Globalization has a major impact on public health in all countries of the world. Unfortunately, there are attempts to treat global challenges in the field of public health separately from national ...ones, following the model of tropical medicine, where the focus of action was in fact primarily on the identification and control of tropical diseases. This was especially in the interest of countries that colonized certain areas in the tropical part of the world. Global health, which is to some extent the successor of tropical medicine, cannot be a separate entity. The lines between global health and public health are blurring. In essence, global health is just another aspect of public health, important both in terms of recognizing the situation and taking action to improve the situation. The problems are mostly no longer local or national, and, to a greater or lesser extent, already affect the entire population or threaten the health of future generations.
Such a view of global health also requires different approaches. Of course, due to cultural and socio-economic characteristics, the field and method of work must be adapted to the specific local environment, but nevertheless, these are challenges that are present everywhere. Therefore, it is vital that we act decisively, with a united approach – regardless of where we live and at what stage of social development we are. The world has become one, so the division into public health and global public health has become meaningless.
To develop and validate a comprehensive questionnaire to be used as an instrument in cross-sectional studies among beekeepers.
A comprehensive questionnaire in Slovenian was validated by an expert ...panel (n=13) for content relevance and a rater panel (n=14) for clarity and comprehensibility. The content validity indices (an item-level content validity index and scale-level content validity index based on the average and universal agreement method) and item-level face validity index were calculated in accordance with the recommended number of both the review panels with their implications on the acceptable cut-off scores. Piloting was performed in a sample (n=50) of the target population (N=1.080) using telephone interviews.
The item-level content validity index and scale-level content validity index based on the average method exhibited excellent content validity (0.97), while the scale-level content validity index based on the universal agreement method reached a value of 0.72. The item-level face validity index of 1.00 indicated that all items were clear and comprehensive.
The new instrument may be considered valid and feasible for use in nationwide population-based studies among Slovenian beekeepers and eventually in other populations.
Adequate trunk muscle endurance is considered to be an important indicator of good low back stability; therefore, its assessment is needed when determining an individual's risk for back pain. Optimal ...tests to assess each trunk muscle group separately are difficult to find. The objective of this study was to verify if two groups of trunk muscle endurance tests (standard and alternative) show comparable results in terms of muscle endurance ratios, holding times and rated perceived effort to perform each test.
The study was designed as a quasi-experimental repeated-measures design. There was a single group of participants who took part in two different trunk muscle endurance testing. Sixty-eight healthy adult volunteers, aged 20-45 years (31.9 ± 7.2 years), without recent musculoskeletal injury or disorder participated in the study. All participants finished the study. Trunk muscle endurance tests as tested on the Roman chair (B tests) were compared with standard tests as suggested by McGill (A tests). Each group of tests consisted of an endurance test for trunk extensors, trunk flexors, and lateral trunk muscles for left and right side. The order of tests' performances was randomly assigned to each participant, whereby a participant did perform A and B tests in the same order. In each test of A and B the holding time was recorded and a perceived effort in each test performance was also assessed by participants. Post testing performance the four ratios of trunk muscles endurance comparison were calculated for each group of tests to determine if there is a good or poor ratio between muscles. Results of each participant were compared for trunk muscle endurance ratio calculations, holding times and rated perceived effort for A and B tests.
Results showed comparable trunk muscle endurance ratios in the three ratios observed, except for the flexors:extensors ratio (A
: 1.2 (IQR: 0.7-1.6)
. B
: 0.6 (IQR: 0.3-0.8);
< 0.001). As compared to A tests, holding times were significantly longer in B tests for the extensors (A
: 125.5 s (IQR: 104.8-182.8 s)
. B
: 284.0 s (IQR: 213.0-342.3 s);
< 0.001) and lateral trunk muscles (A
: 61.0 s (IQR: 48.3-80.8 s)
. B
: 131.5 s (IQR: 95.5-158.5 s); A
: 63.5 s (IQR: 45.8-77.3 s)
. B
: 113.0 s (IQR: 86.3-148.8 s);
< 0.001), both were also rated as slightly easier to perform in the extensors (A
: 13 (IQR: 12.0-14.0) vs B
: 11 (IQR: 10.0-13.0); p
< 0.001) and lateral muscles testing (A
: 14.0 (IQR: 12.3-15.8)
. B
: 13.0 (IQR: 12.0-15.0); p
= 0.001).
