The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated ...radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.
To assess the variation in the waiting time for diagnostic imaging (DI) services among Croatian public hospitals and the utilization of computed tomography (CT) and magnetic resonance imaging (MRI) ...scanners.
We analyzed aggregated data from public hospitals. Counties were classified according to economic strength, and utilization was expressed as the average number of exams per machine. We compared the waiting times for 2018 and utilization for 2015 according to hospital category (high and low level) and economic strength by county.
The waiting time was longer for MRI compared with CT, 268 vs 77.61 days. Overall CT waiting time was in the unfavorable European Health Consumer Index category. High-level hospitals had longer waiting time for MRI and CT. The waiting time positively correlated with economic strength for MRI (P=0.019), but not for CT. In low-level hospitals, MRI utilization ranged from 104 to 6032, whereas CT utilization ranged from 48 to 17852. In high-level hospitals, MRI utilization ranged from 3846 to 11 026, while CT utilization ranged from 503 to 17 234. CT (P=0.041) and MRI (P=0.031) utilization in high-level hospitals was significantly higher than in low-level hospitals.
The waiting times for CT and MRI were exceptionally long regardless of the hospital category, with highly varying utilization. Croatia performed more exams per scanner compared with other EU countries, but not significantly so. High-level hospitals' utilization was significantly higher than that of low-level hospitals, and CT utilization was significantly higher than EU average, while the difference for MRI utilization was not significant.
To identify the share of open access (OA) papers in the total number of journal publications authored by the members of the University of Zagreb School of Medicine (UZSM) in 2014.
Bibliographic data ...on 543 UZSM papers published in 2014 were collected using PubMed advanced search strategies and manual data collection methods. The items that had "free full text" icons were considered as gold OA papers. Their OA availability was checked using the provided link to full-text. The rest of the UZSM papers were analyzed for potential green OA through self-archiving in institutional repository. Papers published by Croatian journals were particularly analyzed.
Full texts of approximately 65% of all UZSM papers were freely available. Most of them were published in gold OA journals (55% of all UZSM papers or 85% of all UZSM OA papers). In the UZSM repository, there were additional 52 freely available authors' manuscripts from subscription-based journals (10% of all UZSM papers or 15% of all UZSM OA papers).
The overall proportion of OA in our study is higher than in similar studies, but only half of gold OA papers are accessible via PubMed directly. The results of our study indicate that increased quality of metadata and linking of the bibliographic records to full texts could assure better visibility. Moreover, only a quarter of papers from subscription-based journals that allow self-archiving are deposited in the UZSM repository. We believe that UZSM should consider mandating all faculty members to deposit their publications in UZSM OA repository to increase visibility and improve access to its scientific output.
This study aims to investigate the altmetric activity of papers published by the University of Zagreb School of Medicine in internationally visible journals and to identify differences in altmetric ...activity between the papers published in international and local journals and between those published in English and Croatian. We also investigated changes in altmetric activity over time and the characteristics of papers with the highest Twitter and Mendeley activity.
The sample included 390 papers collected from the bibliographic database Scopus. Their altmetric and citation activities were measured at three time points: in July 2014, 2015, and 2016.
The findings generally correspond to those observed in the large-scale studies of medical papers. Papers in renowned journals, and papers reporting clinical guidelines and multicentric studies had the most intense altmetric activity. In contrast, papers published in local, Croatian journals showed minimal altmetric activity, especially the papers published in Croatian. These results indicate that the local publishing community has not yet recognised social media as a tool for promoting research and that non-English language publications have minimal chances to receive attention, even in social media.
The evaluative potential of altmetric indicators has to be further explored in a broader context.
The aim of this study was to search for all available reviews, guidelines and analyses and make a literature overview and comparison between countries as a corner stone for a further research with a ...goal of making our national pediatric and neonatal end-of-life guidelines.We conducted a literature search in February 2018 and in September 2019 in bibliographic databases and grey literature sources for the time period from 1990 to 2019. Search strategies in were conducted using MeSH terms and keywords related to ‘pediatric’, ‘neonatal’,’ guidelines’, ‘end of life’, ‘palliative care’ and ‘intensive care unit’ terms. Only documents satisfying all of the inclusion and exclusion criteria were included in the review. This resulted in 12 eligible documents.Ten papers talk about neonatal and four about pediatric issues. Throughout all analyzed papers all of the ethical principles and dilemmas have been mentioned. Best interest model and judicial clarification when parental and physician views collide; doctrines of double effect and omission for withholding and withdrawing of treatment; active and passive euthanasia; quality of life from patient’s/parent’s and physician’s point of view; autonomy and autonomy by proxy; veracity as an informed consent due to shared decision making process; professional duty; beneficence; compassion and nonmaleficence for alleviate suffering; transparency as concealing medical records or documenting detailed plans of care; equality, fairness, social justice and proportionality through treatment justification and allocation of resources for expensive process of treatment or collective society ethics to prevent creation of handicaps; efficacy; utility.By many means pediatric population is very specific as well as relationship that pediatricians build with children as patients and their parents. Death after forgoing life-sustaining-treatment in intensive care unit occurs through a procedure conforming to national ethical guidelines which in turn seem appropriate for newborn infants and children. Subjectivity regarding indirect euthanasia seems unavoidable. Systematic teaching of ethics to all intensive care staff and continued review processes of end-of-life situations are necessary to preserve the best interests of the critically ill children and relieve their families. The degree of involvement of the parents in the decision-making process varies according to cultural factors and to the structure and functioning of the medical team in charge.*This article is part of the research ‘Values and Decisions at the End of Life’, funded by Croatian Science Foundation.
