The Child Health Care System of Croatia Mestrovic, Julije, MD, PhD; Bralic, Irena, MD, PhD; Simetin, Ivana Pavic, MD, PhD ...
The Journal of pediatrics,
10/2016, Volume:
177
Journal Article
Peer reviewed
Open access
The Republic of Croatia is a Parliamentary Republic with a population of 4.2 million people that sits on the Adriatic coast within Central Europe. Gross domestic product is approximately 60% of the ...European Union average, which in turn, limits health service spending. The health system is funded through universal health insurance administered by the Croatian Health Insurance Fund based on the principles of social solidarity and reciprocity. The children of Croatia are guaranteed access to universal primary, hospital, and specialist care provided by a network of health institutions. Pediatricians and school medicine specialists provide comprehensive preventive health care for both preschool and school-aged children. Despite the Croatian War of Independence in the late 20th century, indicators of child health and measures of health service delivery to children and families are steadily improving. However, similar to many European countries, Croatia is experiencing a rise in the “new morbidities” and is responding to these new challenges through a whole society approach to promote healthy lifestyles and insure good quality of life for children.
Adherence to the Mediterranean diet (MD) has been found beneficial for the prevention and treatment of various chronic non-communicable diseases; however, adherence to MD is declining, especially in ...the Mediterranean countries. Croatia is characteristic for having both traditionally continental and Mediterranean regions, with distinct dietary features. The aim of this study was to compare difference in adherence to MD and overall dietary intake between children and adolescents from continental and Mediterranean part of Croatia. Participants were randomly recruited children and adolescents (n=838, mean age 9.96 ± 2.09 years) located in continental and Mediterranean parts of Croatia. Three different questionnaires were distributed and collected: general questionnaire (age and gender), the Mediterranean Diet Quality Index for children and adolescents (KIDMED) and 3-day food records (3DFR). Statistical analysis was performed using SPSS 260 (IBM Corporation, Chicago, Illinois, USA) statistical software. P values less than 0.05 were considered significant. Overall, low adherence to MD was evident in 23.1% of participants, while only 15.8% of children and adolescents had good compliance with MD. A significant difference in KIDMED score has been found between the continental (mean score 4.91 ± 2.33) and Mediterranean (mean score 5.57 ± 2.12) part of Croatia (p<0.001), as well as in the intake of energy and some nutrients. Moreover, participants from the Mediterranean part of Croatia had better compliance with D-A-CH recommendations for some nutrients compared to those from the continental part. Although children and adolescents from the Mediterranean part of Croatia had better adherence to MD than those from the continental part, overall, relatively poor adherence to MD was evident for both regions. Therefore, a healthy, balanced diet should be encouraged in both regions, preferably taking into account traditionally consumed and locally available foods.
Mediteranska prehrana ima važnu ulogu u prevenciji i liječenju različitih kroničnih nezaraznih bolesti. Međutim, pridržavanje mediteranske prehrane posljednjih godina opada, posebno u mediteranskim zemljama. Hrvatska je karakteristična po tome što ima tradicionalno kontinentalnu i mediteransku regiju, sa specifičnim prehrambenim značajkama. Cilj ovog istraživanja bio je usporediti razlike u pridržavanju mediteranske prehrane te nutritivni unos između djece i adolescenata iz kontinentalnog i mediteranskog dijela Hrvatske. Ispitanici su bili nasumce regrutirana djeca i adolescenti (n = 838, prosječna dob 9,96 ± 2,09 godina) koji žive u kontinentalnom i mediteranskom dijelu Hrvatske. Svi ispitanici su ispunili tri različita upitnika: opći upitnik (dob i spol), KIDMED upitnik (mediteranski indeks kakvoće prehrane kod djece i adolescenata) i trodnevni dnevnik prehrane. Statistička analiza provedena je pomoću statističkog softvera SPSS 260 (IBM Corporation, Chicago, Illinois, USA). Vrijednosti P manje od 0,05 smatrale su se značajnima. Rezultati su pokazali da se 23,1% ispitanika slabo pridržava mediteranske prehrane, dok se samo 15,8% djece i adolescenata dobro pridržava mediteranske prehrane. Postoji statistički značajna razlika u KIDMED indeksu između kontinentalnog (srednja vrijednost 4,91 ± 2,33) i mediteranskog (srednja vrijednost 5,57 ± 2,12) dijela Hrvatske (p <0,001), kao i u unosu energije i nekih nutritivnih tvari. Sudionici iz mediteranskog dijela Hrvatske bolje su se pridržavali D-A-CH preporuka za određene nutritivne tvari u usporedbi s onima iz kontinentalnog dijela. Iako su se djeca i adolescenti iz mediteranskog dijela Hrvatske bolje pridržavali mediteranske prehrane nego oni iz kontinentalnog dijela, sveukupno je bilo vidljivo relativno slabo pridržavanje mediteranskoj prehrani za obje regije. Stoga je potrebno u obje regije poticati zdravu, uravnoteženu prehranu, po mogućnosti uzimajući u obzir tradicionalnu i lokalno dostupnu hranu.
