stavove o obrascima ponašanja u socijalnim sukobima. Dobiveni rezultati su korisni za planiranje specifičnih oblika prevencije razvoja poremećaja u ponašanju. Ta se specifičnost ogleda u učenju o socijalnim sukobima. Ključne riječi: socijalni sukobi, obrasci ponašanja, razine poremećaja u ponašanju, adolescenti ABSTRACT The aim of this study was to determine the relationship between levels of behavioral disorders in adolescents and their attitudes toward behavior patterns in social conflicts. The sample consisted of 489 students of Trade high school in Zenica. Data were collected in 2009/2010 school year. The data analysis was performed by descriptive statistics, univariate analysis of variance and two discriminant analysis. The results showed that adolescents who are identified by their teacher as a risk, has most unsuitable social attitudes about the behavior patterns in social conflicts. The results obtained are useful for planning the development of specific forms of prevention of behavioral disorders. This specificity is reflected in learning about social conflicts. Key words: social conflict, patterns of behavior, levels of behavioral disorders, adolescents. PROCESSES OF SOCIAL INCLUSION IN LITHUANIAN NGO’s FOR PEOPLE WITH DISABILITIES Darius GERULAITIS, Liuda RADZEVIČIENĖ, Benas GUDINAVIČIUS Siauliai University, Lithuania Visinskio st. 25, Siauliai, Lithuania Originalan naučni rad Original scientific articles Rad primljen / Received: 12.04.2011. Rad prihvaćen / Accepted: 25.05.2011. ABSTRACT Non – governmental organizations are not just reinforcing the sense of sociality, but also permit to develop for the more universal inherent rights and abilities of a person: to extend the experience of a society while communicating with the disabled, to create a social wealth with educational activities not for yourself but also and for others. The aim of a research is to reveal the principles of a social inclusion of disabled but also and to reveal the assumptions in NGO's activities in Lithuania. The social model instead of a physical disability (also people that are treated as „problematic ones'“) failings suggested to identify the barriers that are socially contrasting in society (when people are facing difficulties). It was set up that one assumption of a successful activity of NGO is the ability of disabled to cooperate that is also determined by peculiarities and motives of inter-communication of disabled, that encourages people for general activity. By the research there found factors that encourages and relieves the cooperation of disabled: the content of NGO's activities and social openness and preparation to collaborate of NGO's members that are participating. Key words: NGO's for people with disabilities, social inclusion, socioeducational activities EVALUACIJA INKLUZIVNOG OBRAZOVANJE DJECE S POSEBNIM POTREBAMA EVALUATION OF INCLUSIVE EDUCATION OF CHILDREN WITH SPECIAL NEEDS Alma DIZDAREVIĆ1, Milena NIKOLIĆ1, Medina VANTIĆ-TANJIĆ1, Bahira DEMIROVIĆ2, Zinaida ČOLIĆ ĆATIĆ3, Arnela BOROVAC-BEKAJ4 1 Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75000 Tuzla, Bosna i Hercegovina 2 Zavod za specijalno obrazovanje i odgoj djece „Mjedenica“ Sarajevo Mjedenica 34, 71000 Sarajevo, Bosna i Hercegovina 3 JU OŠ Tušanj Tuzla Ulica Pašage Mandžića 33, 75000 Tuzla, Bosna i Hercegovina 4 OŠ Skender Kulenović Bulevar Mimar Sinana bb, 71000 Sarajevo, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 01.05.2011. Rad prihvaćen / Accepted: 30.06.2011. APSTRAKT Cilj ovog istraživanja jeste da se izvrši evaluacija inkluzivnog obrazovanja djece s posebnim potrebama kroz procjenu akademske kompetencije, zatim kroz aktivnosti osiguranja podrške djeci s posebnim potrebama u odnosu na uvjete obrazovanja, sa pretpostavkom da djeca sa posebnim potrebama koja se školuju u inkluzivnom obrazovanju postižu veći nivo akademske kompetencije. Istraživanjem je obuhvaćeno 80-ero djece s posebnim potrebama, oba pola, kalendarskog uzrasta od 8 do 13 godina. Akademska kompetencija učenika sa posebnim potrebama ispitana je primjenom Dijagnostičke baterija za procjenu (akademskih) postignuća, Inventara za procjenu školske motivacije i strategija učenja i Skale adaptivnog ponašanja AAMD-II dio. Provedeno istraživanje je bilo