A and B tests are comparable in three of four trunk muscle endurance ratios, while longer holding times and lower perceived effort to perform were observed in most of the B tests. The Roman chair tests could be used as an alternative to standard tests.
To make the treatment approach in patients suffering a European hornet sting allergy reaction more personalized, preparing them also for possible future risks.
In Slovenia an extended retrospective ...observational cohort epidemiological study about the natural history of Hymenoptera venom sensitivity is in progress. The study is based on data from the healthcare records of the University Clinic Golnik (UCG) and data collected by a questionnaire sent to patients from May 2019 to April 2021. For a pilot study, we selected patients who were referred to UCG because of an allergic reaction to European hornet sting and had been re-stung later by a wasp (n=68). The association between severe systemic allergic reactions (SSAR) after wasp sting and potential risk factors in subjects with a history of hornet sting allergy was assessed univariately using the likelihood ratio test.
Among 68 European hornet allergic patients 27 reacted with an SSAR and 41 reacted with a mild SAR. Among 27 patients with SSAR, 4 reacted with an SSAR also to a subsequent wasp sting. Among 41 patients with a mild European hornet sting SAR nobody reacted with an SSAR to a subsequent wasp sting. The association between the severity of the wasp SAR reaction in European hornet allergic patients was statistically significant (p=0.022).
Our results suggest that patients with severe European hornet SAR should be considered for wasp venom immunotherapy or prophylactic prescription of epinephrine auto-injector as they are at risk for an SSAR also after wasp string.
Abstract Aim To analyse if body mass index (BMI) could be used as a fast proxy indicator of poor oral hygiene habits (POHH) among the adult population with diabetes mellitus. Methods Adults, aged ...25-74, from the Slovenian 2016 nationwide cross-sectional survey based on the Countrywide Integrated Non-Communicable Disease Intervention (CINDI) Health Monitor methodology, who reported being diabetic, were included in the study (n=560). We assessed the relationship between POHH and BMI, adjusted to confounders, using multiple binary logistic regression. Results In the total sample, the POHH prevalence was 50.9%. Taking into account BMI, POHH prevalence in participants with normal BMI values was only 37.8%, in the overweight group it was 1.22-times higher (46.0%), while in the obese group it was 1.63-times higher (61.6%) (p<0.001). Also, the odds for POHH were 2.64-times higher in the obese group in comparison to the normal BMI group (95% CI: 1.55-4.51; p<0.001). After adjustment for confounders, this OR decreased only moderately (OR=2.45; 95% CI: 1.35-4.44; p=0.003). Conclusions BMI could be used as a readily assessable, fast, simple, and cheap tool indicating higher odds for having POHH among the diabetic population. By defining the high-risk group it could be easier for physicians and dentists to take further referrals and actions for promoting oral health in this group. The suggested tool can save time and could have an important positive impact on the quality of life of diabetics, as well as on health expenditures.
Abstract Introduction Aimed at preparing the basis for planning evidence-based public health measures for preservation/ improvement of nurses’ work ability (WA), the objective was to assess the ...relationship between WA and sense of coherence (SOC). Methods A cross-sectional study was conducted in 2018 among 713 nurses in Croatia. The association between poor WA index (PWAI) and SOC score (SOCS), adjusted for possible confounders, was determined by binary logistic regression analysis. Results The results of univariate logistic regression analysis showed a statistically significant negative association between SOCS and PWAI (OR=0.977, 95% CI 0.968 – 0.986, p<0.001). The results of multivariate logistic analysis showed an even stronger statistically significant negative association between SOCS and PWAI (OR=0.966, 95% CI 0.954 – 0.977, p<0.001) when adjusted for confounders. Conclusions The present study suggested SOC as an important health promoting resource of nurses which might offer protection regarding work-related stress. Weak SOC could be an important explanatory factor of poor WA. Accordingly, improving SOC by implementing health promotion measures in nurses’ workplace could be an important way to increase the WA among nurses.
