Radom se prikazuje djelovanje Andrije Štampara tijekom Prvoga svjetskog rata (1914‒1918) na suzbijanju zaraznih bolesti na području Banske Hrvatske. Prikazuje se kako je masovna pojava zaraznih ...bolesti tijekom Prvoga svjetskog rata, tipičnih za nehigijenske, ratne uvjete, poslužila Štamparu kao presudno formativno iskustvo u oblikovanju njegovih razmišljanja vezano uz suzbijanje takvih tipova bolesti, uviđajući važnost edukacije stanovništva, preventive i cijepljenja, što je pak utjecalo na njegove daljnje koncepcije i poglede na organizaciju, ustroj i djelovanje javnoga zdravstva. Također se na temelju primjera, počevši od predratnoga razdoblja 1913. do kraja Prvoga svjetskog rata 1918., razmatra kako je Štampar i kojim metodama, svojim brzim i stručnim djelovanjem, savjesnim postupanjem u javnom i općem interesu, uspio u nastojanjima da suzbije zarazne bolesti epidemijskoga karaktera, istodobno analizirajući kontekst općih ratnih zbivanja i pošasti koje su harale u Austro-Ugarskoj Monarhiji u istraživanom razdoblju, želeći na taj način dobiti zaokruženu cjelinu njegova djelovanja. Uspješno se boreći protiv zaraznih bolesti i svodeći ih na najmanju moguću mjeru, pridonio je razvoju javnoga zdravstva i iznimno pridonio suvremenoj medicini, vodeći se idejom da primarna zdravstvena zaštita treba biti dostupna svima. S obzirom na to da je djelovao u pozadini, a ne kao liječnik na bojištu, njegovo se osobno iskustvo razlikuje od iskustava njegovih kolega koji su rat proveli na prvoj crti, čime je dokazao kako je zdravlje stanovništva u pozadini bojišta ključno za opstanak samoga naroda te da ima jednaku važnost kao i zdravlje vojnika na bojištima koji se izravno bore za svoju državu i njezin probitak. Pri istraživanju korištena je arhivska građa pohranjena u Hrvatskom državnom arhivu u Zagrebu, među ostalim građa obiteljskoga fonda Andrije Štampara, kao i periodičke publikacije i literatura, među kojima su i Štamparovi članci, koji su poslužili za rekonstruiranje političkoga duha i vremena.
This paper presents the actions of Andrija Štampar during World War I (1914–1918) in combating infectious diseases in Banal Croatia. It illustrates how the widespread occurrence of infectious diseases during World War I, typical of unhygienic wartime conditions, served as a crucial formative experience for Štampar, shaping his thoughts regarding the control of such diseases. He recognised the importance of public education, prevention, and vaccination, which, in turn, influenced his further concepts and views on the organisation and operation of public health. Based on examples from the pre-war period of 1913 to the end of World War I in 1918, the paper discusses how Štampar, through his rapid and professional actions and conscientious interventions in the public and general interest, managed to control epidemic infectious diseases. It also analyses the context of general wartime events and the diseases that ravaged the Austro-Hungarian Monarchy during the researched period, aiming to provide a comprehensive understanding of his actions. By successfully combating infectious diseases and reducing them to the minimum possible level, Štampar contributed to the development of public health and made an exceptional contribution to modern medicine, guided by the idea that primary healthcare should be accessible to all. As he operated in the background rather than as a frontline physician, his personal experience differed from that of his colleagues who served on the front lines. He thus demonstrated that the health of the civilian population behind the front lines is crucial for the survival of the nation and holds equal importance to the health of soldiers fighting on the battlefields for their state and its interests. Archival material stored in the Croatian State Archives in Zagreb was used for our research. This included, among other things, material from Andrija Štampar’s family fond as well as periodicals and literature, and Štampar’s articles, which were used to reconstruct the political spirit and times in which Štampar worked.