u osnovi eksperimentalno, uz primjenu metode teorijske analize. Na kraju I polugodišta školske 2007./2008. godine identificirano je 40 učenika sa posebnim potrebama u redovnim školama na području Opštine Tuzla i grada Sarajevo, koji su imali potrebu za kreiranjem i pisanjem IEP. Nakon toga formiran je uzorak od 40 učenika sa posebnim potrebama u specijalnom obrazovanju. Uzorci su bili izjednačeni s obzirom na spol, dob i sa obzirom na kategoriju teškoće u razvoju. Možemo reći da prezentirani rezultati analize varijanse na svim varijablama istraživanja između dvije grupe ispitanika ukazuje da su kreirani i implementirani IEP za učenike sa posebnim potrebama u inkluzivnom obrazovanju doveli do značajnog unapređenja njihove akademske kompetencije. Akademska kompetencija kao dio opšte kompetentnosti u procesu učenja i usvajanja znanja, formiranja pozitivnih stavova i vrijednosti i socijalno prihvatljivog ponašanja preduvjet je uspješne inkluzije u obrazovanju i jedna je od glavnih pretpostavki socijalnog uključivanja u odrasloj dobi. Ključne riječi: evaluacija, inkluzivno obrazovanje, djeca s posebnim potrebama. ABSTRACT The aim of this research is the evaluation of inclusive education of children with special needs through assessment of their academic competence, through activities of providing support to children with special needs in relation to requirements of education, with the assumption that children with special needs, who are educated in inclusive education, achieve a higher level academic competence. The study included 80 children with special needs, both sexes, ages of 8-13 years. Academic skills of students with special needs were examined using the Diagnostic Achievement Battery 3, School Motivation and Learning Strategies Inventory and AAMD Adaptive Behavior Scales-Part II. Research was conducted on experimental basis, using methods of theoretical analysis. At the end of the school semester 2007/2008 it where identified 40 students with special needs in mainstream schools in the area of Tuzla and Sarajevo, who had a needs for creating and writing IEP. After that it was formed the sample of 40 students with special needs in special education. The samples were matched with regard to gender, age, and with regard to the category of disability We can say that the presented results of analysis of variance on all variables of the research between two groups of respondents indicating that designed and implemented IEPs for students with special needs in inclusive education have led to significant improvement of their academic competence. Academic competence as part of a general competence in the process of learning and acquiring knowledge, forming positive attitudes and values, and socially acceptable behavior is a prerequisite for successful inclusion in education and is one of the major assumptions of social inclusion in adulthood. Key words: evaluation, inclusive education, children with special needs. STAVOVI O DRUŠTVENOM STATUSU GLUHIH U BOSNI I HERCEGOVINI ATTITUDES ABOUT THE SOCIAL STATUS OF THE DEAF IN BOSNIA AND HERZEGOVINA Sadik AHMETOVIĆ Vijeće ministara Bosne i Hercegovine, Ministarstvo sigurnosti Bosne i Hercegovine Trg BiH 1, 71000 Sarajevo, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 11.02.2011. Rad prihvaćen / Accepted: 21.04.2011. APSTRAKT U radu je prikazano istraživanje stavova o društvenom statusu gluhih u Bosni i Hercegovini. Primijenjen je uzorak od 211 ispitanika, podijeljenih u dva subuzorka, od kojih je prvi subuzorak činilo 105 osoba oštećena sluha, a drugi 106 čujućih ispitanika. Za ispitivanje je korištena anketa, gdje su se ispitanici, potvrdno ili odrično, izjasnili na postavljene tvrdnje. Rezultati istraživanja pokazali su da čujuće osobe imaju pozitivne stavove o društvenom statusu gluhih. Iako su se njihovi odgovori skoro podjednako raspršili na tvrdnju o društvenom položaju gluhih, oni u većem procentu smatraju da su gluhe osobe jednako društveno prihvatljive kao i čujuće. Za razliku od njih, osobe oštećena sluha imaju suprotne stavove. U velikom procentu se izjašnjavaju da gluhe osobe ne mogu imati isti društveni položaj kao čujuće, niti su jednako društveno prihvatljive. Rezultati Hi-kvadrat testa na primijenjene varijable pokazuju da su razlike u