Schooling of children with disabilities

Svako dijete s teškoćom u razvoju kojem je potrebna odgojno-obrazovna podrška mora imati pristup redovnim školama i pravo uključivanja u besplatno osnovno i srednjoškolsko obrazovanje. Utvrđivanjem psihosomatskog stanja djeteta, timskom sintezom sa stručnim suradnicima škole (psiholog, pedagog, defektolog i dr.), specijalist školske i sveučilišne medicine daje mišljenje o odgovarajućem obliku školovanja i potpore djetetu, prilagodbi uvjeta školovanja sukladno potrebama osoba s narušenim zdravljem, pruža potporu i vođenje kroz sustav školovanja uz očuvanje i unapređenje zdravlja. Postupkom utvrđivanja psihosomatskog stanja djece za polazak u prvi razred osnovne škole u Splitsko dalmatinskoj županiji (SDŽ) šk. god. 2015./16., zbog razvojnih smetnji odgođen je upis za 8,23% od ukupno pregledanih, dok je među svim učenicima osnovne škole nađeno 1,36% djece s teškoćama koja su se školovala po utvrđenom, primjerenom obliku školovanja temeljem Rješenja Ureda državne uprave u SDŽ. Od takvih učenika 73,33% je kasnije upisalo trogodišnje strukovne škole, a 26,67% četverogodišnje. Djeca i mladi s razvojnim smetnjama zahtijevaju uključujuće obrazovanje, rehabilitacijske i terapijske postupke, podršku profesionalaca, obitelji i društva, kako bi im omogućili pozitivne obrazovne ishode, socijalnu uključenost i očuvanje psihosomatskog zdravlja.Children with developmental disabilities must have access to free, regular elementary and middle schooling, with adequate educational support. School medicine specialist in cooperation with other experts (e.g. pedagogue, psychologist, defectologist etc.) determines the psychosomatic profile of the disabled person, advises about the most appropriate, individualized curriculum and educational support with general health improvement. During the psychosomatic assessment of preschool children for 2015/16 school year in Split-Dalmatian County, the enrolment was postponed for 8.23% of the examined. Some developmental disability had 1.36%, of the school children attending a preset, appropriate program, defined by the County authorities. Majority (73.33%) of the pupils were later matriculated to a 3-year, and 26.67% to a 4-year vocational colleges. Croatian national framework curriculum provides equal opportunities for handicapped pupils to participate in the educational process in accordance with their capabilities together with their peers, with professional, familial and societal support, assuming they can develop proper potentials in accordance with their learning (cognitive, affective, motivational, social) requirements

Schooling of children with disabilities

Svako dijete s teškoćom u razvoju kojem je potrebna odgojno-obrazovna podrška mora imati pristup redovnim školama i pravo uključivanja u besplatno osnovno i srednjoškolsko obrazovanje. Utvrđivanjem psihosomatskog stanja djeteta, timskom sintezom sa stručnim suradnicima škole (psiholog, pedagog, defektolog i dr.), specijalist školske i sveučilišne medicine daje mišljenje o odgovarajućem obliku školovanja i potpore djetetu, prilagodbi uvjeta školovanja sukladno potrebama osoba s narušenim zdravljem, pruža potporu i vođenje kroz sustav školovanja uz očuvanje i unapređenje zdravlja. Postupkom utvrđivanja psihosomatskog stanja djece za polazak u prvi razred osnovne škole u Splitsko dalmatinskoj županiji (SDŽ) šk. god. 2015./16., zbog razvojnih smetnji odgođen je upis za 8,23% od ukupno pregledanih, dok je među svim učenicima osnovne škole nađeno 1,36% djece s teškoćama koja su se školovala po utvrđenom, primjerenom obliku školovanja temeljem Rješenja Ureda državne uprave u SDŽ. Od takvih učenika 73,33% je kasnije upisalo trogodišnje strukovne škole, a 26,67% četverogodišnje. Djeca i mladi s razvojnim smetnjama zahtijevaju uključujuće obrazovanje, rehabilitacijske i terapijske postupke, podršku profesionalaca, obitelji i društva, kako bi im omogućili pozitivne obrazovne ishode, socijalnu uključenost i očuvanje psihosomatskog zdravlja.Children with developmental disabilities must have access to free, regular elementary and middle schooling, with adequate educational support. School medicine specialist in cooperation with other experts (e.g. pedagogue, psychologist, defectologist etc.) determines the psychosomatic profile of the disabled person, advises about the most appropriate, individualized curriculum and educational support with general health improvement. During the psychosomatic assessment of preschool children for 2015/16 school year in Split-Dalmatian County, the enrolment was postponed for 8.23% of the examined. Some developmental disability had 1.36%, of the school children attending a preset, appropriate program, defined by the County authorities. Majority (73.33%) of the pupils were later matriculated to a 3-year, and 26.67% to a 4-year vocational colleges. Croatian national framework curriculum provides equal opportunities for handicapped pupils to participate in the educational process in accordance with their capabilities together with their peers, with professional, familial and societal support, assuming they can develop proper potentials in accordance with their learning (cognitive, affective, motivational, social) requirements