Oštećenje sluha ima negativne učinke na kvalitetu života, osobito u socijalnoj i emocionalnoj domeni kvalitete komuniciranja. To izrazito dolazi do izražaja u starijoj životnoj dobi, kada je ...slabljenje kognitivnih sposobnosti najviše izraženo. Osim toga, starije osobe oštećenog sluha, koje su još uvijek radno aktivne, shvaćaju da je održavanje dobrog sluha od presudnog značenja za učinkovitost na radnom mjestu. S obzirom na značajnu prevalenciju starijih osoba s oštećenjem sluha koje ne koriste slušno pomagalo, kako u populaciji neverifi ciranih, tako i u audiološki verifi ciranoj populaciji, od ključne je važnosti učiniti dodatne napore da se takvim osobama povećaju spoznaje o prednostima i koristima upotrebe slušnih pomagala. Kako bi se ostvario ovaj cilj, nužan je multidisciplinaran javnozdravstveni pristup u rješavanju ovog zapostavljenog problema. Jedan od smjerova djelovanja bio bi pojačani audiološki probir populacije u domeni primarne zdravstvene zaštite. Drugi smjer djelovanja bio bi da se u sustavu i mreži javnog zdravstva osmisli nacionalni program ranog otkrivanja osoba oštećenog sluha u populaciji starijoj od 50 godina. Program bi trebao putem edukativnih sadržaja podizati svijest o potrebi liječenja i rehabilitacije nagluhih osoba. Treći smjer djelovanja bio bi provođenje randomiziranih kontroliranih studija kojima bi cilj bio ne samo prikupljati podatke povezane s prihvaćanjem, nošenjem i zadovoljstvom sa slušnim pomagalom, već ispitati i parametre koji su pokazatelji poboljšanja općeg zdravlja, kao što su emocionalno i socijalno funkcioniranje, komunikacijske sposobnosti te kognitivne mogućnosti.
Nema mnogo zapisa o povijesti zdravstvene djelatnosti i prakticiranju medicine na području Čazme. Može se pretpostaviti da se nakon osnivanja Zbornog kaptola s dvanaest kanonika u danas postojećoj ...Čazmi prakticirala i medicina. Tadašnja Čazma imala je status pomoćnog centra Zagrebačke biskupije i vjerskog, prosvjetiteljskog i kulturnog središta Čazmanskog arhiđakonata. Povijesni zapisi govore u prilog povezanosti Čazmanskog i Zagrebačkog kaptola, čestih boravaka dostojanstvenika tog vremena u čazmanskome kraju, ali i turskih napada i pustošenja i konačno pada Čazme. Potvrda o zdravstvenoj djelatnosti na tom području može se naći i u navodima o postojanju leprozorija u Čazmi u doba epidemije kuge u srednjem vijeku. Danas u Čazmi postoji organizirana zdravstvena služba primarne zdravstvene zaštite u sklopu Doma zdravlja Bjelovarsko-bilogorske županije, hitna medicinska pomoć županijskog Zavoda za javno zdravstvo i epidemiološka služba pri Zavodu za javno zdravstvo. Razvijena je i ljekarnička djelatnost i služba veterinarske medicine. Sve su te službe tijekom proteklih godina prošle kroz reformu. Od sredine prošlog stoljeća organizacija zdravstvene službe u tadašnjoj Jugoslaviji razlikovala se od današnjeg uređenja. Nekada su ljekarničke i liječničke službe bile u sastavu Doma zdravlja Čazma, a izdvajanjem nekih iz sastava navedenog Doma zdravlja i spajanjem drugih službi u Dom zdravlja bjelovarsko-bilogorske županije neke službe danas djeluju samostalno.