odgovorima dva subuzorka statistički značajne. Neusaglašeni stavovi subuzoraka i negativni odgovori osoba oštećena sluha mogu biti indikator objektivno lošeg društvenog statusa gluhih. Zbog toga je neophodno, na osnovu egzaktnih pokazatelja o učinkovitosti edukacije i profesionalne rehabilitacije ovih osoba, utvrditi stvarno stanje, te ako se ove indicije potvrde, razviti strategiju za poduzimanje stručnih aktivnosti koje bi doprinijele poboljšanju njihovog društvenog statusa. Ključne riječi: gluhe osobe, društveni status, profesionalna rehabilitacija. ABSTRACT The paper presents a study of attitudes about the social status of the deaf in Bosnia and Herzegovina. Sample of 211 subjects is used, which was further divided into two subsamples, of which the first subsample consisted of 105 persons with hearing impairment and another 106 hearing subjects. For this experiment we used surveys/questioner to which responders could reply positively or negatively. The results showed that hearing people have positive attitudes about the social status of the deaf. Although their responses are almost unanimously scattered to the claim on the social status of the deaf, those in the higher percentage believe that deaf people are as socially acceptable as hearing. Unlike them, the hearing impaired have opposing views. Hearing impaired have in a large percentage stated that deaf person do not have the same social status as a hearing, nor are they are equally socially acceptable. Results of chi-square test applied to the variables indicate that the differences in the responses two samples statistically significant. Not harmonized positions of subsamples and negative responses of people with hearing problems can be an objective indicator of poor social status of the deaf. Therefore, there is a necessity, on the basis of precise indicators on the effectiveness of education and professional rehabilitation of these persons, to determine the actual situation, and if these indications are confirmed, to develop a strategy for undertaking professional activities that would contribute to improving their social status. Key words: deaf, social status, occupational rehabilitation. UČESTALOST DEFICITA PAŽNJE I HIPERAKTIVNOG POREMEĆAJA KOD GLUHE I NAGLUHE DJECE FREQUENCY OF ATTENTION DEFICIT AND HYPERACTIVITY DISORDER WITHIN CHILDREN AFFECTED BY HEARING DISABILITY Meliha POVLAKIĆ HADŽIEFENDIĆ, Elvira ČEKIĆ Centar za slušnu i govornu rehabilitaciju Sarajevo Asima Ferhatovića br. 2, 71 000 Sarajevo, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 04.05.2011. Rad prihvaćen / Accepted: 09.06.2011. APSTRAKT Deficit pažnje/hiperaktivni poremećaj (ADHD) je razvojni poremećaj koji se manifestuje nepažnjom, hiperaktivnošću i impulzivnošću. Ciljevi ovog istraživanja bili su: ispitati učestalost ADHD sindroma kod gluhe i nagluhe djece, zatim ispitati da li postoje razlike u učestalosti ADHD sindroma kod gluhe i nagluhe djece, u odnosu na spol; u odnosu na dob i u odnosu na stupanj oštećenja sluha. Istraživanje je obuhvatalo 82 ispitanika oštećena sluha uzrasta do 14 godina, koji pohađaju odgojno-obrazovni proces u Sarajevu i Tuzli. Deficit pažnje/hiperaktivni poremećaj utvrđen je u 14 (17%) gluhe i nagluhe djece. ADHD poremećaj je češći kod dječaka oštećena sluha (19.1%) nego djevojčica (14.3%), ali ta razlika nije statistički značajna. Postoji statistički značajna razlika u učestalosti ADHD-a kod ispitanika u odnosu na dob (p<0.001.). Učestalost je veća u skupini ispitanika od 3-7 godina (53.3%), za razliku od skupine ispitanika od 7-14 godina (9%). Statistički značajna razlika nije pronađena u učestalosti ADHD-a u odnosu na stupanj oštećenja. Učestalost ADHD-a u skupini gluhih učenika iznosi 10.6%, dok u skupini nagluhih učenika, učestalost je 25.7%. Ključne riječi: deficit pažnje, hiperaktivnost, impulzivnost, oštećenje sluha ABSTRACT Attention deficit and hyperactivity disorder (ADHD) is a developmental disorder that is manifested by lack of attention, hyperactivity and impulsiveness. The objectives of this study were: to examine the frequency of ADHD within children affected by hearing disability, to examine whether there are differences in the frequency of ADHD syndrome within children affected by hearing disability, in relation to