Uvod: O reproduktivnem zdravju Rominj, žensk s svojstvenim načinom življenja v posebnih skupnostnih razmerah in z njim lastnimi navadami, je v Sloveniji malo znanega. Namen raziskave je bil ...prepoznati stališča Rominj do reproduktivnega zdravja in okoliščine dostopnosti ter obiska ustreznih zdravstvenih služb na primarni ravni.Metode: Uporabljena je bila opisna kvalitativna metoda. Vzorec je bil namenski. Od 61 povabljenih je sodelovalo 44 polnoletnih Rominj, in sicer od maja 2014 do februarja 2015. Podatki so bili zbrani s tehniko delno strukturiranega intervjuja in analizirani s kvalitativno analizo vsebine.Rezultati: Izdvojenih je bilo 18 kategorij, združenih v 7 tem: (1) skrb za zdravje, (2) stališča o reproduktivnem zdravju, (3) stališča o zdravstveni oskrbi v dispanzerju za ženske, (4) dejavniki, ki vplivajo na dostopnost do zdravstvenih služb, (5) odnosi v zdravstvenih obravnavah, (6) preventiva, (7) izobraževalni programi za romske ženske na področju reproduktivnega zdravja.Diskusija in zaključek: Rominje si želijo stikov z zdravstvenimi službami, enakovrednega pristopa pri obravnavi in predvsem zdravja. Zaznana je potreba po izobraževanju, strokovnih nasvetih, predavanjih in delavnicah s področja reproduktivnega zdravja. Razvojne priložnosti se nakazujejo s pomočjo ozaveščanja o možnostih dostopa do reproduktivnih storitev in obravnave, ki jih ponujajo zdravstvene službe, vključevanja Rominj v zdravstvenovzgojne programe ob upoštevanju njihove kulture in tradicije.
Background: Neonatal hypocalcaemia (hypoCa) is frequently observed clinical and laboratory finding in neonates. A healthy newborn reaches the lowest serum calcium level at 24–48 hours of age. It can ...deteriorate to hypoCa levels in newborns with specific risk factors. Methods: In the analysis, 50 newborns with hipoCa were included. Details of clinical signs and laboratory investigations were obtained from the available medical records and were statistically analysed. Results: Early hipoCa was identified in 41 (82 %) and late in 9 (18 %) cases; 36 (72 %) were asymptomatic and 14 (28 %) symptomatic with the average serum calcium 1.8 (lowest 1.27) and ionized 0.92 mmol /l (lowest 0.63 mmol/l); 18 (36 %) infants had sepsis, 14 (28 %) were premature, 13 (26 %) mothers had gestational diabetes, three were after perinatal asphyxia, three after exchange transfusion, two after bleeding in twins and two had DiGeorge syndrome. Serum levels of 25-OH-vitamin D analysed in 13 newborns was lower than 52 nmol/l; 70 % of convulsions associated with HipoCa were due to vitamin D insuficiency. Conclusion: Neonatal sepsis, maternal gestational diabetes, prematurity and vitamin D deficiency are the predominant risk factors. A low neonatal vitamin D reservoir can be associated with the development of PTH insufficiency, resulting in hipoCa, which can be presented with neonatal convulsions. The results suggest the need to establish guidelines for the prophylactic treatment of pregnant women with vitamin D.
ObjectiveOur aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans.MethodsA ...cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12-15 years. A structured self-administered and anonymous questionnaire inquired about the children's attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children's ability to maintain health.ResultsOverall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0-1.3), middle/low maternal education (OR=1.2, 95%CI=1.1-1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2-1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1-1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4-2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1-1.4).ConclusionsAlmost 1/3rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.