Godišnje radionice Europskog referentnog laboratorija za parazite (EURLP) smještenog u Višem institutu za zdravlje (Istituto Superiore di Sanita) u Rimu, prilika su za upoznavanje s aktualnim stanjem ...najvažnijih parazitarnih zoonoza u Europi. Tijekom dvodnevne radionice predstavnici nacionalnih referentnih laboratorija (NRL) usmeno ili posterima izvještavali su o epidemiološkim i epizootiološkim osobitostima parazitarnih zoonoza u njihovim zemljama tijekom protekle godine. Prezentirani podatci uglavnom se odnose na: godišnje preglede registriranih slučajeva oboljelih ljudi, izvore invadiranja, načine širenja i prenošenja invazija, ispitivanja kojima se provjerava prisutnost, otpornost i preživljavanje razvojnih stadija parazita u okolišu kao i na opise neuobičajenih pojava rijetkih invazivnih zoonoza zabilježenih u europskim zemljama. Epizootiološki podatci odnose se na istraživanja, tj. nadzor nad prisutnošću pojedinih vrsta parazita i/ili njihovih razvojnih stadija u domaćim i divljim životinjama te njihovom potencijalnom značenju za zdravlje ljudi. Sumirane podatke i trendove koji se uoče obradom podataka na razini cijele EU prezentiraju predstavnici Europske agencije za sigurnost hrane (EFSA) i Opće uprave za zdravlje i zaštitu potrošača EU (DG SANCO). Osim predstavnika zemalja članica EU na radionicama su prisutni i predstavnici nečlanica EU, poput Islanda, Norveške, Švicarske, Sjeverne Makedonije i Srbije, koji su često uključeni u zajedničke projekte s članicama zemalja EU i/ili žele biti informirani o aktualnostima iz područja parazitarnih zoonoza na području EU. Posebna pozornost pridaje se predavanjima pozvanih parazitologa iz Europe i svijeta koji prezentiraju rezultate i otkrića dugogodišnjeg rada svojih timova o pojedinim parazitozama i njihovom značenju za javno zdravstvo. Cilj je ovoga rada bio informirati o ehinokokozi i trihinelozi kao najvažnijim parazitozama za javno zdravstvo EU te izvijestiti o značenju i osobitostima opistorhioze koja je opširnije prezentirana na godišnjoj radionici održanoj 2018. godine. Izvijestli smo o neočekivano velikom broju oboljelih ljudi od trihineloze u Hrvatskoj koji je registriran 2017. godine u nekoliko epidemija i sporadičnih slučajeva. Najveća epidemija dogodila se nakon konzumiranja mesnih proizvoda napravljenih od mesa divlje svinje što je i prva službena potvrda invadiranja mesom druge vrste, osim domaće svinje, na području Hrvatske. Zbog karakteristične epidemiološke situacije trihineloza u Hrvatskoj i dalje ostaje parazitoza od najvišeg javno-zdravstvenog značenja.
The annual workshop of the European Reference Laboratory for Parasites (EURLP) at the Higher Health Institute (Istituto Superiore di Sanita) in Rome, is an opportunity for participants to become better acquainted with the current state concerning the most important parasitic zoonoses in Europe. During the two-day workshop, representatives of national reference laboratories (NRL) give oral or poster presentations on the epidemiological and epizootic particularities of parasitic zoonoses in their countries over the past year. The presented data particularly relate to the annual review of registered cases of affected persons, sources of invasion, manner of spread and transmission of invasion, research to test for the presence, resistance and survival of development stages of parasites in the environment, and descriptions of unusual appearances of rare and invasive zoonoses recorded in European countries. The epizootiology data pertain to research and surveillance of the presence of individual species of parasites and their development stages in hosts and wild animals, and their potential significance for human health. The data at the EU level are processed and summarized and trends extracted by the representatives of the European Food Safety Agency (EFSA) and the Directorate General for Health and Food Safety (DG SANCO). In addition to representatives of EU Member States, representatives of non-EU states also attend the workshops, such as Iceland, Norway, Switzerland, North Macedonia and Serbia. These countries are often included in joint projects with EU Member States, and/or wish to be informed of the current trends in the field of parasitic zoonoses within the EU. Special attention is given to lectures by invited speakers in the field of parasitology from Europe and the world. They present their results and discoveries emerging from the work of their teams on individual parasitosis, and their significance for public health. The objective of this paper was to provide an overview of echinococcosis and trichinellosis as the most important parasitoses for public health in the EU, and to inform of the significance and particularities of opisthorchiasis, which was presented in detail at the annual workshop held in 2018. We reported on the unexpectedly large number of persons contracting trichinellosis in Croatia in 2017, with several epidemics and sporadic cases. The largest epidemic occurred following the consumption of meat products made from wild boar meat, which is the first official record of its invasion in the meat of another species, other than domesticated pig, in Croatia. Due to its epidemiological characteristics, trichinellosis remains the most significant public health parasitosis in Croatia.
