33 research outputs found
Alternative Pedagogies In Early And Preschool Education
Tema ovog rada su alternativne pedagogije koje su se javile kao odgovor na zahtjeve suvremenog djeteta. Znanstvenici i roditelji su kroz povijest izražavali nezadovoljstvo tadaÅ”njim pedagoÅ”kim konceptima te kao odgovor ponudili svoje koncepte za bolji odgojno-obrazovni proces prilagoÄeniji djetetu i njegovim potrebama. Posebno važnima istiÄu se djetetova samostalnost, poÅ”tivanje njegovih potreba te suradnja djeteta, roditelja i odgojitelja. U radu je navedeno nekoliko alternativnih pedagogija te viÅ”e o njihovim utemeljiteljima. Iznesena su pedagoÅ”ka naÄela, strategije pouÄavanja, te položaj djeteta i uloga odgojitelja. Alternativni koncepti odgovor su na danaÅ”nji ubrzani razvoj suvremenog svijeta kako bi djetetu ponudili Å”to cjelovitiji rast i razvoj u okolini koja je djetetu poticaj i u kojoj se dijete osjeÄa slobodno i ostvareno.The theme of this paper are alternative pedagogies that have emerged in response to the demands of the modern child. Throughout history scientists and parents have expressed dissatisfaction with pedagogical concepts of that time, and as response they offered their concepts for a better educational process more suited to the child and his needs. Particularly important are pointed out the childās independence, respect for his needs and the cooperation of children, parents and educators. The paper lists several alternative pedagogies and more about their founders. The pedagogical principles, teaching strategies, position of the child and the role of the educator are presented. Alternative concepts are response to todayās accelerated development of the modern world in order to offer the child complete growth and development in an environment that is stimulating to the child and in which he can feel free and fulfilled
Alternative Pedagogies In Early And Preschool Education
Tema ovog rada su alternativne pedagogije koje su se javile kao odgovor na zahtjeve suvremenog djeteta. Znanstvenici i roditelji su kroz povijest izražavali nezadovoljstvo tadaÅ”njim pedagoÅ”kim konceptima te kao odgovor ponudili svoje koncepte za bolji odgojno-obrazovni proces prilagoÄeniji djetetu i njegovim potrebama. Posebno važnima istiÄu se djetetova samostalnost, poÅ”tivanje njegovih potreba te suradnja djeteta, roditelja i odgojitelja. U radu je navedeno nekoliko alternativnih pedagogija te viÅ”e o njihovim utemeljiteljima. Iznesena su pedagoÅ”ka naÄela, strategije pouÄavanja, te položaj djeteta i uloga odgojitelja. Alternativni koncepti odgovor su na danaÅ”nji ubrzani razvoj suvremenog svijeta kako bi djetetu ponudili Å”to cjelovitiji rast i razvoj u okolini koja je djetetu poticaj i u kojoj se dijete osjeÄa slobodno i ostvareno.The theme of this paper are alternative pedagogies that have emerged in response to the demands of the modern child. Throughout history scientists and parents have expressed dissatisfaction with pedagogical concepts of that time, and as response they offered their concepts for a better educational process more suited to the child and his needs. Particularly important are pointed out the childās independence, respect for his needs and the cooperation of children, parents and educators. The paper lists several alternative pedagogies and more about their founders. The pedagogical principles, teaching strategies, position of the child and the role of the educator are presented. Alternative concepts are response to todayās accelerated development of the modern world in order to offer the child complete growth and development in an environment that is stimulating to the child and in which he can feel free and fulfilled
Merkmale der landwirtschaftlichen Erzeugung in den Siedlungen der StarÄevo-Kultur im Gebiet zwischen dem heutigen Vinkovci und Slavonski Brod, Kroatien
Obavljena su istraživanja deset lokaliteta starÄevaÄke kulture u
istoÄnom dijelu Hrvatske. StarÄevaÄka je kultura na prostoru
naŔih istraživanja trajala od 6000. do oko 5100. prije Krista.
Lokaliteti su smjeÅ”teni na povrÅ”ini od oko 1100 km2 izmeÄu
gradova Vinkovaca i Slavonskog Broda. Analizirane su
tehnologije poljoprivredne proizvodnje, procijenjena moguÄnost
obujma proizvodnje i, na osnovi toga, moguÄi rast brojnosti
stanovniŔtva. Upotrebljavane su efikasne tehnologije proizvodnje
žitarica i mesa goveda. Za uspjeŔnu i opsežniju proizvodnju
žitarica i mesa goveda bile su potrebne Ŕumske biljne zajednice.
