Edukacija o kroničnim nezaraznim bolestima

Sredinom 20. stoljeća dolazi do velikih promjena u morbiditetu i mortalitetu u razvijenijim zemljama svijeta. O zaraznim bolestima se već uglavnom sve zna: uzročnici (krajem 19.st. Robert Koch i Louis Pasteur osnivaju granu medicine mikrobiologiju), specifična klinička slika, terapija (1928. god. Aleksandar Fleming otkriva penicilin) i prevencija; djeluje se na povišenje higijenskog standarda, upoznate su mjere suzbijanja pojave epidemije i započinje organizirano procjepljivanje populacije. Terapija postaje vrlo učinkovita otkrićem penicilina, potom i streptomicina, a zatim i antibiotika širokog spektra. S porastom životnog standarda i značajnim napretkom u medicini, većina nekad visoko smrtonosnih bolesti: kuga, pjegavac, variola, kolera, tuberkuloza, trbučni tifus i dr. postepeno nestaju ili se njihov morbiditet i mortalitet naglo smanjuju. Ljudski vijek postaje duži i mjesto vodećih uzroka smrti počinju zauzimati kronične nezarazne bolesti (knb): kardiovaskularne i cerebrovaskularne bolesti, maligne bolesti, nesreće, bolesti respiratornog sustava, bolesti probavnog sustava, bolesti endokrinog sustava (diabetes mellitus) itd. Na medicinskim fakultetima razvijenih zemalja od sredine prošlog stoljeća, u programe nastave se sve više uvode predmeti sa sadržajem iz knb; to se isto odnosi i na poslijediplomske studije i na medicinske specijalizacije

Prehrana za kvalitetan kreativni rad

Cilj: Dati metaanalizu faktora prehrane koji utječu na procese u CNS-u.Metode: Diferencijalni pregled relevantne svjetske znanstvene literature.Rezultati: Izloženi su osnovni prijelazi: homo sapiens - homo nticus - homo creans. Dat je pregled utjecaja industrije hrane prema glavnim vrstama prehrambenih namirnica i njihovog općeg mehanizma djelovanja na CNS. Masnoće, ugljikohidrati i bjelančevine te njihov utjecaj na CNS. Osnovni periodi prehrane čovječanstva: prehrana prije 200.000 godina: minerali, vitamini i masnoće; prehrana prije 20.000 godina: uvođenje žitarica; prehrana prije 2000 godina: agrokultura. Prehrana danas: industrija. Antioksidanti, vitamini, lijekovi. Osnovni ciklusi potrebe CNS-a za hranom. Zaključak: Ukazano je na potrebu i glavne odrednice tzv funkcionalne prehrane za kvalitetan kreativni rad

A model of road traffic as a resource risk loss in the elderly population of Croatia

Background and Purpose: Use of the road traffic resource inevitably leads to significant human andmaterial losses. Thus, the standardized death rate among older people (65years) in the European Union was 19.8 in 2000 and 11.9 in 2011. A model is proposed of human loss through RTA to establish the main resource losses and major risk loss factors for victimization of the elderly population (65years), as compared to the risk prone young population (18–24 years). Materials andMethods:Data onRTA in Croatia are obtained fromthe official government bulletin for road safety of the Ministry of the Interior for the period 2000–2011. Minimum and maximum number of victims and mean expected loss are used for determination of environmental risks and risk proneness. Results and Conclusions: A comparative victimization analysis for Croatia for the period 2000–2011 shows significant losses for mild and severe injury to younger RT participants, increased mild injury to elderly drivers, and increased severe injury among elderly pedestrians.Risk ismostly expressed in fatal RTA for younger participantswith risk proneness of 32.4%. The most exposed RT users are: severely injured elderly drivers with unprofitable and profitable risks between 32.8 % and 50.9 %, fatally injured elderly drivers with unprofitable and profitable risks between 43.2 % and 66.1 %, and fatally injured elderly pedestrians with unprofitable and profitable risks between 93.9%and 86.3%. These facts demand preventive actions for these users on the side of car and road designers and traffic educators as well

