Path Analysis of Familial Resemblance in Blood Pressure in Middle Dalmatia, Croatia

The familial resemblance in blood pressure in Middle Dalmatia, Croatia, has been analyzed using the Path-analytic approach. The sample consisted of 1,126 examinees (526 males and 600 females, aged 17 to 87), inhabitants of the Middle Dalmatia’s islands of Bra~, Hvar, Kor~ula and the Pelje{ac peninsula. The Path analysis was performed with the assumption that each family member (father, mother, offspring 1 and 2) has a latent variable (C) that influences both the blood pressure values (P) and the morphological dimensions significantly correlated with blood pressure (Q). According to the estimates revealed from the most parsimonious models, the diastolic blood pressure has a more pronounced genetic component (h2 = 30–32%) than the systolic blood pressure (h2 = 15%). In contrast to the low intergenerational influences, the members of the same generation showed pronounced effects of shared environment. Common (non-transmitted) offsprings’ environment (B) explains 44% of variance of the individual offspring’s environment (C) in systolic and 33–35% in diastolic blood pressure. The correlation of father’s and mother’s environment (u2) was high in the case of diastolic blood pressure (33–44%) but for the systolic blood pressure it was not significantly different from zero. According to the presented results in insular/peninsular population of Middle Dalmatia, family resemblance of systolic and diastolic blood pressure differs. The resemblance is higher in diastolic blood pressure with stronger additive genetic component and stronger environmental and/or genetic component related with morphology. The sources of high heritability of diastolic blood pressure in Middle Dalmatia as well as the sources of high prevalence of hypertension in the same population are the phenomena that might be connected and thus deserve to be further explored in incoming analyses

Javno zdravstvo i primarna zdravstvena zaštita: mogućnosti i izazovi

Public health and primary health care are two vital components of the sustainability of healthcare systems. Although their collaboration is crucial, their integration remains a major challenge for many countries worldwide. Public health primarily aims to prevent diseases and injuries at the population level, while primary health care provides basic healthcare system services to individuals, with health promotion at the very core of both. Although it is difficult today to draw clear boundaries between public health and primary health care, as there is much overlap, there is an obvious gap between them. The path to successful collaboration between public health and primary health care requires an understanding of their respective roles and responsibilities, communication and coordination strategies, and the development of shared goals and values, and only through such successful collaboration is it possible to achieve their integration. By leveraging their respective strengths and working together, public health and primary health care can optimise resource utilisation, enhance health outcomes, and foster health equity, ultimately leading to universal health coverage, which is the first path to sustainability. One key connecting element between public health and primary health care is disease prevention, which can serve as their bridge. Through collaborative efforts, these fields can develop comprehensive strategies to address the social determinants of health, promote healthy behaviours, and ensure equitable access to high-quality healthcare system services. By adopting an integrated approach, this collaborative effort can enhance health outcomes, mitigate disease burdens, and advances health equity for both the population and individuals.Javno zdravstvo i primarna zdravstvena zaštita dvije su ključne sastavnice održivosti zdravstvenih sustava. Iako je njihova suradnja ključna, njihova integracija i dalje je velik izazov za mnoge države diljem svijeta. Javno zdravstvo prvenstveno ima za cilj sprječavanje bolesti i ozljeda na razini stanovništva, dok primarna zdravstvena zaštita pruža osnovne usluge zdravstvenog sustava pojedincima, pri čemu oboje u svojoj samoj srži imaju promicanje zdravlja. Iako je danas teško povući jasnu granicu između javnog zdravstva i primarne zdravstvene zaštite jer se uveliko preklapaju, očit je jaz između njih. Put do uspješne suradnje između javnog zdravstva i primarne zdravstvene zaštite zahtijeva razumijevanje njihovih uloga i odgovornosti, komunikacijske i koordinacijske strategije te razvoj zajedničkih ciljeva i vrijednosti, a samo takvom uspješnom suradnjom moguće je ostvariti njihovu integraciju. Iskorištavanjem svojih snaga i zajedničkim radom, javno zdravstvo i primarna zdravstvena zaštita mogu postići najbolju iskoristivost dobara, poboljšati zdravstvene ishode te poticati zdravstvenu pravednost, što u konačnici dovodi do sveopće zdravstvene pokrivenosti koja je prvi korak na putu ka održivosti. Jedna od ključnih poveznica između javnog zdravstva i primarne zdravstvene zaštite jest sprječavanje bolesti, što može poslužiti kao njihov most. Kroz zajedničke napore, ova područja mogu razviti sveobuhvatne strategije za rješavanje društvenih odrednica zdravlja, promicanje zdravog ponašanja i osiguranje ravnopravnog pristupa visokovrsnim uslugama zdravstvenog sustava. Primjenom integriranog pristupa, ovaj zajednički napor može poboljšati zdravstvene ishode, ublažiti opterećenje bolestima te poboljšati zdravstvenu jednakost kako za stanovništvo tako i za pojedince