Cilj: Istražiti poznavanje rizičnih čimbenika za sindrom iznenadne dojenačke smrti od pedijatara primarne zdravstvene zaštite uSplitsko-dalmatinskoj, Dubrovačko-neretvanskoj i Bjelovarsko-bilogorskoj ...županiji.Ispitanici i metode: Presječnim istraživanjem obuhvaćeni su PPZZ-i u SDŽ-u, DNŽ-u i BBŽ-u u razdoblju od veljače do rujna 2018.godine. Pedijatrima je dostavljen upitnik sa 18 pitanja koja se odnose na mišljenja o spavanju i dojenju, savjete što ih daju roditeljimasvojih bolesnika te znanje o SIDS-u.Rezultati: Analizirano je 29 anketa, a većina ispitanika je starija od 55 godina. Većina pedijatara (72%) tvrdi da rutinski razgovara sroditeljima svojih bolesnika o sigurnom spavanju. Pritom svi ispitani PPZZ-i savjetuju roditeljima da dojenčad stave spavati u kolijevkuu sobi s njima. Njih 72% preporuča položaj na leđima, a ostali na boku. Više od pola (52%) ispitanika ne smatra da pušenje oca iliizloženost duhanskom dimu majke u trudnoći povećava rizik od SIDS-a, a 38% ih ne smatra ni da majčino pušenje povećava rizik.Većina (76%) PPZZ-a ne zna da hranjenje formulom značajno povećava rizik od SIDS-a. Polovina ispravno smatra da je zajedničkospavanje povezano s duljim trajanjem dojenja.Zaključak: Nedostatno je znanje PPZZ-a o rizičnim čimbenicima za SIDS. S obzirom na to da većina pedijatara rutinski razgovara sroditeljima dojenčadi o sigurnom spavanju, bitno je da budu upoznati s najnovijim preporukama.
Izvanbolničke upale pluća u djece Pavlov, Neven; Banac, Srđan; Bralić, Irena ...
Liječnički vjesnik,
10/2021, Volume:
143, Issue:
9-10
Journal Article
Peer reviewed
Open access
Izvanbolnička upala pluća jest potencijalno ozbiljna infekcija u djece. Dijagnostika izvanbolničkih upala pluća u djece temelji se na anamnestičkim podatcima i kliničkim simptomima i znacima, ...potpomognuto dodatnim dijagnostičkim pretragama: laboratorijskim, slikovnim i mikrobiološkim. Etiologija izvanbolničke upale pluća ovisi o brojnim čimbenicima, kao što su sezonstvo, geografski položaj, dob bolesnika i težina bolesti. Liječenje djeteta s izvanbolničkom upalom pluća uključuje primjenu simptomatskih mjera i u većine bolesnika antimikrobnu terapiju. U radu su prikazane kliničke preporuke Hrvatskog društva za pedijatrijsku pulmologiju radi ujednačenja postupaka i kriterija postavljanja dijagnoze, liječenja i prevencije izvanbolničkih upala pluća u djece.