What Has the Revitalisation of Class Analysis in Croatian Sociology (Not) Achieved?)

Forum - Teorijska bilješkaForum - Theoretical Not

Prevalencija oštećenja sluha među školskim obveznicima – analiza rezultata probira upisnika prvih razreda osnovnih škola na oštećenje sluha na području Grada Splita za školske godine 2014./15.-2016./17.

Cilj ovog rada je prikazati rezultate probira oštećenja sluha kod učenika prvih razreda osnovnih škola na području Grada Splita. Kros-sekcijskom deskriptivnom analizom podataka probira, provedenog tijekom školskih godina 2014./2015., 2015./2016. te 2016./2017., na ukupno 4831 učenika, utvrđena je dijagnoza oštećenja sluha za njih 55 (1,14 %). Provodno oštećenje sluha dijagnosticirano je kod 36, zamjedbeno kod 15, a mješovito kod 4 učenika, i to češće kod dječaka (35), nego kod djevojčica (20). Jednostrano i obostrano oštećenje sluha bilo je jednako zastupljeno. Analiza otvara pitanje modernizacije sustava probira oštećenja sluha u osnovnoškolskoj dobi i praćenja rizičnih i dijagnosticiranih učenika, kao i potrebe organizacije probira na nacionalnoj razini

Sexual dysfunction and sexual life satisfaction among male students

Cilj: Istraživanje seksualnog zdravlja u adolescenata uglavnom se temelji na rizičnom ponašanju i zdravstvenim ishodima, dok se seksualna disfunkcija u adolescenciji rijetko ispituje. Glavni cilj ovoga istraživanja bio je utvrditi učestalost erektilne disfunkcije i prerane ejakulacije među seksualno aktivnim studentima prve godine visokih škola i fakulteta te povezanost s njihovim zadovoljstvom seksualnim životom. Metode: Ukupno je 174 studenata prve godine samostalno ispunilo anonimni anketni list o medicinskim podacima, rizičnim čimbenicima ponašanja i seksualnom životu. Rezultati: Ispitivanje je pokazalo učestalost erektilne disfunkcije od 17,8% i prerane ejakulacije od 9,8%. Samo je 4,6% ispitanika potvrdilo teškoće s erekcijom. Vjerojatnost nastupa erektilne disfunkcije sedam puta je veća kod mladića koji nisu zadovoljni svojim osobnim seksualnim životom (OR 6,75; CI 2,85-15,85; p<0,001). Zaključak: Ovo pitanje zahtijeva pragmatičan pristup imajući na umu specifi čnost populacije adolescenata, osjetljivost ovoga pitanja i često neprepoznavanje erektilne disfunkcije. Dokazano je da je nezadovoljstvo seksualnim životom snažno povezano s erektilnom disfunkcijom. Kako bi otkrili osobe s potencijalnim poremećajem, stručnjaci trebaju započeti s pitanjima o zadovoljstvu seksualnim životom, a ne ispitivati izravno o teškoćama s erekcijom.Purpose: Research on adolescent sexual health is mainly based on risky behaviour and health outcomes, whereas sexual functioning in adolescence is poorly investigated. The main aim of the study was to determine the prevalence of erectile dysfunction and premature ejaculation among sexually active fi rst-year male college and university students, and its association with sexual life satisfaction. Methods: A total of 174 fi rst-year male college students fi lled out an anonymous, self-administered questionnaire on medical information, behavioural risk factors, and sexual life. Results: The current study showed the prevalence of erectile dysfunction and premature ejaculation of 17.8% and 9.8%, respectively. Only 4.6% of the participants acknowledged erection diffi culties. Young men dissatisfi ed with personal sexual life had a seven-fold greater probability to experience erectile dysfunction (OR 6.75; CI 2.85-15.85; p<0.001). Conclusion: Bearing in mind the specifi city of adolescent population, sensitivity of the subject, and often unawareness of erectile dysfunction, approach should be pragmatic. Sexual life dissatisfaction proved to be strongly related to erectile dysfunction. In order to detect those with potential disorder, professionals should initially ask about sexual life satisfaction rather than enquire directly into erection diffi culties