Morfološke i hemodinamske karakteristike vertebralnih arterija kod muškaraca i žena

Introduction: Men and women differ in diameters and MBFVs in VAs. Aim: to compare morphology and hemodynamics of VAs between sexes. Patients and methods: We examined 155 subjects using a linear 7.5 MHz probe (Aloka Prosound SSD-5500). Measurements were obtained at the V2 segment of VAs. Criteria: VA diameter of 2-4mm, systolic MBFVs of 0.35-0.70m/s, normal resistance pattern. Investigated parameters: diameters of VAs, MBFVs in VAs, sum of VA diameters, sum of MBFVs in VAs, diameter of the narrower and wider VA, and age. Results: 68 men and 87 women; 88 with a dominant left VA (56% of men and 58% of woman), 11 (7%) showed no dominance. Group differences: men had both VAs wider, and a larger diameter of the “wider” VA. There were no differences in MBFVs between men and women. Conclusion: Left VA is dominant in both sexes. There was no difference in MBFVs among sexes. Men have a wider VA than women.Uvod: Muškarci i žene se razlikuju u promjerima i srednjim brzinama strujanja krvi (SBSK) u vertebralnim arterijama (VA). Cilj: usporediti morfologiju i hemodinamiku VA među spolovima. Ispitanici i metode: Pregledali smo 155 osoba upotrebom linearne sonde 7,5 mHz (Aloka Prosound SSD-5500). Mjerenja su vršena u V2 segmentu VA. Kriteriji: VA dijametar 2-4mm, sistoličke SBSK 0,35-0,70m/s, normalan otpor. Mjereni parametri: promjeri VA, SBSK u VA, ukupni promjeri VA, ukupne SBSK u VAs, promjeri “uže” i šire VA, i dob. Rezultati: 68 muškaraca i 87 žena; 88 dominantnih lijevih VA (56% muškaraca i 58% žena), 11 (7%) bez dominacije. Razlike među grupama: muškarci imaju šire obje VA i promjer “šire” VA. Nije bilo razlika u sbsk među spolovima. Zaključak: Lijeva VA je dominantna u oba spola, nema razlika u SBSK među spolovima. Muškarci imaju šire VA od žena

Zdravstveno rizična ponašanja i zdravlje stanovništva Hrvatske starijeg od 50 godina

Recent data indicate that self-rated health among Croatians is substantially lower, and the gender gap more pronounced, than the EU28. Thus, our study aims to test the sex-specific associations of various health-risk characteristics with subjective and objective health in the Croatian population aged 50 and older (2,436 individuals, cross-sectional SHARE Wave 6 dataset). The logistic regression analyses were performed on health-risk behaviours (nutrition, physical activity, smoking, and alcohol consumption), together with the selected socioeconomic variables and the quality of life scale (CASP-12). The study revealed the importance of vigorous physical activity and the CASP score as being consistently relevant for objective and subjective health in both sexes. Univariate associations of the majority of health- -risk behaviours and health have disappeared from the multivariate model; we have thus concluded that they are often a proximate reflection of underlying economic and psychosocial factors. Furthermore, our findings support the necessity of country-specific health-risk research since the relevance of particular health risks can be considered culturally specific.Noviji podaci pokazuju da je samoprocjena zdravlja stanovnika Hrvatske značajno niža i da je razlika po spolu naglašenija nego u EU28. Stoga je cilj ove studije bio ispitati odnos raznih karakteristika povezanih sa zdravljem sa dva pokazatelja zdravlja (subjektivnog i objektivnog) u stanovništvu Hrvatske starijem od 50 godina (2436 osoba, presječno istraživanje studije SHARE, 6. val). Analize logističke regresije napravljene su primjenom značajki ponašanja (prehrana, tjelesna aktivnost, pušenje, konzumacija alkohola), uz uključivanje odabranih društvenih i ekonomskih varijabli, te skale procjene kvalitete života (CASP-12). Nalazi upućuju na važnost intenzivne tjelesne aktivnosti i samoprocjene kvalitete života (CASP skala) kao dva obilježja koja su se konzistentno pokazala važnima za objektivno i subjektivno zdravlje u oba spola. Kako je univarijatna povezanost većine ispitivanih elemenata ponašanja i zdravlja nestala u multivarijatnom modelu, zaključujemo da je takva povezanost samo neposredan odraz ekonomskih i psihosocijalnih čimbenika koji stoje u podlozi određenoga zdravstveno rizičnog ponašanja. Rezultati ove studije pružaju dodatni argument za potrebu provedbe istraživanja zdravstvenih rizika unutar svake države posebno, jer je važnost određenih obilježja očito kulturno specifična