Značajke edukacije iz Epidemiologije

Epidemiologija je preventivna grana medicine i medicinska struka koja se bavi proučavanjem i praćenjem zdravstvenog stanja u populaciji, otkrivanjem uzroka i rizika pojave bolesti, te prevencijom i suzbijanjem masovnih i značajnih bolesti. Epidemije postoje od pamtivijeka, ali u razdobljima velikih društvenih previranja, ratova i prirodnih katastrofa, pojavljuju se u posebno velikim valovima, sa teškim posljedicama i visokom smrtnošću. Tijekom 19.stoljeća u vrijeme industrijalizacije, ljudi masovno sele u gradove, zapošljavaju se u tvornicama i tako u potpunosti mijenjaju način života, radni i kućni okoliš. Stres zbog velikih promjena, socijalni, ekonomski problemi i poremećaji u međuljudskim odnosima, dovode do pogoršanja zdravstvenog stanja stanovništva. Pojava epidemija je češća i u težim oblicima: tuberkuloza, pneumonije, trbušni tifus, kolera, dizenterija i dr. Liječnici i drugi javnozdravstveni djelatnici tog doba počinju se pitati: kolika je učestalost tih bolesti i koliko ljudi od njih umire; koji su glavni uzroci i uvjeti širenja, te kako spriječiti daljnju pojavu bolesti i zaustaviti njihovo širenje? Upravo to su bili začeci epidemiologije koja odgovara na sva ta pitanja i koju karakteriziraju navedeni zadaci i ciljevi

A model of road traffic as a resource risk loss in the elderly population of Croatia

Background and Purpose: Use of the road traffic resource inevitably leads to significant human andmaterial losses. Thus, the standardized death rate among older people (65years) in the European Union was 19.8 in 2000 and 11.9 in 2011. A model is proposed of human loss through RTA to establish the main resource losses and major risk loss factors for victimization of the elderly population (65years), as compared to the risk prone young population (18–24 years). Materials andMethods:Data onRTA in Croatia are obtained fromthe official government bulletin for road safety of the Ministry of the Interior for the period 2000–2011. Minimum and maximum number of victims and mean expected loss are used for determination of environmental risks and risk proneness. Results and Conclusions: A comparative victimization analysis for Croatia for the period 2000–2011 shows significant losses for mild and severe injury to younger RT participants, increased mild injury to elderly drivers, and increased severe injury among elderly pedestrians.Risk ismostly expressed in fatal RTA for younger participantswith risk proneness of 32.4%. The most exposed RT users are: severely injured elderly drivers with unprofitable and profitable risks between 32.8 % and 50.9 %, fatally injured elderly drivers with unprofitable and profitable risks between 43.2 % and 66.1 %, and fatally injured elderly pedestrians with unprofitable and profitable risks between 93.9%and 86.3%. These facts demand preventive actions for these users on the side of car and road designers and traffic educators as well

Metabolic Syndrome in a Metapopulation of Croatian Island Isolates

Aim: To investigate the prevalence and factors associated with the metabolic syndrome in 9 isolated populations on Adriatic islands, Croatia, and in the group of immigrants to these islands. Methods: Random samples of 100 inhabitants from each village and 101 immigrants were collected during 2002 and 2003. Bivariate and multivariate methods were used in data analysis. Age, gender, village, diet, smoking habits, physical activity, education, occupational class, and personal genetic history (a pedigree-based estimate of the individual genome-wide heterozygosity level) were used as independent variables in logistic regression. Results: A total of 343 (34%) examinees met criteria of the metabolic syndrome diagnosis, with significant differences in the prevalence among villages (P=0.002). Metabolic syndrome was most frequently detected on Mljet island (53%), where all examinees exhibited fasting plasma glucose over 6.1 mmol/L. Examinees with metabolic syndrome were significantly older than those without it (median age 60.0 vs 53.0; P<0.001). Women were more frequently diagnosed than men (39% vs 28%; P<0.001). The highest prevalence of the metabolic syndrome was found in the autochthonous group, whereas the lowest proportion was recorded in the admixed group (39% vs 21%, respectively, P = 0.017). However, only age (odds ratio [OR], 1.06; 95% confidence intervals [CI], 1.03-1.08) and having a university degree (OR, 0.18; 95% CI 0.04-0.92) were significantly associated with metabolic syndrome in the regression model. Conclusion: Metabolic syndrome was not associated with pedigree-based individual genome-wide heterozygosity estimate, after controlling for a number of confounding factors. More precise marker based genomic measures are needed to provide a clear answer whether metabolic syndrome development is influenced by the population genetic structure