Uvod: Aplikacija intramuskularne injekcije je pogosta intervencija v zdravstveni negi, ki za pacienta predstavlja potencialno varnostno tveganje. Namen raziskave je bil ugotoviti dejavnike, povezane ...z aplikacijo intramuskularne injekcije v glutealno področje, ki vplivajo na pozitivne in negativne izide pri pacientu.Metode: Izveden je bil sistematični pregled literature v podatkovnih bazah PubMed, Medline, ScienceDirect in CINAHL. V pregled so bili vključeni članki glede na ustreznost vsebine, vrsto raziskav, polno dostopnost, jezik ter objavo do decembra 2018. Iskanje je potekalo s pomočjo ključnih besed: »patient«, »intramuscular dorsogluteal injection«, »intramuscular ventrogluteal injection«, »dorsogluteal site«, »ventrogluteal site«, »outcome«, »injury«, »safety«, »complications«, »pain«. Kakovost posamičnih raziskav je bila ocenjena s pomočjo orodja National Heart Lung and Blood Institute. Zbrani podatki so bili sintetizirani z metodo analize vsebine.Rezultati: Izmed 95 identificiranih zadetkov je bilo v končno analizo vključenih 25. Ugotovitve so bile združene v pet kategorij, dejavnikov, ki vplivajo na varnost pri aplikaciji intramuskularne injekcije: značilnosti področja aplikacije ter konstitucionalne značilnosti pacientov, izbor področja in vbodnega mesta aplikacije, tehnika aplikacije intramuskularne injekcije, aspiracija in dejavniki, povezani z bolečino, in tehnike zmanjševanja bolečine.Diskusija in zaključek: Za zagotavljanje varnosti pri aplikaciji intramuskularne injekcije je potrebno poznavanje dejavnikov, ki vplivajo na izide pri pacientu. Zaradi ugotovljenih pomanjkljivosti v praksi bi bilo smiselno raziskati znanje zdravstvenih delavcev o aplikaciji intramuskularne injekcije.
Incidenca malignega melanoma v Sloveniji v zadnjih desetletjih strmo narašča, poznavanje malignega melanoma in dejavnikov tveganja pa je med populacijo še vedno vprašljivo in malo raziskano. ...Najpomembnejši dejavnik tveganja za nastanek bolezni je delovanje ultravijoličnih žarkov, pred katerimi se je treba fizično zaščititi in uporabljati sredstva za zaščito pred soncem, predvsem v mladosti. Namen raziskave je bil pridobiti podatke o poznavanju malignega melanoma, dejavnikov tveganja in odnosu do njih ter primerjava odgovorov med študenti Medicinske fakultete in študenti treh ostalih fakultet. V presečno in anketno raziskavo so bili vključeni študentje štirih fakultet Univerze v Ljubljani: Medicinske fakultete, Fakultete za elektrotehniko, Fakultete za farmacijo ter Fakultete za matematiko in fiziko, ki so prek spletne povezave odgovarjali na anonimni vprašalnik. Odgovori 66,3 odstotka študentov Medicinske fakultete in 33,7 odstotka študentov ostalih fakultet kažejo, da je poznavanje malignega melanoma boljše med študenti Medicinske fakultete, razlika je statistično značilna (p = 0,0001). Študenti se v poznavanju dejavnikov tveganja statistično značilno razlikujejo le v pogostnosti uporabe zaščite pred soncem (p = 0,0001) in uporabljenem zaščitnem faktorju (p = 0,015). Študenti medicine s svetlimi tipi kože se pred soncem zaščitijo pogosteje, obstaja statistično značilna razlika (p = 0,001). Študenti Medicinske fakultete statistično značilno bolje prepoznavajo maligni melanom kot nevarno obliko kožnega raka. Pogosteje se tudi zaščitijo pred ultravijoličnimi žarki in uporabljajo višje zaščitne faktorje kot študenti ostalih fakultet. Kljub zelo visokem vedenju o škodljivosti izpostavljanja UV-žarkom med mlado slovensko populacijo je ukrepanje bistveno slabše.
Ozadje in izvirnost: Dobro počutje na delovnem mestu predstavlja pozitivne in povezovalne koncepte ter zajema več dejavnikov, kateri pomembno prispevajo k zdravju in kakovostnemu življenju ...zaposlenih. Namen raziskave je opredeliti dimenzije dobrega počutja na delovnem mestu na podlagi pregleda stališč različnih avtorjev, pri tem identificirati dejavnike s pozitivnim in dejavnike z negativnim vplivom na dobro počutje zaposlenih ter z njimi povezane posledice za organizacijo. Metoda: Raziskava temelji na sistematičnem pregledu obstoječe literature. Iskanje je bilo omejeno na iskalno bazo SpringerLink. Na podlagi postavljenih raziskovalnih vprašanj smo določili ključne besede in časovni okvir iskanja, ki je zajemal znanstvene in strokovne članke odprtega tipa, objavljene med leti 2010 in 2022. Iskalni niz je ponudil 123 takih člankov. V