Hipoplazija vertebralne arterije: značajke u uzorku hrvatske populacije

Vertebral arteries are responsible for 1/3 of the brain blood supply, supplying primarily posterior parts of the brain. About 15% of all strokes occur in posterior parts of the brain, which should be kept in mind when dealing with disorders that can cause hemodynamic changes in vertebral arteries. Vertebral artery hypoplasia (VAH) is an inborn abnormality of vertebral artery defined by smaller lumen diameter and lower blood flow velocities, and is most commonly found in healthy subjects. The aim of this study was to establish the characteristics of VAH in a Croatian population sample, and to determine differences in its presentation according to sex and affected side. Study results may prove valuable for future identification of individuals at an increased risk of cerebrovascular incidents or traumatic injuries that could lead to adverse changes of posterior circulation. Color Doppler flow imaging (CDFI) reports of 277 patients were analyzed. All measurements were obtained in the V2 segment of vertebral artery, between the C6-C5 vertebrae, using a linear 7.5 MHz probe on an Aloka Prosound SSD-5500. The criteria for normal vertebral arteries were lumen diameter of 2.5-4.5 mm, systolic mean blood flow velocity of 0.35-0.70 m/s, and normal resistance pattern. Study results showed the left vertebral artery to be dominant in 57% of study subjects, VAH to be more common in women, and right vertebral artery to be more often involved by hypoplasia than the left one. The width of the .wider. vertebral artery was greater in the group with VAH, suggesting a way of the deficit compensation. The study demonstrated that the deficit caused by VAH cannot be fully compensated for despite larger arterial diameter.Vertebralne arterije čine 30% krvne opskrbe mozga, opskrbljujući pretežito stražnje dijelove mozga. Petnaest posto svih moždanih udara nastaje u stražnjim dijelovima mozga, stoga je važno imati na umu značenje poremećaja koji uzrokuju hemodinamske promjene u vertebralnim arterijama. Hipoplazija vertebralne arterije je urođeno stanje koje obilježava uži lumen krvne žile i snižene srednje brzine strujanja krvi. Najčešće je prisutna kod zdravih pojedinaca. Cilj ovoga istraživanja bio je ustanoviti prisutnost i značenje hipoplazije vertebralne arterije u hrvatskoj populaciji, odrediti njenu pojavnost među spolovima i prema strani na kojoj se pojavljuje. Vjerovanja smo da je ovo istraživanje vrijedno zbog buduće lakše identifikacije pojedinaca izloženih većem riziku od nastanka cerebrovaskularnih poremećaja ili ozljeda koje mogu dovesti do problematičnih promjena u stražnjoj cirkulaciji. Analizirali smo nalaze 277 ispitanika. Sva mjerenja su izvedena u segmentu V2 vertebralne arterije, najčešće između vratnih kralježaka C6 i C5, upotrebom linearne sonde od 7,5 mHz na uređaju Aloka Prosound SSD¬5500. Kriteriji za uredan nalaz CDFI nad vertebralnim arterijama su: promjer vertebralne arterije od 2,5-4,5 mm, sistolične srednje brzine strujanja krvi od 0,35-0,70 m/s i zadovoljavajući cirkulacijski otpor u vertebralnim arterijama. Dobiveni rezultati su pokazali da je lijeva vertebralna arterija dominantna kod 57% ispitanika, hipoplazija vertebralne arterije češće zahvaća žene, a desna vertebralna arterija je češće hipoplastična od lijeve. Također, širina "šire" vertebralne arterije je veća kod ispitanika s hipoplazijom vertebralne arterije, što bi moglo upućivati na mehanizam kompenzacije deficita uzrokovanog hipoplazijom. Ovo istraživanje je pokazalo kako unatoč većoj širini nehipoplastične vertebralne arterije nije moguće u potpunosti nadoknaditi nedostatak uzrokovan hipoplazijom