sex, in relation to age and in relation to degree of hearing loss. The survey included 82 students affected by hearing disability under the age of 14 years, attending the educational process in Sarajevo and Tuzla. Attention deficit and hyperactivity disorder was found in 14 (17%) children affected by hearing loss. ADHD is more frequent among boys affected by hearing disability (19.1%), than among girls (14.3%), but this difference was not statistically significant. The study confirmed that there is a statistically significant difference in the frequency of ADHD among subjects in relation to the age (p<0.001.). The frequency is higher in the group of subjects under the age of 3-7 (53.3%), in the contrary to the group of subjects 7-14 (9%). There is a not statistically significant difference found in the frequency of ADHD in relation to the degree of the hearing impairment. The prevalence of ADHD among the group of deaf students is 10.6%, while it is 25.7% in the group of partly deaf students involved in the study. Key words: attention deficit, hyperactivity, impulsiveness, hearing impairment SPOLNA DISTRIBUCIJA AFAZIJA NAKON MOŽDANOG UDARA THE FREQUENCY OF APHASIC DISORDERS AFTER A STROKE Jasmina KLEBIĆ1, Nevzeta SALIHOVIĆ1, Aida ŠEHANOVIĆ2, Rusmir SOFTIĆ3 1 Edukacijsko-rehabilitacijski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75000 Tuzla, Bosna i Hercegovina 2 Javna zdravstvena ustanova Univerzitetski klinički centar Tuzla, Klinika za neurologiju Trnovac bb, 75 000 Tuzla, Bosna i Hercegovina 2 Javna zdravstvena ustanova Univerzitetski klinički centar Tuzla, Klinika za psihijatriju Trnovac bb, 75 000 Tuzla, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 12.05.2011. Rad prihvaćen / Accepted: 10.06.2011. APSTRAKT Afazija zahvata više ili manje razara sve razine jezičke sposobnosti oduzimajući čovjeku sposobnost verbalnog komuniciranja sa okolinom. Cilj ovog rada je bio utvrditi učestalost afazičnih poremećaja neposredno i nakon godinu dana od moždanog udara (MU) u odnosu na spol. Istraživanje je retrospektivno-prospektivno i obavljeno je u Klinici za neurologiju u periodu od 01.01.2006 god. do 31.12.2006 god. Ispitivani su pacijenti sa afazijom nakon prvog MU. Pacijenti su testirani od strane logopeda pomoću Internacionalnog testa za afazije, neposredno na prijemu i godinu dana nakon MU. Od 72 ispitanika sa afazijom, 35 (48.61%) je muških, a 37 (51.38%) ženskih pacijenata. Godinu dana nakon MU 20 (27.7%) pacijenata je umrlo, od toga 7 (18.9%) žena i 13 (37.1%) muškaraca. Nije bilo statistički značajne razlike u prosječnoj životnoj dobi pacijenata sa afazijom u odnosu na spol (p=0.2). U odnosu na tip MU afazija je bila najučestalija kod ishemijskog MU (88.9%) i to uz veću učestalost kod žena, ali bez statistički značajne razlike (51.3%:48.6%, p=0.5). Pri prijemu kod žena najučestalija je bila Brocaova (27%), globalna (27%) i anomička (21.60%) afazija uz statistički značajnu razliku u učestalosti (p<0.001). Nakon godinu dana najučestalija je bila anomička (36.7%) i Brocaova (16.7%) afazija uz statistički značajnu razliku u učestalosti (p=0.001). Pri prijemu kod muškaraca najučestalija je bila Brocaova (40%), globalna (31.4%) i anomička (20%) afazija uz statistički značajnu razliku u učestalosti (p=0.001). Na kontrolnom pregledu najučestalija je bila Brocaova (36.4%), anomička (31.8%) i konduktivna (13.6%) afazija uz statistički značajnu razliku u učestalosti (p=0.06). Spol značajno ne utiče na učestalost tipa afazičnih poremećaja nakon moždanog udara. Najučestaliji tipovi afazičnih poremećaja neposredno nakon MU i kod žena i kod muškaraca su Brocaova i globalna afazija. Godinu dana nakon MU kod žena je najučestalija anomička i Brocaova afazija, a kod muškaraca Brocaova i anomička afazija. Ključne riječi: afazija, moždani udar, spol, ishod afazije ABSTRACT Aphasia destroys all levels of language competence and thus deprives patients of the ability to communicate verbally. This research has been made with aim to determine the frequency of aphasic disorders immediately and one year after a stroke with regard to sex. The research is retrospective - prospective and was performed at the Neurology Clinics in the period January 1, 2006 - December 31,2006. The patients with aphasia acquired after