nadaljnjo obravnavo smo vključili članke, v katerih različni avtorji prikazujejo vidike in dejavnike vpliva na dobro počutje. Kriterijem je ustrezalo 37 člankov. Rezultate glavnih ugotovitev smo prikazali v tabelah. Rezultati: Zaznani dejavniki, ki pozitivno vplivajo na dobro počutje zaposlenih so avtonomija in visok nadzor nad lastnim delom, intervencija kovčinga, fleksibilno delo, intervencija obvladovanja tveganj povezanih z utrujenostjo, podpora vodstva, intervencije pozitivne psihologije, oblikovanje politik zmanjševanja delovnih zahtev, optimizem in pozitivna čustva, dobri medosebni odnosi, povratne informacije in uresničevanje ciljev. Kot glavne dejavnike z negativnim vplivom smo identificirali vedenje nadzornikov, psihosocialna tveganja/delovni stres, nižje ravni informacijske in medosebne pravičnosti, negotovost zaposlitve, slab poklicni ugled in nespoštljivo vedenje. Dejavniki v povezavi z dobrim počutjem zaposlenih, ki kažejo vplive na organizacijo so kadrovska fluktuacija, absentizem, prezentizem, vpliv na produktivnost, predčasna upokojitev, angažiranost zaposlenih in kakovost opravljenega dela. Družba: Članek predstavlja doprinos k razumevanju pomembnosti ustvarjanja zdravih delovnih mest. Z uvajanjem različnih pristopov, ki bazirajo na spodbujanju dobrega počutja zaposlenih na delovnem mestu, se krepi njihovo zadovoljstvo, ki rezultira v večji pripadnosti organizaciji in zavzetosti pri delu ter hkrati prispeva k zmanjševanju absentizma, kot posledice nezadovoljstva pri delu. Ravno tako prispeva k vsesplošni pozitivni naravnanosti, zmanjševanju obsega in intenzitete stresorjev, kar pa bistveno pripomore k boljšemu zdravstvenemu stanju obče populacije. Omejitve/nadaljnje raziskovanje: Raziskava je omejena na pregled obstoječe literature ene izmed elektronskih baz podatkov. V nadaljevanju raziskave bi lahko vključili ostale baze, elemente, ki spodbujajo dobro počutje zaposlenih na delovnem mestu pa dejansko implementirali v določeno organizacijo. S preverjanjem stanja pred in po uvedbi, znotraj določenega časovnega okvirja, bi s tem odprli nove možnosti za ugotavljanje statističnih značilnosti ter uspešnosti same implementacije.
The study aimed to determine the push and pull factors and the impact of the pandemic and the opening of the Austrian labour market for Croatian citizens in 2020 on the migration of Croatian citizens ...to Austria after Croatia entered the EU. The study was conducted using qualitative methodology, i.e., semi-structured interviews as the main research method. The results showed that, in addition to the influence of economic and personal factors on emigration from Croatia, social migrant networks stood out as a strong pull factor for respondents to migrate to Austria. Nevertheless, some respondents, regardless of family and friends in other countries, migrate to Austria for its better living and working conditions. The pandemic and the opening of the Austrian labour market in 2020 were at one time an obstacle to emigration for some respondents, and their experiences indicate that in the next few years the number of Croats who immigrate to Austria could increase, both due to delayed emigration from Croatia and the migration of Croats from Germany.
V članku razpravljamo o dejavnikih, ki vplivajo na zgodnje opuščanje šolanja, in o ukrepih, ki so bili v Sloveniji sprejeti, da bi slednje preprečili. Zmanjšanje zgodnjega opuščanja šolanja na manj ...kot 10 % do leta 2020 je namreč eden ključnih ciljev strategije Evropa 2020, Slovenija pa omenjeni cilj že presega. Po zadnjih raziskavah ima namreč naša država eno izmed najnižjih stopenj zgodnjega opuščanja šolanja med državami Evropske unije (EU). V prispevku proučujemo razloge za omenjeno nizko stopnjo zgodnjega opuščanja šolanja ter podajamo pregled institucionalnih in političnih ukrepov, ki jih je Slovenija sprejela, da bi zmanjšala osip in mladostnike čim dlje zadržala v izobraževalnem sistemu. Rezultati študije kažejo, da je v državah EU delež moških, ki so opustili šolanje, večji od deleža žensk ter da obstaja pozitivna povezanost med dejavniki, kot sta izobrazba staršev in socialno-ekonomski status družine, ter zgodnjim opuščanjem šolanja. Prav tako smo ugotovili, da je delež mladih priseljencev, ki so opustili šolanje, dvakrat večji od deleža mladih, ki živijo v državi, v kateri so se tudi rodili.