ZakljuÄeno je da je stanovniÅ”tvo doseljeno, jer nema nalaza koji
bi dokazivali postupni razvoj poljoprivrednih tehnologija. Uzgajali
su emmer (Triticum dicoccum) i einkorn (Triticum monococcum) te
veÄ domesticirane ovce, a mjesto domestikacije emmera,
einkorna i ovce su podruÄja Palestine i Anatolije. S istraženoga
podruÄja nastavilo se seljenje prema zapadu Hrvatske gdje se
javlja linearnotrakasta keramika koja se daljnjim seljenjem, uz
prenoÅ”enje žitarica (emmera i einkorna) i ovÄarske proizvodnje,
proÅ”irila do podruÄja Nizozemske i Ukrajine, a brže seljenje
odvijalo se u smjerovima na kojima su se nalazile Ŕumske biljne
zajednice. Prijelaz iz starÄevaÄke u sopotsku kulturu koji
karakteriziraju veÄe druÅ”tvene promjene, mogao je ubrzati
iseljavanje stanovniÅ”tva iz južne i zapadne Panonije.Research of ten sites of the StarÄevo culture in the eastern
part of Croatia has been published. The StarÄevo culture, in
the area of our research, existed from 6000 to 5100 B.C.
The sites are situated in an area of 1100 square km between
the towns Vinkovci and Slavonski Brod. The authors of the
research analysed technologies of agricultural production,
assessed the possibility of production volume thus estimating
the possible growth of population. Efficient technologies of
cereal crops and beef production were used. For a successful
and more extensive production of cereals and beef
woodland plant communities were needed. It has been concluded that the inhabitants were settlers because there
are no findings to prove a gradual development of
agricultural technologies. They cultivated emmer (Triticum
dicoccum), and einkorn (Triticum monococcum) and raised
already domesticated sheep, Palestine and Anatolia being
the places of domestication for emmer, einkorn and sheep.
From the area researched movement continued towards the
west of Croatia where linear-stripped ceramics could be
found, moving further again with the crops (emmer and
einkorn) and sheep raising, spreading all the way to the
Netherlands as well as Ukraine, while a faster movement
took place in the directions where there were woodland plant
communities to be found. The transformation from the
StarÄevo to the Sopot culture, characterised by significant
social changes, could have quickened the pace of
emigration from southern and west Panonia.Der Artikel berichtet Ć¼ber die Erforschung von Siedlungsresten
an insgesamt zehn LokalitƤten der StarÄevo-Kultur im
Osten Kroatiens. Die in diesem Raum nachgewiesene Kultur
dauerte von 6000 bis etwa 5100 v.Chr. Die Siedlungsreste
befinden sich auf einer FlƤche von ungefƤhr 1100 km2
zwischen den StƤdten Vinkovci und Slavonski Brod. Man
analysierte die zu jener Zeit verfĆ¼gbare Technologie der
Feldbestellung, unternahm eine SchƤtzung des
landwirtschaftlichen Ertrags sowie aufgrund dessen eine
SchƤtzung des Bevƶlkerungswachstums. Es konnte nachgewiesen
werden, dass wirksame Methoden zur Getreidegewinnung
und Rinderzucht angewandt worden waren. Zur
Steigerung der Erzeugung von Getreide und Rindfleisch war
der Aufenthalt in der unmittelbaren NƤhe von Wald-Pflanzengemeinschaften
notwendig. Die Forschung kam zum
Schluss, dass es sich bei den Menschen der StarÄevo-Kultur
um ZuzĆ¼gler handelte, da es keinerlei Nachweise gibt, die
die allmƤhliche Entwicklung landwirtschaftlicher Technologien
bestƤtigen. Angebaut wurden Emmer (Triticum dicoccum) und
Einkorn (Triticum monococcum), als Haustiere dienten bereits
domestizierte Schafe. Es ist jedoch bekannt, dass die
genannten Getreidearten sowie das Schaf im Gebiet
PalƤstinas und Anatoliens domestiziert wurden. Die Menschen
der StarÄevo-Kultur setzten ihre Wanderung in das Gebiet
Westkroatiens, wo die ersten GefƤĆe aus Schnurkeramik
gefunden wurden, fort. Von dort weitete sich die
Schnurkeramik mitsamt dem darin transportierten Getreide
(Emmer und Einkorn) wie auch die Schafzucht bis in das
Gebiet der heutigen Niederlande und der Ukraine aus. In
waldreichen Gegenden gingen die WanderzĆ¼ge schneller vor