Diseases caused by group A streptococci: burden and public health significance during the COVID-19 pandemic

Cilj: S pojavom bolesti COVID-19 primijetilo se smanjenje broja infekcija respiratornim patogenima, što je bilo najizraženije na početku pandemije. Cilj ovoga rada je prikaz pojavnosti neinvazivnih i invazivnih bolesti izazvanih streptokokom grupe A u Hrvatskoj tri godine prije (2017. – 2019.) i tijekom tri pandemijske godine (2020. – 2022.). Ispitanici i metode: U ovo retrospektivno istraživanje uključeni su svi bolesnici s dijagnozama streptokokne angine, šarlaha, erizipela, bakterijskog meningitisa i sepse prijavljeni u Registar zaraznih bolesti Hrvatskog zavoda za javno zdravstvo i sve epidemije izazvane streptokokom grupe A od 2017. do 2022. godine prijavljene Službi za epidemiologiju zaraznih bolesti Hrvatskog zavoda za javno zdravstvo. Rezultati: Uočen je značajno veći broj prijavljenih streptokoknih angina, šarlaha i erizipela prije pandemije u odnosu na tri pandemijske godine (p = 0,0086, p = 0,0276, p = 0,0017). Primjetna je izrazita sezonalnost kod streptokokne angine i šarlaha samo u pretpandemijsko doba. Kod angine se najveći broj oboljelih bilježio od rujna do prosinca (p = 0,0003), a kod šarlaha od siječnja do ožujka (p = 0,0039). Što se tiče bakterijske sepse i meningitisa uzrokovanih piogenim streptokokom, ne postoji značajna razlika u broju prijavljenih bolesnika u dva promatrana razdoblja. Zabilježeno je 35 epidemija streptokokne angine s 277 oboljelih te šest epidemija šarlaha s 51 oboljelom osobom. Najviše epidemija zabilježeno je u vrtićima (33 s 293 oboljelih), potom su zabilježene u obiteljima (šest s 20 oboljelih) te školama (dvije s 15 oboljelih) što je sukladno dominantnoj dobnoj distribuciji oboljelih. Zaključak: Zabilježen je manji broj streptokoknih infekcija tijekom tri pandemijske godine u odnosu na godine prije pandemije. Kako se smatra da je sa smanjenjem prakticiranja nefarmakoloških mjera prevencije širenja COVID-19 moguć porast broja oboljelih, treba nastaviti pažljivo i pouzdano nadzirati kretanje streptokokoza. S obzirom na mogućnost ozbiljnih oblika bolesti, važno je da se slučajevi šarlaha i streptokokne angine odmah liječe antibioticima kako bi se ograničilo daljnje širenje i smanjio rizik od potencijalnih komplikacija. Dominirajuća pojavnost epidemija u vrtićima upućuje na potrebu educiranja zaposlenika vrtića, pomnog nadzora pobola od strane vrtićkoga zdravstvenog osoblja te brzu komunikaciju s nadležnim epidemiologom. Kako se ove bolesti ne mogu prevenirati cijepljenjem, ostaju kontinuiranim izazovom i kliničarima i liječnicima preventivne medicine.Aim: With the emergence of COVID-19, a decrease in the number of infections with respiratory pathogens was observed, which was most pronounced