Mycobacterium tuberculosis is a necessary, but not sufficient, cause of tuberculosis. A number of studies have addressed the issue of risk factors for tuberculosis development. Croatia is a European ...country with an incidence rate of 14/100 000 which is slowly decreasing. The aim of this study is to evaluate the potential demographic, socioeconomic, behavioural and biological risk factors for tuberculosis in Croatia in comparison to other high-income, low-incidence European countries.
A total of 300 tuberculosis patients were matched for age, sex and county of residence to 300 controls randomly selected from general practitioners' registers. They were interviewed and their medical records were evaluated for variables broadly described as potential risk factors.
In multiple logistic regression, the following factors were significant: parents born in a particular neighbouring county (Bosnia and Herzegovina) (OR = 3.90, 95% CI 2.01-7.58), the lowest level of education (OR = 3.44, 95% CI 1.39-8.50), poor household equipment (OR = 4.72, 95% CI 1.51-14.76), unemployment (OR = 2.69, 95% CI 1.18-6.16), contact with tuberculosis (OR = 2.19, 95% CI 1.27-3.77), former (OR = 2.27, 95% CI 1.19-4.33) and current smoking habits (OR = 2.35, 95% CI 1.27-4.36), diabetes (OR = 2.38, 95% CI 1.05-5.38), a malignant disease (OR = 5.79, 95% CI 1.49-22.42), being underweight in the previous year (OR = 13.57, 95% CI 1.21-152.38).
In our study, the identified risk groups for tuberculosis reflect a complex interaction between socioeconomic conditions, lifestyle and non-communicable diseases. Interventions focused on poverty will undoubtedly be useful, but not sufficient. Tuberculosis control would benefit from a combination of broad public health activities aimed at the prevention and control of risky lifestyles and non-communicable diseases, interventions outside the health sector, and efforts to constantly improve the Croatian national tuberculosis programme.
Human error caused by the interaction and effect of fatigue, stress and anxiety in seafarers is the subject of this research. The human element is a major part of the maritime system. We used ...Bayesian networks to predict human error in maritime affairs by analysing interactions between people, technology, organisational and environmental factors which make up the specificity of the maritime system. Bayesian networks are graphical structures developed to represent the conditional dependencies among a number of variables and to make conditional conclusions related to the selected variables. Through the analysis of psychic causes such as stress, fatigue, anxiety and so on, the model can produce graphic diagrams indicating which rank on which type of vessel at which seafarers age contributes to an increase in conditional probability of human error. The contribution of the paper is to find the worst combinations of influencing variables that can lead to an increase in the risk of human error. The results show a significant level of fatigue and stress in all officers (engine and nautical), regardless of the type of vessel they serve. A strong presence of anxiety is also reported in all surveyed officers, with a higher degree between engine officers.
Ageism in the Age of Pandemic Jerončić Tomić, Iris; Mulić, Rosanda
In medias res,
05/2021, Letnik:
10, Številka:
18
Journal Article
Recenzirano
Odprti dostop
Elderly persons, in addition to their health needs, also have a need for being socially perceived as persons and for considering aging as a normal life process. Throughout history, older people have ...been considered a social problem, resulting in a negative attitude towards the old age group. Ageism is a term denoting discrimination of a group of people because of their old age. Discrimination occurs because of the belief that aging causes negative changes that make a person less attractive, less intelligent and, most importantly, less productive. During a pandemic, the society’s unethical actions towards this particularly vulnerabile group become evident. These include cruelties in the triage procedure in some EU countries, giving preference to those who have a better chance of survival, and the recurring impression among the younger populations that nothing significant has changed in their lives and that, accordingly, nothing should be changed in their habits and behaviour.