The aim of the study was to explore the association between Glasgow Coma Scale (GCS), Paediatric Index of Mortality (PIM2) and Injury Severity Score (ISS), and the long-term outcome of children with ...injuries. The health related quality of life (HRQL) was assessed by using the Royal Alexandra Hospital for children Measure of Function (RAHC MOF), 12 months post discharge. Out of 118 children with injuries (9% of all patients), 75 had injury of the head as the leading injury. There were no significant differences at admission in the severity of clinical condition, as expressed by PIM2 and ISS, between patients with head injuries and patients with other injured leading body regions. Children with head injuries had significantly worse HRQOL than children with other leading injured body region (p < 0.045), and children from road traffic accidents had significantly worse HRQL (p = 0.004), compared to other mechanisms of injury. HRQL correlated significantly with GCS (p = 0.027), but not with ISS and PIM2. As the conclusion, among all scoring systems applied, only GCS, which demonstrates severity of head injury, showed significant impact on long-term outcome of injured children.
The changes in long-term quality of life (QOL) of children treated in paediatric intensive care unit (PICU) were investigated in relation to their QOL before critical illness together with the ...influence of underlying chronic health condition and severity of illness estimated by Paediatric Index of Mortality 2 on the long-term outcome. This study included 189 children treated in PICU and 179 children from outpatient clinics as controls. QOL was evaluated according to the Royal Alexandra Hospital for Children Measure of Function (RAHC MOF). The long-term QOL in 70 % of children treated in PICU was good, although there was a significant diminution of QOL in children treated in PICU in comparison with their preadmission scores and with the children from outpatient clinics who served as controls (
p
< 0.001). Severity of illness had a significant impact on children’s QOL (
p
= 0.016) 6 months after treatment in PICU. Twenty-four months after discharge, the RAHC MOF score was still decreased in 19 % of children treated in PICU, and in significantly more patients with a chronic health condition (CHC) treated in PICU, than in their peers from outpatient clinics (
p
= 0.029). Reduced QOL was significantly more frequent in children with neurodevelopmental disability than in children without CHC 24 months after discharge from PICU (
p
= 0.013).
Conclusion:
Acute illness has a significant impact both on children with and without CHC after treatment in PICU 6 months after discharge. Twenty-four months after discharge, comorbidity was identified as the decisive factor for diminished QOL in children after PICU treatment.
Priča iz života sokolova Radonić, Marija; Mihatović, Marija
Dijete, vrtić, obitelj,
06/2015, Volume:
20, Issue:
77/78
Web Resource
Open access
Slikovnica ‘Priča iz života sokolova’ rezultat je istoimenog projekta koji se provodio u Dječjem vrtiću Konavle. Želja za razvijanjem zajedništva djece rezultirala je provedbom niza aktivnosti ...povezanih s njegovanjem izvornih vrijednosti.
DIJETE U SUVREMENOME HRVATSKOM DRUŠTVU Julije Meštrovi, Julije Meštrović; Bralić, Irena; Buljan Flander, Gordana ...
Liječnički vjesnik,
10/2010, Volume:
132, Issue:
9-10
Journal Article
Peer reviewed
Open access
U Zagrebu je 12. prosinca 2009. održan simpozij »Dijete u suvremenome hrvatskom društvu«, koji su organizirali Hrvatsko pedijatrijsko društvo, Hrvatska akademija znanosti i umjetnosti, Ministarstvo ...zdravstva i socijalne skrbi i UNICEF za Hrvatsku. Predavači su prikazali važne podatke o teškoćama kojima su izložena djeca u Hrvatskoj. Naime, nove bolesti, koje su u suvremenom svijetu sve češće u djece, zahtijevaju od svih koji su uključeni u zdravstvenu zaštitu djece nove pristupe radu, što podrazumijeva i dodatnu edukaciju. To nisu bolesti uobičajene u svakodnevnoj liječničkoj praksi. Pristup društva, zbog raznolikosti teškoća s kojima se djeca suočavaju, može biti samo multidisciplinaran. Temeljni nacionalni interes društva je usmjeriti više pozornosti i financijska sredstva na zdravstvenu zaštitu djece, jer to osigurava opstanak i zdravu budućnost društva. Taj pristup zahtijeva nacionalni konsenzus i jasnu političku odluku svih odgovornih službi.
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