U radu se prezentira fotografska građa iz fundusa Hrvatskoga muzeja medicine i farmacije Hrvatske akademije znanosti i umjetnosti, koji je osnovan rješenjem Ministarstva kulture Republike Hrvatske od ...7. srpnja 2014., a počeo je s radom u ožujku 2015. godine. Hrvatski muzej medicine i farmacije zamišljen je kao ustanova u kojoj bi se javnost kontinuirano upoznavala s razvojem medicinskih znanosti, otkrićima iz toga područja i njihovom primjenom, na osnovi materijalne i nematerijalne baštine. Inicijalnu jezgru fundusa Muzeja čini Zbirka za povijest medicine i farmacije preuzeta od Odsjeka za povijest medicinskih znanosti, koja se kontinuirano obogaćuje novim donacijama. Danas muzejski fundus obuhvaća raznovrsnu građu medicinske i farmaceutske baštine, ukupno više od 6000 predmeta, koji su razvrstani u 15 zbirki. Radom se žele predstaviti tematske cjeline unutar Zbirke fotografija Hrvatskoga muzeja medicine i farmacije Hrvatske akademije znanosti i umjetnosti koje su po sadržaju i namjeni odraz Štamparove ideologije. Odabrani uzorak čine ostavštine hrvatskih liječnika Luje Thallera (1891–1949) i Vladimira Ćepulića (1891–1964), nekadašnjega Muzeja za povijest zdravstva u Hrvatskoj osnovanoga pri Hrvatskom liječničkom zboru u Zagrebu i Kluba narodnoga zdravlja. Ova građa predstavlja materijalno svjedočanstvo o javnozdravstvenim projektima, socijalnomedicinskim istraživanjima, terenskom radu i zdravstvenom prosvjećivanju u Hrvatskoj u doba djelovanja Andrije Štampara i nekoliko desetljeća kasnije. Svojim sadržajem zbirka pridonosi čuvanju memorije o specifičnom socijalnomedicinskom modelu razvoja hrvatskoga zdravstva te čini potentno polazište u daljnjim interpretacijama i prezentacijama Štamparova djela.
The paper presents photographic material from the fonds of the Croatian Museum of Medicine and Pharmacy of the Croatian Academy of Sciences and Arts, which was established by the decision of the Ministry of Culture of the Republic of Croatia on 7 July 2014, and began to operate in March 2015. The Croatian Museum of Medicine and Pharmacy was conceived as an institution where the public would continuously become acquainted with the development of medical sciences, discoveries in that field, and their application, based on both material and non-material heritage. The initial core of the museum’s collection consists of the History of Medicine and Pharmacy Collection—transferred from the Division for the History of Medical Sciences—which is continuously enriched with new donations. Today, the museum’s collection encompasses a diverse range of medical and pharmaceutical heritage materials, totalling more than 6,000 items, which are categorised into 15 collections. The goal of the paper is to present thematic sections within the Collection of Photographs of the Croatian Museum of Medicine and Pharmacy of the Croatian Academy of Sciences and Arts that reflect Štampar’s ideology in terms of content and purpose. The selected sample consists of the legacies of Croatian physicians Lujo Thaller (1891–1949) and Vladimir Ćepulić (1891–1964), the former Croatian Museum of Healthcare History founded at the Croatian Medical Association in Zagreb, and the National Health Club. This material represents material testimony about public health projects, social medical research, field work and health education in Croatia during the time of Andrija Štampar’s activities and several decades later. With its content, the collection contributes to preserving the memory of the specific social medical model of the development of Croatian healthcare and forms a potent starting point for further interpretations and presentations of Štampar’s work.
