A validation study of appropriate phonological verbal fluency stimulus letters for use with Croatian speaking individuals [Fonološka verbalna fluentnost na hrvatskom uzorku: primjena testa, izbor podražaja i norme]

The aim of this study is to determine the word frequency for all thirty letters of the Croatian alphabet and to collect normative data for the letter fluency task in Croatian speakers. Ninety two healthy participants were given each of the Croatian letters, and asked to generate as many words as possible in 60 seconds for each letter. Results suggested that participants generated most frequently words starting with the letters as follows: »K«, »P«, »S« and »M«

Akutes post-traumatisches Streßsyndrom bei ehemaligen Kriegsgefangenen

The aim of the present study was to assess acute psychiatric disturbances in Croatian prisoners of war (POWs) released after 6-9 months of detention. Immediately (1-3 days) after exchange with the other side, 47 prisoners of war were examined at the Zagreb University Clinic for Infectious Diseases by a team of medical professionals to assess their physical and psychological health, and therapeutic needs. The team consisted of a general practitioner, surgeon, infectious diseases specialist, psychiatrist and clinical psychologist. All prisoners were active soldiers from Vukovar, and were of similar age, social background, combat activity and duration of detention. All were severely physically and psychically maltreated in the detention camp. Sixteen (34%) had symptoms of current post-traumatic stress syndrome as assessed by the Watsons PTSD questionnaire. In a structured clinical interview, all POWs reported at least 2 (average 8-9) symptoms of psychological disturbance. All POWs ranked the withdrawal of information on their families and the situation in Croatia as the most painful experience during detention. Minnesota Multiphasic Personality Inventory (MMPI-201 version) profiles of the prisoners of war showed a significant difference between the POWs with and without diagnosed PTSD on the paranoia scale. In conclusion, although only one third of the POWs released after 6-9 months of detention and torture had manifest PTSD, most had several symptoms of psychological disturbances with dominating anxiotic-depressive and psychosomatic reactions. Careful follow-up is needed to asses the extent and late consequences of polytrauma experienced by this high-risk group.Cilj ove studije bilo je utvrditi akutne psihičke poremećaje kod hrvatskih ratnih zatočenika puštenih nakon šest do devet mjeseci pritvora. Odmah nakon razmjene (jedan do tri dana) s drugom stranom, 47 ratnih zatočenika pregledala je na Zagrebačkoj sveučilišnoj klinici za zarazne bolesti skupina medicinskih stručnjaka kako bi utvrdila njihovo tjelesno i psihičko zdravlje te odredila liječenje. Skupinu je činio liječnik opće prakse, kirurg, stručnjak za zarazne bolesti, psihijatar i klinički psiholog. Svi su zatočenici bili pripadnici redovnih vojnih snaga iz Vukovara, bili su podjednake starosti, društvenog podrijetla, borilačke aktivnosti i trajanja pritvora. Svi su bili izloženi teškom tjelesnom i umnom zlostavljanju u zatočeničkom logoru. Šesnaest zatočenika (34 posto) pokazivalo je znakove akutnog sindroma posttraumatskog stresa utvrđenog Watsonovim PTSD upitnikom. U strukturiranom kliničkom upitniku svi su ratni zatočenici potvrdili bar dva (u prosijeku osam do devet) znakova pshihološkog poremećaja. Svi su zatočenici rangirali nedostatak obavijesti o svojim obiteljima i stanju u Hrvatskoj kao najbolnije iskustvo za trajanja pritvora. MMPI-201 (Minnesota Multiphasic Personality Inventory) profili ratnih zatočenika pokazali su značajnu razliku između zatočenika kojima jest i nije dijagnosticiran PTSD na ljestvici paranoje. U zaključku valja reći da je, iako je samo kod jedne trećine ratnih zatočenika puštenih nakon šest do devet mjeseci pritvora i mučenja utvrđeno postojanje PTSD, većina pokazivala nekoliko znakova psiholoških poremećaja s prevladavajućim anksiozno-depresivnim i psihosomatskim reakcijama. Potrebno je pažljivo pratiti ove rezultate kako bi se procijenili opseg i zakašnjele posljedice politraumatskih iskustava te visoko-rizične skupine.Ziel dieser Studie war, akute seelische Störungen bei kroatischen Kriegshäftlingen, die nach 6 bis 9 Monaten Internierung freigelassen wurden, zu ermitteln. Gleich nach dem Gefangenenaustausch (1-3 Tage später) untersuchte man in der Zagreber Universitätsklinik für Ansteckungskrankheiten 47 kroatische Kriegshäftlinge, um ihren körperlichen wie seelischen Zustand zu prüfen und erforderliche Behandlungsverfahren festzulegen. Das zuständige Ärzteteam bestand aus einem allgemeinen Arzt, einem Chirurgen, einem Facharzt für Ansteckungskrankheiten, einem Psychiater und einem klinischen Psychologen. Sämtliche ehemalige Kriegshäftlinge waren Mitglieder regulärer Militäreinheiten aus Vukovar, hatten annährend dasselbe Alter und denselben gesellschaftlichen Status, waren in den Kampfsportarten ausgebildet und verbrachten gleich lange in Kriegsgefangenschaft. Als Inhaftierte waren sie denselben körperlichen und seelischen Mißhandlungen ausgesetzt. 16 der ehemaligen Kriegshäftlinge (34%) wiesen Symptome eines akuten post-traumatischen Streßsyndroms auf, das anhand des Watson-Fragebogens ermittelt wurde. Nach diesem strukturierten, klinischen Fragebogen zeigten alle ehemaligen Kriegsgefangenen mindestens 2 (im Durchschnitt 8 bis 9) Symptome seelischer Störungen. Auch erklärten alle ohne Ausnahme, es sei die schmerzlichste Erfahrung während der Haft gewesen, daß sie nichts über ihre Angehörigen und über die Lage in Kroatien wußten. Gemäß dem MMPI-201 (Minnesota Multiphasic Personality Inventory) ergaben sich bedeutende Unterschiede zwischen den ehemaligen Kriegsgefangenen, denn gemessen an der Skala zur Ermittlung von Paranoia zeigten bestimmte Kriegsgefangene ganz klar das Bestehen von post-traumatischem Streßsyndrom, andere wiederum nicht. Abschließend muß gesagt werden, daß zwar nur ein Drittel der nach 6 bis 9 Monaten Kriegshaft und schweren Mißhandlungen freigelassenen kroatischen Soldaten Symptome eines post-traumatischen Streßsyndroms bekundete, daß aber bei den meisten von ihnen Anzeichen seelischer Störungen vorlagen, bei denen Angst- und Depressionszustände mit psychosomatischen Reaktionen überwogen. Diese Umfrageergebnisse müssen sorgfältig überwacht werden, um Umfang und verspätete Folgen mehrfacher traumatischer Erfahrungen dieser ausnehmend gefährdeten Risikogruppe beurteilen zu können