The aim of this study was to search for all available reviews, guidelines and analyses and make a literature overview and comparison between countries as a corner stone for a further research with a ...goal of making our national pediatric and neonatal end-of-life guidelines.We conducted a literature search in February 2018 and in September 2019 in bibliographic databases and grey literature sources for the time period from 1990 to 2019. Search strategies in were conducted using MeSH terms and keywords related to ‘pediatric’, ‘neonatal’,’ guidelines’, ‘end of life’, ‘palliative care’ and ‘intensive care unit’ terms. Only documents satisfying all of the inclusion and exclusion criteria were included in the review. This resulted in 11 eligible documents.Most of the articles, eight of them are focused on neonatal issues and only three mention specificity of pediatric problems. Among all articles five are general guidelines with examples of diagnosis, five have week by week algorithm and classification of neonatal interventions and three have obstetrical algorithms of prenatal interventions, one article talks about perinatal prognostic factors, four about starting provisional intensive care and reassessment when in doubtful cases, six have a list of clinical procedures in end-of-life decisions, four articles point out a prevalence of neurological impairment after survival as a relevant clinical factor in future end-of-life decisions, four tackle with question of active euthanasia, two recommend palliative care after forgoing life-sustaining treatment with examples of diagnosis, three distinguish different modes of forgoing life-sustaining treatment and two mention organ donation after death.Clinical guidelines on EOLD are intended as a general framework to help all decision-making parties, but because of uniqueness of every physician, parent, child, diagnosis and underlaying background there are still grey zones that tackle with ethical issues and individual decisions outside the guidelines are always possible.*This article is part of the research ‘Values and Decisions at the End of Life’, funded by Croatian Science Foundation.
Common complex diseases are influenced by both genetic and environmental factors. Many genetic factors overlap between various autoimmune diseases. The aim of the present study is to determine ...whether four genetic variants known to be risk variants for several autoimmune diseases could be associated with an increased susceptibility to type 1 diabetes mellitus.
We genotyped four genetic variants (rs2358817, rs1049550, rs6679356, rs9865818) within VTCN1, ANXA11, IL12RB2 and LPP genes respectively, in 265 T1DM family trios in Croatian population. We did not detect association of these polymorphisms with T1DM. However, quantitative transmission disequilibrium test (QTDT, orthogonal model) revealed a significant association between the age of onset of T1DM and IL12RB2 rs6679356 variant. An earlier onset of T1DM was associated with the rs6679356 minor dominant allele C (p = 0.005). The association remained significant even after the Bonferroni correction for multiple testing and permutation.
Variants originally associated with juvenile idiopathic arthritis (VTCN1 gene), sarcoidosis (ANXA11 gene), primary biliary cirrhosis (IL12RB2 gene) and celiac disease (LPP gene) were not associated with type 1 diabetes in our dataset. Nevertheless, association of IL12RB2 rs6679356 polymorphism with the age of T1DM onset suggests that this gene plays a role in defining the time of disease onset.
The majority of the scientific papers include keywords besides the obligatory title and abstract. The use of keywords is not just for the description of content, but it is a viral part of the ...scientific paper which is later used for information retrieval function. The aim of this paper is to present comparison of author suggested keywords in scientific papers of Faculty of Electrical Engineering and Computing (FER), IEEE terms and user tags in academic social network Mendeley. This paper will examine the scientific papers represented in IEEE Journals and Magazines indexed in the IEEE/IET Electronic Library reviewing the overlap between author keywords and IEEE terms from a controlled vocabulary (IEEE thesaurus) and user tags in Mendeley. The results showed no significant use of controlled vocabulary and social tags, which leads to the conclusion that the authors are not aware of the importance of controlled keywords.
One of the basic needs of contemporary engineering students is to, evoke their individual ability for creative and critical thinking in science, professional or research and development (R&D) field. ...This ability descends from an individual's level of information competency that, as the basis of lifelong learning, poses several distinctions compared to the level of one's skills in the fields of electrical engineering, computing and information and communication technology (ICT). Previous researches show that the quality of those skills in the students' practices is markedly high, but the lack of information competencies is still notable. The aim of this paper is to present the results of the information behavior and information competencies survey conducted among students of the Faculty of Electrical Engineering and Computing (FER) at all undergraduate and graduate levels. The results of the study will be processed to determine the skill level of information competencies and behavior of engineering students. The outcome will be beneficial in the planning process for information providing strategies in academic libraries in the electrical engineering, computing, information, and communication technology (ICT) fields.
Intensive care unit health care professionals must be skilled in providing end-of-life care. Crucial in this kind of care is end-of-life decision-making, which is a complex process involving a ...variety of stakeholders and requiring adequate justification. The aim of this systematic review is to analyse papers tackling ethical issues in relation to end-of-life decision-making in intensive care units. It explores the ethical positions, arguments and principles.
A literature search was conducted in bibliographic databases and grey literature sources for the time period from 1990 to 2019. The constant comparative method was used for qualitative analysis of included papers in order to identify ethical content including ethical positions, ethical arguments, and ethical principles used in decision-making process.
In the 15 included papers we have identified a total of 43 ethical positions. Ten positions were identified as substantive, 33 as procedural. Twelve different ethical principles emerged from the ethical arguments. The most frequently used principles are the principles of beneficence, autonomy and nonmaleficence.
We have demonstrated that recommendations and guidelines designed specifically by intensive or critical care experts for intensive care units promote similar ethical positions, with minimal dissenting positions.
•End-of-life recommendations for ICUs promote similar ethical positions•Some expert recommendations don't provide ethical arguments nor principles for proposed actions•End-of-life recommendations should be supported by ethical arguments and principles
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