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.
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.
Institucionalna igra moči Sedmak, Mateja; Medarić, Zorana
Javnost (Ljubljana, Slovenia),
12/10/2018, 2018-12-10, Volume:
25, Issue:
sup1
Journal Article
Peer reviewed
Prispevek obravnava izkušnjo nasilja migrantk v okviru zdravstvenega sistema, natančneje na področju spolnega in reproduktivnega zdravja. Osredotoča se na institucionalno nasilje v obliki ...diskriminatornih praks, omejitev v dostopu do pravic, kršenja pravic, zlorabe moči zdravstvenega osebja in drugo. Rezultati kvalitativne študije, izvedene med zdravstvenim osebjem in migrantkami na območju treh obalnih občin, izpostavijo obstoj diskriminacije, nesprejemanje drugačnih kulturnih praks ravnanja in omejitve v dostopu do ustrezne zdravstvene obravnave. Pri tem so ključni komunikacijski izzivi, ki izvirajo iz nepoznavanja slovenskega jezika, (posledično) slaba informiranost migrantk ter otežen dostop do (ustreznih) zdravstvenih storitev. Problematično je tudi pomanjkanje medkulturnih kompetenc zdravstvenega osebja in primanjkljaj sistemskih rešitev na področju spolnega in reproduktivnega zdravja, ki bi naslavljale migrantke.
SAŽETAK
Rad donosi analizu okolnosti pojave prvih eugeničkih rasprava na području Hrvatske od kraja devetnaestog stoljeća do 1918. godine. Na temelju uvida u radove objavljene u Liječničkom vjesniku ...pokazalo se da se eugenička razmatranja najčešće pojavljuju u liječničkim raspravama o tzv. socijalnim bolestima (tuberkuloza, sifilis, alkoholizam), a u kontekstu tada aktualnih javnozdravstvenih politika. Hrvatski su liječnici, slijedeći Lamarckovu pretpostavku o nasljeđivanju stečenih svojstava, vjerovali da se poboljšanjem socijalno-higijenskih uvjeta i edukacijom, ali i prisilnim mjerama poput zabrane braka može utjecati na zdravlje nasljednog materijala te time spriječiti degeneracija naroda. Njihova su polazišta individualnog karaktera i nisu dovela do utemeljenja eugeničkih društava ili razrađenih eugeničkih programa, no utjecala su na ranu institucionalizaciju hrvatske medicine. Eugeničke koncepcije koje inzistiraju na nacionalnom prosperitetu putem biološkog osnaženja nadovezivale su se na južnoslavenski politički projekt te retorički, simbolički i ideološki oponirale Habsburškoj monarhiji.
The plague epidemics that ravaged the Habsburg Monarchy from 1677 to 1716 strongly influenced the development of health institutions and the organization of a public health system. Primarily, there ...was a need to employ a larger number of educated medical doctors and to establish institutions that would deal with health and epidemiological issues, especially during the epidemics. In 1710, Emperor Joseph I established the Court Sanitary Commission (Sanitäts-Hofkommission), which would soon become the central public health institution in the Habsburg Monarchy. Research of historical documents has shown that two other institutions were especially important for the Croatian-Slavonian lands during the epidemic of 1708-1716: the Court War Council in Vienna, and from 1710 the Hauptdeputation in Contagionssachen in Graz. It is evident from the mentioned documents that the Deputation, as the main (Haupt-) Inner Austrian anti-epidemic institution, also coordinated the anti-epidemic activities in Banal Croatia and the Varaždin Generalate. The plague epidemic in the Habsburg Monarchy from 1708 to 1716 is very important in this sense, because the experience and structure of the anti-epidemic system built at that time were the basis for the establishment of a later permanent system of Sanitary Commissions and Sanitary Cordon, which began in the 1730s and was fully formed with the enactment of the General Health Act (Generale Normativum in Re Sanitatis) in 1770. These experiences proved to be especially useful for Banal Croatia, which was not affected by the plague epidemic of 1708-1716 due to the anti-epidemic measures.
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