at the beginning of the pandemic. The aim of this work is to present the incidence of non-invasive and invasive diseases caused by group A streptococcus in Croatia three years before (2017–2019) and during three pandemic years (2020–2022). Participants and methods: All patients registered in the Register of Infectious Diseases of the Croatian Institute of Public Health with the diagnosis of streptococcal pharyngitis, scarlet fever, erysipelas and bacterial meningitis, sepsis and all outbreaks caused by Streptococcus group A from 2017–2022 notified to the Infectious Diseases Epidemiology Division of the Croatian Institute of Public Health were included in this retrospective study. Results: A significantly higher number of reported streptococcal pharyngitis, scarlet fever and erysipelas was observed before the pandemic compared to the three pandemic years (p= 0.0086, p=0.0276, p=0.0017). A distinct seasonality was observed in streptococcal angina and scarlet fever only in the pre-pandemic era. With angina, the largest number of patients was recorded from September to December (p=0.0003), and with scarlet fever from January to March (p= 0.0039). Regarding bacterial sepsis and meningitis caused by this pathogen, there is no significant difference in the number of reported patients in the two observed periods. A total of 35 epidemics of streptococcal pharyngitis with 277 patients and six epidemics of scarlet fever with 51 patients were recorded. Most epidemics were recorded in kindergartens (33 with 293 patients), with outbreaks in families following (six with 20 patients) and schools (two with 15 patients), which is in accordance with the dominant age distribution of the patients. Conclusion: A lower number of streptococcal infections was recorded during the three pandemic years compared to the years before the pandemic. As it is considered that with a reduction in the practice of non-pharmacological measures to prevent the spread of COVID-19, an increase in the number of patients is possible, the burden of streptococci should be carefully and reliably monitored. Therefore, the burden of streptococci should be carefully and reliably monitored. Given the ossibility of serious forms of the disease, it is important that cases of scarlet fever and strep throat are treated immediately with antibiotics to limit further spread and reduce the risk of potential complications. Dominant occurrence of outbreaks in kindergartens points to the need for education of kindergarten employees, close monitoring of illnesses by the kindergarten health staff, and quick communication with the competent epidemiologist. As these diseases cannot be prevented by vaccination, they remain a continuous challenge for both clinicians and doctors of preventive medicine