the first stroke were tested. The patients were tested by a speech therapist and International Test for Aphasias was used. They were tested immediately when admitted and one year after the stroke. Out of 72 patients with aphasia, 35 (48,61%) were males, and 37 (51,38%) were females. One year following the stroke 20 (27,7%) patients died, out of which 7 (18.9%) were females and 13 (37.1%) were males. There was no statistical difference in average age of the patients with aphasia with regard to sex (p=0.2). With regard to the type of stroke the aphasia was the most frequent at ischemic stroke (88,9%) and with the higher frequency at women, but with no statistically significant difference (51.3%:48.6%, p=0.5). At admission, Broca's aphasia (27%), global aphasia (27%) and anomic (21.60%) aphasia were the most frequent at women with the statistically significant difference in frequency (p<0.001). One year after, the most frequent were anomic aphasia (36.7%) and Broca's aphasia (16.7%) with the statistically significant difference in frequency (p=0.001). At admission, Broca's aphasia (40%), global aphasia (31.4%) and anomic (20%) aphasia were the most frequent at men with the statistically significant difference in frequency (p=0.001). At the check-up the most frequent were Broca's aphasia (36.4%),anomic aphasia (31.8%) and conduction aphasia (13.6%) with the statistically significant difference in frequency (p=0.06). Sex does not have a significant influence on the type of aphasic disorder following a stroke. The most frequent types of aphasic disorders immediately after a stroke at both women and men are Broca's aphasia and global aphasia. One year after a stroke the most frequent aphasia at women is Broca's aphasia, and at men the most frequent aphasias are Broca's aphasia and anomic aphasia. Key words: aphasia, stroke, sex, outcome of aphasia VRSTA I UČESTALOST INFEKCIJA U DJECE SA PRIMARNIM IMUNODEFICIJENCIJAMA TYPE AND FREQUENCE OF INFECTIONS IN CHILDREN WITH PRIMARY IMMUNODEFICIENSES Belkisa ČOLIĆ-HADŽIĆ, Maida JAHIĆ, Almira ĆOSIĆKIĆ Klinika za dječije bolesti, Univerzitetski klinički centar Tuzla, Trnovac bb, 75000 Tuzla, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 10.03.2011. Rad prihvaćen / Accepted: 25.05.2011. APSTRAKT Cilj rada je bio da se ukaže na specifičnosti infektivnog agensa, intenziteta i frekvence infekcija u djece sa primarnim imunodeficijencijama. Materijal i metode Studija je retrospektivno-prospektivno, rađena u periodu od 01.01.l997. do 31.12.2007 godine, provedena na Klinici za dječije bolesti Univerzitetsko kliničkog centra Tuzla. Rezultati opisana su 53 pacijenta, oba spola, dobi od 1 mjeseca do 12.7 godina života. Poremećaj nespecifične humoralne imunosti (deficit C3 komplementa) zabilježen je u 5 (9.3%) pacijenata. Ponavljane infekcije kože sa sepsom (Staphylococcus aureus), dijagnostikovana je u 3, a u 2 pacijenta je dijagnostikovan meninigitis izazvan sa Neisseria meningitidis. Poremećaj specifične imunosti imalo je 48 (90.7%) pacijena; sa poremećajem celularne imunosti 1 (1.9%) pacijent, u kojeg su dominantni simptomi infekcije vezani za sistemsku kandidijazu i CMV, sa teškim tokom i po život opasnim ponavljanim infekcijama respiratornog i gastrointestinalnog trakta. Poremećaj humoralne imunosti imalo je 47/53 (88.8%) djece. Sa agamaglobulinimejom bilo je 2/47 (3.8%) djece. Hemokulturom i ostalim mikrobiološkim pretragama izolovani su Staphylococcus aureus, Acinetobakter species, Pseudomonas aeroginosa, a zahvaćen je respiratorni sistem sa sinusitisom, recidivirajućim upalama i abscesom pluća. Selektivnu IgA imunodeficijenciju imalo je 32/47 (60.4%) djece, a od uzročnika izolovani su Klebsiella spp.u 64.3%, Proteus mirabilis 27,6% i Rotta virus u 8.1% pacijenata. U Hiper IgE sindromu u 7/47 (13.2%) pacijenata dominirale su infekcije respiratornog trakta i kože, a uzročnici su bili bakterije i virusi (Staphylococcus aureus, Acinetobakter species, Pseudomaona aeroginosa i Cytomegalovirosis (CMV). Hiper IgM sindrom 3/47 (5.7%) i selektivnu IgM imunodeficijenciju imalo je 3/47 (5.7%) pacijenata, a vrsta i lokalizacija infekcija su bili kao u ostalih poremećaja humoralne imunosti. Ishod liječenja ovisio je o vrsti imunološkog poremećaja, vrsti patogena, dobu djeteta i prethodnim infekcijama. Ključne riječi: infekcije, primarne imunodeficijencije, djeca ABSTRACT The goal of the study was to indicate on the specificities of an infective agens, intensity and frequency of infection in children with primary immunodeficiency’s. The study was retrospectively-prospectively conducted in period from 01.01.2007. to 31.12.2007. at The Clinic for Children's Diseases of the University Clinical Center Tuzla. 