Despite modern ship technologies, high-quality crew accommodation and exceptional communications, the absence of a doctor on board presents an issue in terms of the timely, adequate and efficient ...response to acute health disorders and life-threatening injuries. A serious health condition of an injured or sick person, insufficient medical knowledge of the on-board officers, inadequately equipped ship's infirmary, or scarce supply of medicines are among the typical reasons for requesting professional shore-based medical assistance. This can be achieved by requesting Radio Medical Advice or by activating air-borne medical assistance, i.e. bringing a doctor by helicopter or by Medical Evacuation, i.e. transferring the ill or injured person to the shore medical institution. The Maritime Telemedical Assistance Services are available across the world. They use all the technical possibilities available, including e-mails and very widely used photo and video attachments as well as the emergency real-time live videos. In on-board practice, the most common solution is to use medical advice over the radio (through terrestrial or satellite networks). This paper discusses the ways of requesting professional medical advice or aid on board ocean-going merchant ships in the Republic of Croatia.
BACKGROUNDSeafarers are usually exposed to many stressors that are related to different duties on board. Several notable researchers have argued that stress is a transactional phenomenon between the ...individual and the environment that is largely dependent on the meaning given to the stimulus by the perceiver. One of the many causes of stress are poor communication skills. SUBJECTS AND METHODSThe aim of the study was to xplain why respondents drop out of research. The project was originally supposed to take place over a period of two years and involve a minimum of 30 respondents per group (30 skippers and 30 seafarers) who would take part in the research for at least four weeks while on board, or during the skipper season. Activity was to be measured with the Polar A370 fitness tracker, worn as a wrist-watch or bracelet and used for 24-hour heart rate, bodily activity and sleep pattern tracking for every respondent. The other device used is TANITA MC780MA, which is a segmental body composition analyser. RESULTSWe contacted overall 146 seafarers, of whom: 40 (27.4%) skippers, 43 (29.5%) deck officers and 63 (43.1%) engine officers. Participation was refused by 18 (12.3% of all contacted) individuals and 108 (74.0%) respondents dropped out during the research. Due to group dispersal and a low number of respondents who reached the end of the research, the project will have to be prolonged. CONCLUSIONWe believe that the reasons behind respondent dispersal can be found in their inability to recognize the state they are in and in poor communication skills, while at the same time being exposed to extreme and possibly precarious work conditions. This forms a closed loop that only continues to generate even higher stress levels. Further research is needed to look into this phenomenon.
Ships are supplied with water from various sources: directly from the public utility system at the port, from water supply vessels or barges, bottled water, ice or, if water production on board is ...possible,through processes such as desalination and reverse osmosis. All elements of a ship's water supply chain are exposed to the influence of different factors that may have a negative impact on water safety on board or on human health. Potable water standards are the same for vessels and for land-based facilities. In recognition of the importance of drinking water and the impact it can have on human health, stringent quality standards have been laid down in national and global regulations. The aim of the study was to describe the water supply system on ships and its weak points, as well as the health risks that the use of npolluted drinking water can entail.
The Medline Database has been searched using the following key words: ship, water supply, waterborne infections. Other available literature has also been used, as well as national and international regulations on drinking-water safety.
Drinking water on ships is managed in line with the hygienic and health standards applied along the entire supply chain, from the source to the point of consumption. Regardless of the sanitary control system used by the authorised institutions on the ground, ship officers must oversee the entire water supply and distribution system on board, as well the water production systems if these exist. That means that they must be well aware of all of the fundamental facts of the supervision system, as well as the weaknesses of the water supply system. Maritime studies students, future deck officers and engine officers, must all receive training on the weak points of the system and on water contamination prevention.
To estimate global morbidity from acute bacterial meningitis in children.
We conducted a systematic review of the PubMed and Scopus databases to identify both community-based and hospital ...registry-based studies that could be useful in estimation of the global morbidity from bacterial meningitis in children. We were primarily interested in the availability and quality of the information on incidence rates and case-fatality rates. We assessed the impact of the year of study, study design, study setting, the duration of study, and sample size on reported incidence values, and also any association between incidence and case-fatality rate. We also categorized the studies by 6 World Health Organization regions and analyzed the plausibility of estimates derived from the current evidence using median and inter-quartile range of the available reports in each region.