Background: Vaginal delivery is the most important risk factors for development of faecal incontinence, which significantly affects quality of life. Foreign studies show OASIS occur at 20 to 40 % of ...vaginal deliveries. In Slovenia we recognize sphincter injuries at 1.7 % of deliveries, while true incidence of OASIS in our population remains unknown. Caesarean section prevents anal sphincter injuries. Known risk factors in foreign studies include prolonged second stage of labour, fetal weight > 3500 g, malpresentation, forceps delivery, maternal age more than 35 years at the time of first delivery, first delivery. Few women complain about defecatory problems in puerperium unless they are directly asked about them, so true incidence of such injuries is grossly underestimated. Previously compensated anal sphincter dysfunction can clinically manifest as late as in menopause. The most probable cause is atrophy of muscle and fibrous tissue of pelvic floor and anal sphincter due to lack of estrogen support in this period. With anal ultrasound we tried to determine the incidence of occult damage to anal sphincter in primiparas after vaginal delivery and the relation of injury to symptoms 6 weeks after delivery and identify possible risk factors in our population. We also tried to find out how many patients with anal sphincter injury become symptomatic immediately after deliv- ery. Methods: From January to June 2009 we examined 26 primiparas after vaginal delivery in the Ljubljana Maternity Hospital with anal ultrasound and compared various data about the delivery from our national delivery form. We excluded all patients with caesarean section, recognized anal sphincter injury at the time of the delivery or previous anorectal surgery, history of irritable bowel syndrome or pre-existing inflammatory bowel disease. All patients completed a bowel-function questionnaire, which included questions about faecal urgency and involuntary passing of gas, liquid or solid stools, before and six weeks after delivery. Faecal urgency was defined as inability to hold passing of stools for more than 5 minutes, anal incontinence as partial or complete inability to control passing of winds, liquid or formed stools. Patients were examined with 7 MHz 360-degrees rotating probe on the second or third day after delivery. With the probe we identified the U-shaped puborectalis muscle, then slowly extracted the probe through the anal canal towards the anus. We examined ultrasound im- age of puborectalis muscle, internal anal sphincter, longitudinal muscle and external anal sphincter. Internal anal sphincter (IAS) appears as a uniform hypoechoic circle, which is surrounded by heterogenous hyperechoic circle of external anal sphincter (EAS). External anal sphincter defect was defined as hypoechoic gap of various size in hyperechoic circle, that enlarges with voluntary contraction. Internal anal sphincter defect was defined as a gap in hypoechoic circle. All patients were contacted by telephone 6 weeks after delivery to complete the same ques- tionnaire again. Deliveries were managed by midwives according to standard active delivery management protocols the Ljubljana Maternity Hospital. All episiotomies were mediolateral. Information about pregnancy and delivery was obtained with patient’s consent from national delivery forms. We analysed use of analgesia at the delivery, induction and stimulation of labour, difference in body mass index (BMI) before pregnancy and before the delivery, duration of labour, fetal weight and head circumference and maternal age. Results: We found signs of external anal sphincter injury in 12 (46 %) out of 26 patients examined, all of them had only external sphincter injury. None of them had any de novo symptoms regarding defecation or problems restraining winds or stool 6 weeks after delivery (Table 1). There was no significant statistic difference for use of analgetics, stimulation of labour, vacuum extraction and episiotomy. There might be a difference in maternal age, but data was insufficient due to small number of patients. Conclusions: With our research we showed that incidence of sphincter injuries at vaginal delivery in our hospital is underestimated, as we found occult anal sphincter injury in 12 out of 26 patients. The number of patients was small so we were not able to estimate the importance of various possible risk factors for OASIS. All analysed cases showed no significant statistic difference due to small number of patients in the study. All patients were asymptomatic 6 weeks after delivery, but how many of them develop symptoms in later life remains unknown.
Introduction: Trust is crucial in forming a good relationship between a patient and a doctor, where both persons believe that they are benevolent, competent and willing to act in their best interest. ...This research examines factors associated with patient trust in their general practitioner (GP). Method: Every third patient at the General Practice in Pernica was asked to participate in a voluntary, anonymous survey. 464 questionnaires (92.8 % response rate) were filled in. The questionnaire consisted of patient demographic data, the Trust in Physician Scale (Cronbach α = 0.795), and the Humanistic Behaviours Questionnaire (Cronbach α = 0.965). The research sample was described with frequency and percentage distribution, average values and standard deviation. Factor analysis was implemented. Using linear regression modelling, the connection between patient demographic data, patient health status and patient’s cooperation with the GP, along with factors describing trust in physician, was analyzed. Factors of physician behaviour were included in the linear regression as independent variables. Results: Positive past experience with the GP (β = 0.20, p < 0.001), greater care and involvement in treatment (β = 0.28, p < 0.001), and greater benevolence (β = 0.32, p < 0.001) were positively correlated with the competence of the GP. A lower degree of benevolence (β = -0.28, p < 0.001) was associated with greater distrust. Discussion: Physician behavior was statistically associated with patient trust. With appropriate interventions we could improve patients’ trust in their physician and thus influence a better treatment outcome, continuity of care, better cooperation and most importantly, patient satisfaction.
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