Spending one's last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of ...palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.
This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.
This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.
This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.
During the Covid-19 pandemic, one of the best means of personal protection was using face masks. In this context, the World Health Organization has declared the attempts to produce masks inactivating ...airborne virus species a welcome initiative. This preliminary study aimed to prove that airborne germs passing through a mask filter cartridge can be destroyed by the rays emitted from UVC LEDs placed in such cartridge. We therefore designed such a face mask and tested the efficiency of UVC LEDs placed in its cartridge against common contaminants, gram-positive
, gram-negative
, and the influenza A/Puerto Rico/8/1934 virus because of its similarity with SARS CoV-2. Eight UVC LEDs with a total power of 75 mW provided sufficient germicidal effect for all three germs. In terms of safety, ozone production released during UVC LED emission was negligible. Our findings are promising, as they show that well-designed UVC-based face masks can be effective against airborne germs, but further research on a greater sample may help us learn more and optimise such face masks.
Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized ...nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk.
A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m
; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients' first visit with a clinical dietitian.
The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003).
Nutritional intervention delivered by a clinical dietitian improved patients' nutritional intake and nutritional and functional status.
Po brzini primjene i osmišljenosti inovativnih rješenja za suzbijanje
zaraza pojedini elementi dubrovačkoga modela smatraju se pretečom protuepidemijskih
mjera u Europi. U radu se razmatraju ...okolnosti nastanka toga modela u prvom
stoljeću kuge i utvrđuju najvažnija obilježja temeljnih elemenata dubrovačkoga
sustava za suzbijanje zaraza. Polazeći od spoznaje da su mjere za obranu od
zaraza djelo vlastelina-poduzetnika, pokazuje se ključni utjecaj gospodarstva
na oblikovanje tih mjera.
As
for the speed of implementation and the innovative solutions in controlling
infectious diseases, certain elements of the Dubrovnik model are considered to
be the forerunners of anti-epidemic measures in Europe. This paper discusses
the circumstances of the emergence of this model in the first century of the
Black Death, identifying the most important features of the basic elements of
Dubrovnik’s system for controlling infectious diseases. Starting from the
insight that the measures for protection against infectious diseases resulted
from the efforts of entrepreneurial noblemen, the key impact of economy on
these measures is discussed.
Healthcare systems collect little information about the experiences and outcomes of care from the perspectives of patients. Patient Reported Indicator Surveys (PaRIS) is an OECD initiative to measure ...the outcomes and experiences of people living with chronic conditions, who are managed in primary care.
To evaluate the feasibility of the methodology employed in the Field Trial of the PaRIS survey in Slovenia and propose adjustments to enhance sampling in the Main Survey.
In 2022, we conducted a cross-sectional observational study in 50 family medicine practices in Slovenia with a target of recruiting 70 patients per practice. We used the Slovenian version of the PaRIS questionnaires, and evaluated sampling and data collection.
The sample contained 21 providers (42.0% response rate) and 454 patients (50.7% response rate). The provider sample did not differ from the population characteristics, while the patient sample differed significantly from the patient population. All providers completed the survey online, in 20.9±11.1 minutes and had 1.5±1.5 restarts. Most patients (74.9%) completed the survey online and needed 36.0±22.6 minutes, and the mean number of restarts was 1.4±2.2.
Based on the results, we recommend conducting a methodology test for quality assessment studies before initiating the main survey. Legal issues should be addressed and considered early when developing the methodology. It is also necessary to be aware of the feasibility of the study in practice, to avoid a low participation rate.
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