Abstract Tolerability to gemcitabine radiochemotherapy was evaluated in 33 patients with inoperable, locally advanced transitional-cell bladder cancers. The dose of 75 mg/m2 gemcitabine once a week, ...concurrently with standard radiotherapy of 60 Gy/6 weeks, was found to be acceptable. Eighty-one percentage of 3-year local progression-free survival suggests efficiency warranting further studies.
To elucidate potential risk factors important for the appearance of late rectal toxicity (LRT) after high-dose-rate boost treatment (HDRBT) of prostate cancer and to validate the predictive value of ...the minimal dose to the most exposed 2 cc of rectum received with HDRBT (D2cc
).
The study of LRT, defined as relative deterioration of defecation problems (RDDP) (stool frequency, pain, rectal bleeding, fecal urgency, and incontinence) during follow-up period, was carried out on 88 patients, consecutively treated from October 2006 through April 2011 with HDRBT of 3 × 6-7 Gy to 50-50.4 Gy of EBRT. The impact of patients and treatment characteristics on third year prevalence of RDDP was analyzed by using binary logistic regression method.
At third year of follow-up, RDDP was evidenced in 30 of 77 (39.0%) patients. More important as D2cc
(OR, 1.15; 95% CI, 0.99-1.34; p = .059) was minimal dose to the most exposed 1 cc of the rectum (D1cc
; OR, 1.15; 95% CI, 1.01-1.31; p = .032), whereas the sum of D1cc
and EBRT mean rectal dose (EDmean
) was the only significant parameter in multivariate analysis (OR, 1.12; 95% CI, 1.04-1.22; p = .004). Based on a multivariate model, the safe compound 2 Gy equivalent dose was estimated at 44.4 Gy with the average ratio of D1cc
:EDmean
= 1:3.1 (95% CI ± 1.8) and negative predictive value of 0.828.
The study confirms the value of composite dose parameter and the importance of rectal high-dose and low-dose regions for LRT. Taking account of suggested dose constraints and CT/MRI-based HDRBT, the incidence of LRT can be reduced by a half.
Objectives: The pandemic caused by the novel coronavirus (SARS-CoV-2) affected a disproportionately high percentage of healthcare workers (HCWs). The aim of the study was to assess the seroprevalence ...of SARS-CoV-2-specific IgG antibodies in nurses and clinicians working in 2 Slovenian regional hospitals, and to identify the factors associated with seropositivity. Material and Methods: The study was designed as a cross-sectional study. Clinicians and nurses were invited to participate in November-December 2020. The respondents (813, 65.8%) completed a questionnaire and consented to provide 10 ml of blood for determining the presence of SARS-CoV-2 IgG antibodies. Results: The authors observed a seroprevalence rate of 20.4%. The results of the univariate analysis proved that the age of a nurse or clinician was the factor most strongly associated with seropositivity--in fact, the youngest nurses and clinicians were 8.33 times more likely to be seropositive than those in the oldest age group (p = 0.041). Being in contact with a family/household member who was SARS-CoV-2-positive was also a very important factor. In the work-related factors group, being in the contact with a SARS-CoV-2-positive colleague (OR = 2.35, p = 0.026) or being in contact with a COVID-19 patient (OR = 1.96, p = 0.004) correlated with seropositivity. In the primary work location/department group, the only significant association appeared among those working in surgical, ENT or ophthalmology departments. The results of the multivariate analysis further supported the thesis that the age of nurses and clinicians was the factor most strongly associated with seropositivity. The youngest nurses and clinicians were 12.5 times more likely to be seropositive than those in the oldest age group (p = 0.024). Being in contact with a SARS-CoV-2-positive family/household member remained the second most important factor. Conclusions: A significant number of clinicians and nurses working in secondary healthcare were infected in the first 9 months of the pandemic. Int J Occup Med Environ Health. 2022;35(5):571 -84 Key words: seroprevalence, nurse, clinician, healthcare professional, COVID-19, SARS-CoV-2
Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status ...measured by the number of missing teeth and self-rated health (SRH).
The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed.
In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001).
Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth.
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