The frequency and the risk factors for vitamin D deficiency in preschool children at Split and Dalmatian County

Iako nedostatak vitamina D predstavlja globalni problem, posebno kod djece, postoji manjak informacija o ovoj problematici u odnosu na predškolsku djecu iz jugoistočne Europe. Cilj ove studije ustanoviti je prevalenciju nedostatka vitamina D, te povezanost u odnosu na spol, vrijeme provedeno na otvorenom, tjelesnu aktivnost (TA), indeks tjelesne mase (ITM), omjer opsega struka i visine WHtR, mediteranski tip prehrane (prediktori) i status vitamina D (rezultat/ishod) kod zdrave predškolske djece. Sudionici su bili predškolci (svi u dobi od 5 do 6 godina) iz južne Hrvatske. Svi sudionici su testirani tijekom obveznog sistematskog pregleda, 6-7 mjeseci prije upisa u školu. TA je izračunata uz pomoć Pre-Paq upitnika koji kategorizira TA na pet razina (od sjedilačke do visoke razine tjelesne aktivnosti). Prevalencija nedostatka vitamina D bila je visoka; kod 58% djece razine vitamina D, 25(OH)D bile su <50 nmol/l (VDD), dok je kod ostalih 29% zabilježena nedostatna koncentracija vitamina D, 25(OH)D 50- 75 nmol/l (VDI). Kod dječaka razine vitamina D bile su više nego kod djevojčica (49.61±19.67 i 43.37±20.23 nmol/l, pojedinačno; t-test: 2.52, P < 0.01). Uz pomoć multinomijalne regresije kojom se računao učinak vitamina D i dostatna razina (25(OH)D >75 nmol/l) kao referentna vrijednost, utvrđeno je kako je spol signifikantni prediktor statusa vitamina D, pri čemu su dječaci pod nižim rizikom od razvoja nedostatka vitamina D u odnosu na djevojčice (OR: 0.33; 95%CI: 0.15-0.74). ). Kao značajan čimbenik više razine D vitamina utvrđen je Kidmed indeksa veći od 7 što govori o optimalnom pridržavanju principa mediteranske prehrane. Pomoću Bayesianske selekcije modela, dokazana je pozitivna povezanost razina D vitamina sa konzumacijom više od dva obroka voća dnevno i upotrebom maslinovog ulja, dok je preskakanje obroka imalo negativan utjecaj na razine D vitamina. Model je mogao objasniti samo 5,2% raznolikosti u razinama VD u krvi, ali je statistički značajan. Ovi rezultati pokazali su visoku prevalenciju nedostatka vitamina D kod predškolaca iz južnog dijela Hrvatske, što je posebno alarmantno s obzirom na geografski položaj promatrane regije (42oN) kao i veliki broj sunčanih sati (>2600 sati godišnje). Postoji potreba za daljnjim istraživanjima ostalih potencijalnih poveznica s vitaminom D i utemeljenje javnozdravstvene platforme za nadoknadu vitamina D.The deficiency of the vitamin D is an important global problem, particularly in children. However, in relation to preschool children from Southern Europe there is a lack of information regarding this issue. The aim of this study was to establish the prevalence of vitamin D deficiency and the association in relation to gender, time spent out doors, physical activity (PA), body mass indeks (BMI), waist and height ratio (WhtR), Mediterranean diet (predictors) and vitamin D status (outcome) in healthy preschool children. The participants were preschool children (all aged 5 to 6 years) from South Croatia. All participants were tested during mandatory medical examination, 6-7 months prior to school enrollment. The PA was calculated using Pre-Paq questionnaire categorizing PA in to five levels (from sedentiary to high level of physical activity). The prevalence of vitamin D deficiency was high; 58% of children had vitamin D, 25(OH)D levels <50 nmol/l (VDD), while in the remaining 29% an insufficient concentration of vitamin D, 25(OH)D 50-75 nmol/l (VDI) was reported. The boys had higher levels of vitamin D than girls (49.61±19.67 i 43.37±20.23 nmol/l, respectively; ttest: 2.52, P < 0.01). Using multinomial regression in order to calculate the effectof vitamin D and the sufficient level (25(OH)D >75 nmol/l) as the reference value, the gender was determined as a significant predictor for vitamin D status, with boys being at lower risk for vitamin D deficiency in relation to girls (OR: 0.33; 95%CI: 0.15-0.74). As a significant factor of high vitamin D levels, the KIDMED index higher than 7 points was indicated, which suggested an optimal following of the Mediterranean diet. The implementation of Bayesian model selection enable devidence of the postive correlation between vitamin D and the intake of more than two servings of fruit per day as well as the olive oil consumption, where as skipping meals had negative effect on vitamin D levels. The model could have accounted for only 5.2% of variations in blood levels of VD, but it was statistically significant. These results indicated the high prevalence of the vitamin D deficiency in the preschool children from South Croatia, which is especially alarming given the geographical position of the studied region (42 o N) as well as the high number of sunlight hours(>2600 hours per year). Further investigation for other potential correlations with vitamin D is essential, also the establishment of a public health platform for vitamin D supplementation

The frequency and the risk factors for vitamin D deficiency in preschool children at Split and Dalmatian County