Impact Analysis of a Regional Scientific Journal (1980–2000): Supporting Promising Local Researchers Pays the Greatest Dividends

During the past 28 years, the journal »Collegium Antropologicum« has continuously served as one of the main disseminators of anthropological scientific production in Central and Eastern Europe. The journal was committed to its role of a multidisciplinary platform for presenting wide range of research topics relevant to anthropology, from investigations within social and cultural anthropology and archaeology to those covering contemporary population genetics, human evolution and biomedical issues. Two key strategies aimed at sustaining and increasing the impact of this journal were oriented towards: i) identification of promising local groups of researchers who were at disadvantageby many aspects (e.g. educational curricula, financial supports, language barriers etc.) when trying to publish their research internationally, and ii) invitation and encouragement of already established international scientists to make contributions for »Collegium Antropologicum«. From 1980–2000, 89 articles (or 6.3% of all published papers duringthat period) were cited 6 or more times, contributing disproportionately to journal’s impact (nearly a third of all citations received). In an attempt to identify such papers more readily among the submissions to the journal in the future, we analyzed research topics and affiliations of the authors among the 89 papers receiving most citations in comparison to all papers published. Among the papers most frequently cited, we found greater-than-expected prevalence of Croatian researchers (especially when publishing in collaboration with international scientists) and studies of special populations. Several papers received more than 25 citations or had overall citation intensity greater than 2 per year.This implies that an interesting article from a local group of researchers can still resonate with international audience although published in a regional journal. Present analysis supports current editorial strategy that with a help of the international .consulting editorial board continuously improves international recognition of this journal. The results imply that a balanced encouragement to promising local groups of researchers and to contributions of already established international scientists is a strategy superior to others in maintaining and increasing the impact of this regional journal

Are the Physically Active Adolescents Belonging to the »At Risk of Overweight« BMI Category Really Fat?

The adolescence is recognized as one of the critical periods for the development of obesity. Children and adolescents who practice sports regularly have higher muscle mass and lower percentage of body fat than their peers who are physically less active. Since body mass index (BMI) is a widely used indicator of overweight/obesity in spite of the fact that it directly measures excess in weight but not in fat, it often misclassifies athletic populations, both children and adults. The specific aim of this study was to evaluate whether BMI adequately assesses fatness in adolescents, especially physically active ones. The analysis was performed on anthropometric data from two surveys (1997 and 2009/2010) of Zagreb secondary school adolescents, 1315 girls and 1034 boys, aged 15–19 years. The group defined as »physically active« consisted of adolescents who practice organized sports (36.2% girls, 44.6% boys), while the »physically inactive« group was made of their peers who practice sport only as a part of physical education in schools. The standardized values, calculated within each sex by survey, were used for comparison of adolescents with different levels of physical activity. Physically active adolescents of both sexes had lower sum of skinfolds mean Z-values (pgirls<0.05, pboys<0.001); additionally, boys had higher Z-values for body weight (p<0.05) and triceps/subscapular ratio (indicating peripheral distribution of body fat) (p<0.05) than their less active peers. In order to evaluate whether BMI was adequate indicator for body composition during adolescence, we estimated the concordance of above-median category defined by BMI and the other body fat indicators. The largest discrepancy was found for sum of skinfolds in both sexes and was more pronounced in physically active adolescents. This finding was further confirmed in more extreme BMI category (85th – 95th percentile) which indicated that adolescents categorized as »at risk of overweight« were predominantly characterized by larger lean body mass and not by increased fatness