We found 71 studies that met the inclusion criteria. The only two significant associations between the reported incidence and studied covariates were the negative correlation between the incidence and sample size (P<0.001) and positive correlation between incidence and case-fatality rate (P<0.001). The median incidence per 100000 child-years was highest in the African region - 143.6 (interquartile range IQR 115.6-174.6), followed by Western Pacific region with 42.9 (12.4-83.4), the Eastern Mediterranean region with 34.3 (9.9-42.0), South East Asia with 26.8 (21.0-60.3), Europe with 20.8 (16.2-29.7), and American region with 16.6 (10.3-33.7). The median case-fatality rate was also highest in the African region (31.3%). Globally, the median incidence for all 71 studies was 34.0 (16.0-88.0) per 100000 child-years, with a median case-fatality rate of 14.4% (5.3%-26.2%).
Our study showed that there was now sufficient evidence to generate improved and internally consistent estimates of the global burden of acute bacterial meningitis in children. Although some of our region-specific estimates are very uncertain due to scarcity of data from the corresponding regions, the estimates of morbidity and case-fatality from childhood bacterial meningitis derived from this study are consistent with mortality estimates derived from multi-cause mortality studies. Both lines of evidence imply that bacterial meningitis is a cause of 2% of all child deaths.
BACKGROUNDThe International Labour Organization (ILO, 2000) has defined stress and exhaustion from working shifts and night work, and psychological and organizational stressors conditions that create ...health risks for surgical nurses. Among the OR nurses/ technicians 41.9% reported that causes of their stress included inadequate teamwork, ineffective communication, and especially surgeons' negative attitudes. SUBJECTS AND METHODSThe stuudie has been held in Clinical Hospital Centre Split, the sample consists of a total of 62 out of 109 possible respondents participated in the study. A total of 23 (37%) anesthesiology technicians and 39 (63%) ICU nurses / technicians participated in the survey. In the empirical part of this research, the importance of selected stressors was tested using quantitative methods in biomedicine. The existence of stress was tested by the Wilcoxon test. Stress level in the ICU was tested by T-test The analysis was elaborated in the statistical software STATISTICA 12. Conclusions were made at a significance level of 5%. The research was conducted through the questionnaire taken from the paper Milan Milošević entitled: "Development of a measuring instrument of stress in the workplace hospital health professionals and an assessment of its use value" (2010). RESULTSBased on the empirical t value of 3.42 at 59 degrees of freedom the conclusion is that there was found a statistically significant difference in the level of stressors in the workplace between nurses / technicians in the ICU and anesthesiology technicians. The conclusion was reached at an empirical level of significance <0.001. CONCLUSIONThe highest level of stress among medical staff is caused by the factor of insufficient number of employees, followed by work overload, inadequate material resources for work (financial constraints), poor organization at work, and the factor of poor communication with superiors.
BACKGROUND: There are a number of stereotypes of seafarers in today’s society. In Croatia, the prevailing stereotype assumes that they are a specific population having an ideal life and a great time ...both at sea and at home and have a liberal worldview. In the reality, seafaring is a hardly, demanding, stressful and high-risk occupation. The goal of this research was to gain comparative insights into the standpoints of the students of the University of Split Faculty of Maritime Studies and School of Medicine on the issues regarding reproductive health and contraception. MATERIALS AND METHODS: We used the views on contraception questionnaire created by Kelly J. Black from the University of Washington. The respondents participating in the research are the students of the two constituent faculties at the University of Split: School of Medicine and the Faculty of Maritime Studies. A total of 274 students took part in the research, out of which 116 were female students. RESULTS: There is a significant difference in the attitude to the use of contraception, which is more positive in female student population. The students of medical science have a more positive attitude to contraception than their peers at the Faculty of Maritime Studies. Conclusions: Considering the results obtained through the survey and the information from relevant sources, it can be concluded that it is necessary to enhance health literacy in the seafaring population, given the challenges in their working and living environment.
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