The aim was to perform adaptation and validation of the Perceived Implicit Rationing of Nursing Care. Implicit delaying of nursing care is an intermediate step, linking nurses with the quality of ...outcomes for patients and nurses, and it is the result of prioritization of health care measures within the assigned group of patients cared for by nurses. The Perceived Implicit Rationing of Nursing Care instrument is a tool used to assess the rationing of care in nursing practice. Study participants were nurses working at hospital wards in 4 university hospitals in the Republic of Croatia. The questionnaire was filled-in by 438 nurses. Data were collected between April and November 2018. After principal axis factoring, a single factor solution based on the correlation matrix was adopted. The measured construct is one-dimensional, and the extracted factor explains 47.2% of its variance. Additionally, the reliability of the whole questionnaire was determined by using the internal consistency coefficient Cronbach alpha on the Perceived Implicit Rationing of Nursing Care with 31 of 0.96 particles, which is extremely high internal consistency reliability. In conclusion, the study found a high level of reliability and validity of the translated Perceived Implicit Rationing of Nursing Care questionnaire, fully comparable to that of the original. The questionnaire can be used to assess the phenomenon of implicit care rationing in Croatian hospitals.
Aging interventions will be ineffective if we do not understand the basic principles of aging. Currently, there is no consensus on the issue whether aging is programmed or not. The hypothesis ...presented in this article indicates that aging (at least graying of male hairs) is programmed. This hypothesis is supported by the symmetry of the graying of male beard hairs. According to stochastic theories of aging, aging is a passive non-programmed process where random dispersion of graying hairs should result. On the contrary, programmed theories of aging would predict that there should be symmetry on the left and right parts of the face showing the same proportion, pattern and time of appearance of graying hairs.
Inflammatory bowel disease (IBD) patients with vitamin D deficiency show an increased risk of hospital admission, surgery, and loss of response to biologic therapy while high vitamin D levels are ...identified as a protective factor. Our goal was to investigate the prevalence of untreated and undertreated vitamin D deficiency and factors associated with vitamin D deficiency. In this cross-sectional study, we measured serum vitamin D in a random sample of Caucasian IBD patients. Vitamin D deficiency was defined as <50 nmol/L and insuficiency as 50-75 nmol/L. Supplementation was defined as taking 800-2000 IU vitamin D daily. Untreated patients were defined as not taking supplementation and undertreated group as receiving supplementation but showing vitamin D deficiency or insuficiency despite treatment. Our study included 185 IBD patients, i.e. 126 (68.1%) with Crohn's disease (CD) and 59 (31.9%) with ulcerative colitis (UC). Overall, 108 (58.4%) patients had vitamin D deficiency and 60 (32.4%) patients vitamin D insuficiency. There were 16 (14.8%) and 11 (18.3%) treated patients in vitamin D deficiency and vitamin D insuficiency group, respectively. The rate of untreated patients was 81.7% (n=49) in vitamin D deficiency group and 85.2% (n=92) in vitamin D insuficiency group. Tumor necrosis factor alpha inhibitors were associated with higher serum vitamin D levels in CD and UC, and ileal involvement, ileal and ileocolonic resection with lower levels. In conclusion, not only is vitamin D deficiency common in IBD patients but the proportion of untreated and undertreated patients is considerably high. We suggest regular monitoring of vitamin D levels in IBD patients regardless of receiving vitamin D supplementation therapy. Key words: Inflammatory bowel diseases; Vitamin D deficiency; Crohn's disease; Colitis, ulcerative
Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing prevalence worldwide due to its close association with the epidemic of obesity. Currently there is no ...standardized pharmacological treatment, and the only proven effective therapeutic strategy is lifestyle modification, therefore it is important to determine the potential dietary targets for the prevention and treatment of NAFLD. We assessed nutritional status in 30 patients diagnosed with NAFLD using anthropometric parameters, hand grip strength, and lifestyle and dietetic parameters (physical activity, NRS2002 form and three-day food diary). The mean body mass index was 29.62±4.61 kg/m2, yielding 86.67% of obese or overweight patients. Physical activity results indicat-ed poorly active subjects. Excessive energy intake was recorded in 27.78% of patients. The mean in-take of macronutrients was as follows: 15.5% of proteins, 42.3% of carbohydrates and 42.2% of fat, with -deficient micronutrient intake of calcium, magnesium, iron, zinc, and vitamins A, B1 and B2. The -results showed that the quality of nutrition in study subjects was not accordant to current rec-ommendations and that they consumed a high proportion of fat, especially saturated fatty acids, along with low micronutrient intake. The results obtained might point to the importance of unbalanced diet as a contributing factor in NAFLD development.
The role of T regulatory lymphocytes (T
) particularly in cancer is well known. The goal of the present study was to determine the contribution of these lymphocytes in the regulation of anti-tumor ...immunity of CBA/HZgr mice against MC-2 fibrosarcoma (4
generation of methylcholanthrene induced tumor). The levels of T lymphocytes (CD4+, CD8+ and CD4+CD25+) were determined 8 and 20 days after tumor transplantation. Further, the role of CD4+CD25+ (T
) in tumor-host interaction was evaluated
and
by using specific monoclonal antibodies. We found that splenocytes of both control and T
depleted tumor bearing mice strongly but differently inhibited growth of tumor cells
. While splenocytes of untreated mice exhibited significant decrease of this activity (from 74.4% to 62.6% and 32.95%), the splenocytes of T
depleted mice showed increase of this activity (from 79.5% to 84.3% and 86.2%) from day 6 to day 13 and day 21 after tumor grafting, respectively. Further, upon i.v. injecting specific monoclonal anti-T
antibody tumor immediately prior to tumor cell intracutaneous transplantation, the tumor was rejected after initial growth. In treated mice, the incidence of T
cells was very low initially, reaching normal values two weeks later. These animals were shown to be resistant to tumor transplantation four months later.