Seasonality of Births in Croatia

The aim of this paper was to investigate seasonal fluctuations of the number of births in Croatia. Vital registration data from the years 1970–2002 was used for analysis of the quarterly data (from the years 1970–1997), and monthly data (from the years 1998–2002). Both data sets were smoothed, using seasonal variation removal for quarterly data, and T4253H smoothing for monthly data. Edwards test and Ratchet circular scan tests were used in analysis. The results showed an increase in the summer birth proportion and decrease in the spring birth proportion, distorted during the wartime period (1991–1995). Monthly analysis reveals highest birth proportion in Croatia during July–September period, with peak date moving towards the end of summer, and reaching stability in the beginning of September during the years 2000–2002. This presumes highest conception rate during the beginning of the Christmas holiday season. Secondary peak in January was found in some years, which presumably sets second period of increased conception rate into the Easter holiday season, supporting the observation of the holiday-related birth peaks. Both quarterly and monthly data indicate a birth pattern that does not resemble either »European« or »American« seasonal pattern. Regional analysis showed lack of seasonality in the capital city of Zagreb and either intermittent or stable seasonality pattern in the rest of the country

Effects of Inbreeding, Endogamy, Genetic Admixture, and Outbreeding on Human Health: A “1001 Dalmatians” Study

Aim: “1001 Dalmatians” research program collects biomedical information from multiple small isolated populations (“metapopulation”) on Adriatic islands, Croatia, and investigates health effects of human population isolation, inbreeding, admixture, and outbreeding. Methods: We collected random samples of 100 individuals from 9 island settlements and an additional sample of 101 immigrants to the islands, pooled from all study populations. According to their personal genetic histories, the examinees were categorized as inbred, autochthonous, admixed, and outbred. A total of 76 inbred individuals from a total sample of 1001 examinees were matched to 76 autochthonous, 76 admixed, and 76 outbred controls by gender, age (±5 years), village of residence, education, and socio-economic status. We investigated the effects of presumed individual genome-wide heterozygosity predicted from personal genetic histories on the following 10 traits: systolic and diastolic blood pressure, body mass index, high and low density lipoproteins and total cholesterol, triglycerides, uric acid, creatinine, and blood glucose. Results: Personal genetic history significantly affected systolic blood pressure (Spearman ρ=-0.157, P=0.006), while the effect on cholesterol (ρ=-0.105, P=0.069), and high density lipoprotein cholesterol (ρ=0.104, P=0.071) was suggestive. Admixed individuals and immigrants consistently showed values associated with lower health risk. When inbred and autochthonous samples were merged and compared with the admixed and outbred samples to increase the power of the study, the effects on the three traits above and also on body mass index and diastolic blood pressure became statistically significant. The medians for all 10 medically relevant traits in inbred and autochthonous group, with lower values of presumed individual genome-wide heterozygosity, were less favorable in terms of health. Conclusion: The combined effects of founder effect, genetic drift, and inbreeding can increase the frequency of detrimental rare variants in human metapopulations, leading to overall worsening of population health, whereas admixture and outbreeding appear to have the opposite effect

Youth and AIDS – A Study of Attitudes, Knowledge, Behavior and Risks in the Post-War Croatia

According to the latest reports, the Eastern Europe currently exhibits the greatest relative increase in the number of newly registered HIV infections in the world. At the same time, Central Europe remains relatively spared from the epidemic, with reported rates significantly lower than those in both Eastern and Western Europe. Croatia geographically affiliates to Central Europe, but it has two specific potential risk factors in comparison to neighboring countries: recent War events and a summer season when immigration of large number of tourists from Central and Eastern Europe is expected. Therefore, it is critical to examine AIDS attitudes in young people, increase their knowledge, monitor their behavior and warn on risks in order to prevent larger spread of epidemics from Eastern Europe to Croatia. In this study, we report on a large related survey and education program among 17-year-old high school pupils that was conducted in years immediately following the War (1996–1999)