Iako nedostatak vitamina D predstavlja globalni problem, posebno kod djece, postoji manjak informacija o ovoj problematici u odnosu na predškolsku djecu iz jugoistočne Europe. Cilj ove studije ustanoviti je prevalenciju nedostatka vitamina D, te povezanost u odnosu na spol, vrijeme provedeno na otvorenom, tjelesnu aktivnost (TA), indeks tjelesne mase (ITM), omjer opsega struka i visine WHtR, mediteranski tip prehrane (prediktori) i status vitamina D (rezultat/ishod) kod zdrave predškolske djece. Sudionici su bili predškolci (svi u dobi od 5 do 6 godina) iz južne Hrvatske. Svi sudionici su testirani tijekom obveznog sistematskog pregleda, 6-7 mjeseci prije upisa u školu. TA je izračunata uz pomoć Pre-Paq upitnika koji kategorizira TA na pet razina (od sjedilačke do visoke razine tjelesne aktivnosti). Prevalencija nedostatka vitamina D bila je visoka; kod 58% djece razine vitamina D, 25(OH)D bile su <50 nmol/l (VDD), dok je kod ostalih 29% zabilježena nedostatna koncentracija vitamina D, 25(OH)D 50- 75 nmol/l (VDI). Kod dječaka razine vitamina D bile su više nego kod djevojčica (49.61±19.67 i 43.37±20.23 nmol/l, pojedinačno; t-test: 2.52, P < 0.01). Uz pomoć multinomijalne regresije kojom se računao učinak vitamina D i dostatna razina (25(OH)D >75 nmol/l) kao referentna vrijednost, utvrđeno je kako je spol signifikantni prediktor statusa vitamina D, pri čemu su dječaci pod nižim rizikom od razvoja nedostatka vitamina D u odnosu na djevojčice (OR: 0.33; 95%CI: 0.15-0.74). ). Kao značajan čimbenik više razine D vitamina utvrđen je Kidmed indeksa veći od 7 što govori o optimalnom pridržavanju principa mediteranske prehrane. Pomoću Bayesianske selekcije modela, dokazana je pozitivna povezanost razina D vitamina sa konzumacijom više od dva obroka voća dnevno i upotrebom maslinovog ulja, dok je preskakanje obroka imalo negativan utjecaj na razine D vitamina. Model je mogao objasniti samo 5,2% raznolikosti u razinama VD u krvi, ali je statistički značajan. Ovi rezultati pokazali su visoku prevalenciju nedostatka vitamina D kod predškolaca iz južnog dijela Hrvatske, što je posebno alarmantno s obzirom na geografski položaj promatrane regije (42oN) kao i veliki broj sunčanih sati (>2600 sati godišnje). Postoji potreba za daljnjim istraživanjima ostalih potencijalnih poveznica s vitaminom D i utemeljenje javnozdravstvene platforme za nadoknadu vitamina D.The deficiency of the vitamin D is an important global problem, particularly in children. However, in relation to preschool children from Southern Europe there is a lack of information regarding this issue. The aim of this study was to establish the prevalence of vitamin D deficiency and the association in relation to gender, time spent out doors, physical activity (PA), body mass indeks (BMI), waist and height ratio (WhtR), Mediterranean diet (predictors) and vitamin D status (outcome) in healthy preschool children. The participants were preschool children (all aged 5 to 6 years) from South Croatia. All participants were tested during mandatory medical examination, 6-7 months prior to school enrollment. The PA was calculated using Pre-Paq questionnaire categorizing PA in to five levels (from sedentiary to high level of physical activity). The prevalence of vitamin D deficiency was high; 58% of children had vitamin D, 25(OH)D levels <50 nmol/l (VDD), while in the remaining 29% an insufficient concentration of vitamin D, 25(OH)D 50-75 nmol/l (VDI) was reported. The boys had higher levels of vitamin D than girls (49.61±19.67 i 43.37±20.23 nmol/l, respectively; ttest: 2.52, P < 0.01). Using multinomial regression in order to calculate the effectof vitamin D and the sufficient level (25(OH)D >75 nmol/l) as the reference value, the gender was determined as a significant predictor for vitamin D status, with boys being at lower risk for vitamin D deficiency in relation to girls (OR: 0.33; 95%CI: 0.15-0.74). As a significant factor of high vitamin D levels, the KIDMED index higher than 7 points was indicated, which suggested an optimal following of the Mediterranean diet. The implementation of Bayesian model selection enable devidence of the postive correlation between vitamin D and the intake of more than two servings of fruit per day as well as the olive oil consumption, where as skipping meals had negative effect on vitamin D levels. The model could have accounted for only 5.2% of variations in blood levels of VD, but it was statistically significant. These results indicated the high prevalence of the vitamin D deficiency in the preschool children from South Croatia, which is especially alarming given the geographical position of the studied region (42 o N) as well as the high number of sunlight hours(>2600 hours per year). Further investigation for other potential correlations with vitamin D is essential, also the establishment of a public health platform for vitamin D supplementation