Key performance Indicator

In this thesis, we raised the issue of the overview of the departments' work process. In work process, several systems that store data in separate systems and databases are used. Due to data dispersion across different systems work process overview is unclear and time consuming. We developed software solution that enables gathering of data from databaes and application programming interfaces on several systems. Solution also features data analysis and its presentation as Key Indicators in web interface. Web interface is designed for graphic and data display of certain information that department managers can use for optimizing work process of the department on one and comprehensive overview of Key Indicators of the department on the other hand. KPI displays information from different systems as it combines all the key information needed to review the work of the Technical Support department in particular

Alzheimer’s Dementia: Current Data Review

The review focuses on current data on Alzhemier’s dementia, a clinical syndrom characterised with acquired deterioration of cognitive functioning and emotional capacities, which impaires everyday activity and quality of life. Alzheimer’s dementia is the most common type of dementia in clinical surveys. The diagnosis of Alzheimer’s dementia is primarily based on symptoms and signs and memory impairment is clinically most signifficant. Cholinesterase inhibitors – donepezil, rivastigmine and galantamine are considered to be the first line pharmacotherapy for mild to moderate Alzheimer’s disease. Currently, no effective pharmacologic interventions have been researched enough to support their use in prevention of Alzheimer’s dementia. Studies suggest that healthy lifestyle, ongoing education, regular physical activity, and cholesterol control, play a role in prevention of Alzheimer’s dementia

Morality, honesty, justice and primum non nocere - From the point of view of a psychiatrist

U radu se žele prikazati neki aktualni problemi i dileme ne o tome što je moralnost, čestitost i poštenje već sušta aktualna realnost kako da liječnik u svojoj svakodnevnoj praksi iznađe pragmatični izlaz i rješenje paradigme primum non nocere a bez namjere da relativizira ostale vrijednosne sustave i ljudsko dostojanstvo. Moralnost se po definicijama pojedinih autora razlikuje, no čini se da je vrlo obuhvatna, prihvatljiva i vrlo jasna definicija koja kaže da je moral, skup društvenih normi koje su u skladu s određenim poimanjem dobra, te da je uz to i pravo i obveza pojedinca da živi i ponaša se po principima čestitosti i poštenja te da bude korektivni čimbenik i drugima. U radu je prikazana realna situacija odnosa liječnik-bolesnik u uvjetima današnje psihijatrije sa stajališta kako ostati ili postati moralan prema svojim bolesnicima s nekoliko pristupa: odnos prema konkretnom bolesniku, zaštita prava, dostojanstva i interesa bolesnika ali i liječnika terapeuta, kako se nositi sa zakonodavstvom i duševnom bolesti i ponašanjem duševno bolesnih te moralnošću i vlastitom savješću. Posebno su prikazani problemi etičke dileme aktualno često opisivanih kliničkih studija ispitivanja lijekova sa stajališta duševnih bolesnika i uloga psihijatra kao sudskog vještaka.The article aims to present some contemporary problems and dilemmas, not about what is morality, rectitude and honesty, but what is the essential contemporary reality of how a physician in his everyday practice finds a pragmatical outcome and resolution of the paradigm primum non nocere, however without intention to relativise other value systems and human dignity. Still, we can state that morality, as defined by some authors, differs, but it seems that a very comprehensive, acceptable and clear definition would be that which considers that morality is an ensemble of social norms which are in harmony with a certain concept of goodness, and that it is also the right and obligation of an individual to live and behave according to principles of rectitude and honesty and to be thus a corrective factor for others. The article presents the real situation of the relationship physician – patient in circumstances of today\u27s psychiatry from the viewpoint of how to remain or become moral towards one\u27s patients by several approaches: relationship with a specific patient, protection of his rights, dignity and interests, as well as of those of the therapist - how to deal with legislation and the psychical illness and the behaviour of psychically sick patients and his own morality and consciousness. Problems and ethic dilemmas of today\u27s frequently described clinical studies on drug tests from the standpoint of psychically sick persons and the role of psychiatrist as court expert are especially presented