Pulmonary hypertension (PH) is a chronic disease which severely impairs quality of life (QoL). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the first disease-specific tool to ...assess patient-reported symptoms, functioning and QoL in PH patients. The aim of this study was to adapt and validate the CAMPHOR for use in Croatia. The adaptation process involved three stages: translation (bilingual and lay panel), cognitive debriefing interviews with patients and psychometric validation. For the latter stage, a postal survey was conducted with 50 patients to examine the reliability and validity of the adapted scale. All three scales of the Croatian CAMPHOR demonstrated excellent internal consistency (Symptoms = 0.93; Activity limitations = 0.94; QoL = 0.92) and test-retest reliability correlations (Symptoms = 0.90; Activity limitations = 0.95; QoL = 0.90). Predicted correlations with the SF-36 scales provided evidence for construct validity of the CAMPHOR scales. Evidence for known group validity was shown by the ability of the scales to distinguish between participants based on patient-perceived general health and disease severity. The Croatian version of the CAMPHOR is a valid and reliable tool for use in clinical routine and clinical research.
To determine the efficacy of paracetamol and tramadol analgesia via patient controlled pump and intermittent administration using the Short-Form McGill Pain Questionnaire after L4/L5 discectomy in ...neurosurgical patients.
Fourteen months prospective quantitative study with 200 neurosurgical patients' participation who underwent elective discectomy of the L4/L5 intervertebral disc extrusion. The study was conducted due to a patient-controlled analgesia pump and intermittent analgesia application. Pain was assessed using the Short-Form McGill Pain Questionnaire in the Croatian language during the zero, first, and second postoperative day.
Perception of pain was reduced in patient controlled analgesia pump groups after the second measurement during the first postoperative day 95% CI: −3.89, −0.76, regardless of administered analgesic (p< 0.001). After the final measurement, at 7 PM on the second postoperative day, the differences were not significant (p= 0.070). This study results are registered and allocated in the Australian New Zealand Clinical Trials Registry (ANZCTR).
Analgesia administration via patient-controlled pump contributes to the alleviation of postoperative pain after L4/L5 disc extrusion surgery regardless of administered analgesic.
An international exchange program is an increasing phenomenon across Europe. Any opportunity for students to work or study abroad whilst undertaking their degree program could have a positive impact ...on their well-being, professional development, and general competences.
The study was conducted on a cohort of 99 nursing students from the School of Nursing, who were followed before and after a one-month Erasmus+ mobility period. Quantitative data were collected using a sense of coherence, subjective well-being, and sociodemographic characteristics questionnaire. Qualitative data were collected using open-ended questions and interviewing the focus group.
Student mobility did not significantly alter their sense of coherence or subjective well-being. A significant positive correlation before and after mobility occurred between the sense of coherence, subjective well-being, and school success. According to the qualitative analysis, the students' experiences were overall positive and stimulating, with many of them noticing better working conditions abroad.
Although the international mobility of nursing students does not affect their sense of coherence and subjective well-being, it does contribute to changes in certain attitudes related to the profession and living conditions abroad. These findings may prove helpful in planning future mobilities during more favorable periods when school obligations are fewer.
This review article is focused on the impact of antioxidants and prooxidants on health with emphasis on the type of antioxidants that should be taken. Medical researchers suggest that diet may be the ...solution for the control of chronic diseases such as cardiovascular complications, hypertension, diabetes mellitus, and different cancers. In this survey, we found scientific evidence that the use of antioxidants should be limited only to the cases where oxidative stress has been identified. This is often the case of specific population groups such as postmenopausal women, the elderly, infants, workers exposed to environmental pollutants, and the obese. Before starting any supplementation, it is necessary to measure oxidative stress and to identify and eliminate the possible sources of free radicals and thus increased oxidative stress.
To compare the effect of intermittent tramadol dosing vs tramadol administration via patient-controlled pump on pain after lumbar discectomy.
This randomized prospective study enrolled 100 patients ...who underwent elective LIV-LV lumbar discectomy in the neurosurgery department at Sestre Milosrdnice University Hospital Center from May 2016 to July 2017. Patients were randomized to receive either tramadol (600 mg daily) via a patient-controlled analgesia (PCA) pump or intermittently. Pain was evaluated by the Croatian version of Short-Form McGill Pain Questionnaire.
Forty percent of patients were women. The median (interquartile range) age of the patients was 51 (40-61) years. The groups did not differ in pain at 7 pm on the day of discectomy. However, in the morning and evening on the first postoperative day and in the morning and evening of the second postoperative day, the PCA group had significantly lower pain (P=0.023, P<0.001, P<0.001, P=0.026, respectively).
This is the first study that used the Short Form McGill Pain Questionnaire to compare the effect of tramadol administration via PCA pump and intermittent administration on pain after LIV-LV discectomy in a neurosurgery department. Tramadol showed a good analgesic efficacy in lumbar spine surgery; tramadol via PCA controlled pain more effectively than intermittently administered tramadol.
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