53 patients have been described, both sexes, and with the age from 1 month to 12.7 months of life. The deficit of C3 complement was noted in 5 (9.3%) patients. Repeated skin infections with sepsis (Staphylococcus aureus) in a way of clinical manifestation, was diagnosed in 3 patients, while in 2 patients we diagnosed meningitis caused by Neisseria meningitidis. Disorder of cellular immunity was diagnosed in 1 (1.9%) patient, with dominant symptoms of infection related to the systemic candidiasis and CMV, with heavy process and life threatening, dangerous, repeated infections of respiratory and gastrointestinal tract. Disorder of humoral immunity was diagnosed in 47 (88.8%) children. There were 2 (3.8%) children with agammaglobulinemia. Using the hemoculture and other microbiological searches and tests, we have isolated Staphylococcus aureus, Acinetobacter species, Pseudomonas aeruginosa, while the respiratory system was caught by sinusitis, recidivous inflammations and lung abscess. 32 (60.4%) children had selective IgA immunodeficiency, and among the causative agents we have isolated Klebsiella enterobacteria in 64.3% patients, Proteus mirabilis in 27.6% patients and Rotta virus in 8.1 patients. In hyper IgA syndrome, 7 (13.2%) patients had dominant infections of respiratory tract and skin, and causative agents were the following bacteries and viruses (Staphylococcus aureus, Acinetobacter species, Pseudomonas aeruginosa and Cytomegalovirosis (CMV). In hyper IgM syndrome 3 (5.7%) patients, and selective IgM immunodeficiency 3 (5.7%) patients, type and the infection localization were the same as in the other disorders of humoral immunity. The result of a treatment depended on the type of immunological disorder, the type of pathogen, the age of a child and previous infections. Key words: Infections, Primary immunodeficiencies, children. DENTALNI STRAH, DENTALNA ANKSIOZNOST I FOBIJA: BIHEVIORALNI PRISTUP DENTAL FEAR, DENTAL ANXIETY AND PHOBIA: BEHAVIORAL APPROACH Pavla RAKOVEC1, Nurka PRANJIĆ2 Stomatološka služba, Dom zdravlja Tuzla sa poliklinikom Mustafa Šehović Albina Herljevića 1, 75 000 Tuzla, Bosna i Hercegovina 2 Katedra za medicinu rada, Medicinski fakultet, Univerzitet u Tuzli Univerzitetska 1, 75 000 Tuzla, Bosna i Hercegovina 1 Stručni rad Proffesional articles Rad primljen / Received: 29.04.2011. Rad prihvaćen / Accepted: 26.05.2011. APSTRAKT Novija medicinska literatura ukazuje na važnost dentalnog straha, anksioznog poremećaja ili fobije u stomatološkom tretmanu. Brojni pacijenti iskuse strah i anksioznost prilikom posjete stomatologu. Cilj je ukazati na bihevioralni pristup problemu dentalnog straha, dentalne anksioznosti i dentalne fobije. Metoda istraživanja bila je komparativna analiza prethodno publikovanih rezultata vezanih sa sličnom problematikom. Dentalni strah, dentalna anksioznost i fobija ne podrazumijevaju isti fenomen. Oni su efekat psihološkog stresa koji je pokrenut kliničkim okruženjem i posljedičnom neugodom povezanom sa stomatološkim tretmanom ili nekim njegovim fazama. Presudno utiču na postizanje kvalitetne stomatološke zaštite i oralnog zdravlja pacijenta. Etiološki, dentalna anksioznost u stresogenim situacijama kao što je stomatološki tretman raste zbog straha od bola ili nelagode. Ona raste i u iščekivanje predstojećeg stomatološkog tretmana zbog prethodnih iskustava, te pokreće akutnu reakciju na stres ili retraumatsku reakciju na stres sa psihičkim i somatskim manifestacijama. Postoje i uspješno se primjenjuju različite bihevioralne i farmakološke tehnike u savladavanju dentalnog straha. Ključne riječi: dentalni strah, stres, anksioznost, bihevioralne tehnike ABSTRACT Recent medical literature emphasizes the importance of dental fear, anxiety disorder or phobia in dental treatment. Many patients experience fear and anxiety during dental visits. The goal is to highlight a behavioral approach to the problem of dental fear, dental anxiety and dental phobia. The research method applied was a comparative analysis of previously published results with similar problems. Dental fear, dental anxiety and phobia do not imply the same phenomenon. They are effects of psychological stress, which is caused by the clinical environment and consequent discomfort associated with dental treatment or some of its stages. They affect the crucial achievement of the quality of dental care and oral health of the patient. Etiologically, dental anxiety in stressful situations including dental treatment is increasing because of fear of pain or discomfort. It increases in anticipation of upcoming dental treatment because of previous experiences, and runs an acute reaction to stress or re-traumatic reaction to stress with mental and somatic manifestations. A variety of behavioral and pharmacological techniques to cope with dental fear exists and is being successfully implemented. Key words: dental fear, stress, anxiety, behavioral techniques UTJECAJ KIRURŠKE PROCEDURE NA EMOTIVNO SOCIJALNI RAZVOJ DJETETA THE INFLUENCE OF SURGERY PROCEDURE ON THE EMOTIOSOCYAL DEVELOPMENT OF THE CHILD Elvira KONJIĆ, Nada MLADINA, Devleta HADŽIĆ, Belkisa HADŽIĆ-ČOLIĆ Javna zdravstvena ustanova Univerzitetski klinički centar Tuzla, Klinika za dječije bolesti Trnovac bb, 75 000 Tuzla, Bosna i Hercegovina Originalan naučni rad Original scientific articles Rad primljen / Received: 19.04.2011. Rad prihvaćen / Accepted: 13.05.2011. APSTRAKT Svako dijete je individua za sebe i ima svoje reakcije u datoj situaciji. Psihodinamski promatrano, dijete misli, osjeća, želi i fantazira. Sve to utječe na ponašanje. Unutrašnji život djeteta je veoma bogat i važan izvor njegove energije, akcije i reakcije. Mnogi događaji izvana, iz okoline, utječu na ponašanje i mijenjaju ga. Ova studija prikazuje kako kirurška procedura mijenja ponašanje djeteta. Frojd je dao podjelu psihičkog sistema: ID je organizirani dio psihičkog aparata, prisutan je od samog rođenja, utkan u konstituciju osobe, smješten u našem nesvjesnom i predstavlja naše nagone; EGO je svjesni dio naše ličnosti, naša percepcija, govor, motorika, učenje, memorija, rasuđivanje, akcija i naše vrijeme; SUPEREGO se odnosi na naše moralne zahtjeve, zabrane društva i idealne težnje. To je naša savjest. Svi ovi dijelovi našeg psihičkog sistema su u dinamičkoj ravnoteži u kojoj će biti i nakon vanjskih udara. Težnja je da se uspostavi ravnoteža, koju postižemo najprije rasterećenjem stvorene napetosti, a kasnije njenim potiskivanjem. Ako to ne uspije javlja se osjećaj opasnosti. Ova studija pokazuje kako kirurška trauma utječe psihički balans djeteta. Ključne riječi: kirurška trauma, akutni stresni poremećaj, posttraumatski stres poremećaj, dijete ABSTRACT Each child is a separate individual and has own reactions in a given situation. Psycho-dynamically observed, child thinks, feels, wants and fantasizes. All those things influence behavior. Inferior life of a child is very rich and important source of they energy, action and reaction. Many outside events, events from surrounding influence that behavior and change it. This study presents how surgery procedures change behavior of the child. Freud divided psychic system on: ID, which is unorganized part of psychic apparatus and is present from birth and weaved in person's constitutions, placed in our unconscious and represents our instinct; EGO is conscious part of our personality, our perception, speech, mobility, learning, memory, reasoning, action and our time; SUPEREGO is related to our moral demands, society prohibitions and ideal striving. That is our conscience. All these parts of our psycho-system are dynamical balance, where they want to stay even after outside attacks. Striving is to establish balance, which we achieve primarily, by unburdening of created tension, and later by repressing it. If it is not successful, a feeling of danger is created. This study presents how a surgery procedure influences on the balance psycho-system of the child. Key words: surgery trauma, acute stress disorder, posttraumatic stress disorder, child UTICAJ FIZIKALNE TERAPIJE NA PROMJENU INTENZITETA BOLA, JUTARNJE UKOČENOSTI I FUNKCONALNE SPOSOBNOSTI U BOLESNIKA SA REUMATOIDNIM ARTRITISOM THE EFFECTS OF PHYSICAL THERAPY ON CHANGES IN PAIN INTENSITY, MORNING STIFFNESS AND FUNCTIONAL CAPACITY OF PATIENTS WITH RHEUMATOID ARTHRITIS Šahza KIKANOVIĆ1, Nedima KAPIDŽIĆ-BAŠIĆ1, Asja HOTIĆ-HADŽIEFENDIĆ1, Dževad DŽANANOVIĆ2 Univerzitetski klinički centar Tuzla, Klinika za fizikalnu medicinu i rehabilitaciju Trnovac bb, 75 000 Tuzla, Bosna i Hercegovina 2 Javna ustanova Dom zdravlja Tuzla, Poliklinika za fizikalnu medicinu i rehabilitaciju Albina Herljevića 1, 75 000 Tuzla, Bosna i Hercegovina 1 Originalan naučni rad Original scientific articles Rad primljen / Received: 12.04.2011. Rad prihvaćen / Accepted: 05.06.2011. APSTRAKT Reumatoidni artritis (RA) karakteriše bol, jutarnja ukočenost i funkcionalna onesposobljenost. Cilj rada je utvrditi uticaj fizikalne terapije na jutarnju ukočenost i jačinu bola kod bolesnika sa RA te povezanost ovih parametara sa funkcionalnom sposobnošću. Istraživanje je bilo prospektivno, obuhvatilo je 80 bolesnika sa dijagnostikovanim RA koji su liječeni u Klinici za fizikalnu medicinu i rehabilitaciju u Tuzli u periodu od januara 2008.godine do januara 2009.godine. Anamnezom i kliničkim pregledom je utvrđena dužina trajanja jutarnje ukočenosti (u minutama), intenzitet boli (mjeren Visual Analog Scale-VAS), utvrđena je bolna osjetljivost zglobova (Ritchie artikularnim indexom), a funkcionalna onesposobljenost je utvrđena sa Health Assessment Queestionnaire-HAQ. Fizikalna terapija je trajala 4 sedmice u toku kojih su bolesnici imali 20 tretmana. Utvrđeno je signifikantno smanjenje boli (p<0.001), bolne osjetljivosti zglobova (p<0.001), jutarnje ukočenosti (p<0.001), funkcionalna sposobnost je poboljšana, prosječna vrijednost HAQ-skora na prijemu je iznosila 2.10±0.48; a na otpustu 1.57±0.58. Bol i jutarnja ukočenost su značajno (p<0.01) korelirale sa funkcionalnom sposobnošću. Određivanje jačine bola i jutarnje ukočenosti iako subjektivno predstavlja značajne parametre koji daju uvid u aktivnost bolesti, a korelira sa funkcionalnom sposobnošću. Visoka vrijednost bola i duža jutarnja ukočenost ukazuju na veći stepen funkcionalne onesposobljenosti. Procjenom ovih parametara mogu se pratiti efekti terapije i sposobnost bolesnika u svakodnevnim aktivnostima. Ključne riječi: rheumatoid arthritis, bol, jutarnja ukočenost, funkcionalna sposobnost. ABSTRACT Rheumatoid arthritis (RA) is characterized by pain, morning stiffness and functional disability. The aim of this study: to establish the effects of physical therapy on morning stiffness and pain intensity of patients with RA, as well as the correlation of these parameters with functional capacity. The research was prospective; it included 80 patients diagnosed with RA who were treated at Physical Medicine and Rehabilitation of the UKC Tuzla during the period from January 2008 to February 2009. Duration of morning stiffness (expressed in minutes) and pain intensity (measured by Visual Analog Scale–VAS) was determined by anamnesis and clinical examination. Joint pain sensitivity was also determined, measured by Ritchie Articular Index, as well as the functional capacity of the patients by using Health Assessment Questionnaire–HAQ. Physical therapy lasted for 4 weeks, during which the patients had 20 treatments. There has been a significant reduction in pain intensity (p<0.001), joint pain sensitivity (p<0.001), and morning stiffness (p<0.001). Functional capacity of the patients was also improved; on admission, the average HAQ score value was 2,10±0,48, and on discharge it was 1.57±0.58. Pain and morning stiffness correlated significantly (p<0.01) with functional capacity. Although determining pain intensity and morning stiffness is highly subjective, it represents important parameters that provide inside into disease activity, and it also correlates with functional capacity. High value of pain and longer morning stiffness implicate higher level of functional disability. By the evaluation of these parameters, one can monitor the effects of the therapy and the abilities of the patients in everyday actions. Key words: rheumatoid arthritis, pain, morning stiffness, functional capacity.
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