sich. Der Ćbergang von der StarÄevo- zur Sopot-Kultur, den
bedeutende gesellschaftliche Wandel charakterisieren, hat
mƶglicherweise die Auswanderung der in SĆ¼d- und
Westpannonien lebenden VolksstƤmme beschleunigt
Der Ausgangspunkt des pythagoreischen Lehrsatzes in der Vu~edol-Kultur, Kroatien
Van der Waerden, u knjizi Geometry and Algebra in Ancient Civilization
poÄetke matematiÄke znanosti smjeÅ”ta u srediÅ”nju Europu
u vrijeme izmeÄu 3000. i 2500. godine prije Krista. Waerden
navodi da je veÄ tada spoznat raÄun koji je kasnije definiran kao
Pitagorin pouÄak, jer je bilo poznato kako nacrtati geometrijske
crteže kojih se duljine stranica odnose kao cijeli brojevi. Ove spoznaje
su se iz srediŔnje Europe proŔirile do Engleske i Škotske na
zapad, te do Bliskog istoka, Indije i Kine na istok. U vrijeme u kojem
Waerden drži da su spoznata navedena matematiÄka znanja
u srednjoj Europi, na prostoru izmeÄu Jadranskog mora, Karpata
i Alpa razvila se vuÄedolska kultura koja je trajala od 3000.
do 2200. god. prije Krista. Istraživanja su dala rezultate na temelju
kojih je bilo moguÄe zakljuÄiti da su prva poljoprivredna naselja
podignuli doseljenici Äije je podrijetlo iz Palestine i Male Azije
te da su s poÄetkom uporabe drveta kao graÄevnog materijala
morali dolaziti do matematiÄkih spoznaja koje nisu bile potrebne
kada se gradilo u kamenu. U vuÄedolskom druÅ”tvu onoga vremena
postoje obredi vezani uz astronomske dogaÄaje, a svetiÅ”ta
se grade po odreÄenim matematiÄkim pravilima. Geometrijski
crtež na kojemu su sve stranice Äetverokuta, trokuta, dijagonale
Äetverokuta i visine trokuta cijeli brojevi postaje simbolom koji se
na prostoru Hrvatske održao 3000 godina. Izneseno omoguÄava
zakljuÄak da su njegovi crtaÄi spoznali raÄun Pitagorina pouÄka,
Å”to, uz ostalo, potvrÄuje stajaliÅ”ta B. L. van der Waerdena o vremenu
i mjestu poÄetaka, te pravcima Å”irenja matematiÄke znanosti.Van der Waerden in his book Geometry and Algebra in
Ancient Civilization places the beginnings of mathematical
science in Central Europe between the years 3000 and 2500
before Christ. Waerden states that the calculus, later defined
as Pythagorasā Theorem, was discovered as early as then,
because it was known how to make geometric drawings
whose side lengths interrelated as whole numbers. This
knowledge was spread from Central Europe to England and
Scotland in the West, and to the Near East, India and China
in the East. In the period in which Waerden considers that
this mathematical knowledge was perceived in Central
Europe, in the region between the Adriatic Sea, Carpathian
Mountains and the Alps, the Vu~edol Culture developed
lasting from 3000 to 2200 B.C. In our research we looked
for those phenomena in the area of development of the
Vu~edol Culture which entailed certain mathematical
knowledge. Research provided results based on which it was
possible to conclude that the first agricultural settlements had
been raised by settlers originating from Palestine and Asia
Minor. Furthermore, at the initial stage of using wood as
building material they were bound to come to mathematical
solutions, quite unnecessary when the material for
construction used to be stone. In the Vu~edol society of that
time certain rituals existed connected to astronomical events,
while shrines were built according to defined mathematical
rules. The geometric drawing on which all sides of the
quadrangle, triangle, quadrangle diagonals and triangle
perpendiculars are whole numbers has become the symbol
to survive in these Croatian parts for 3000 years. A symbol
of such features enables the conclusion that its drawers knew
the calculus of Pythagorasā Theorem. It is therefore possible
to assume that perception about the period between the years 3000 and 2500 B.C., taking place in the Vu~edol
Culture in Croatia, as well as knowledge of the period prior
to the Vu~edol Culture, confirm the statements of B.L.van der
Waerden concerning the time and place of the beginnings of
mathematical science. Perceptions which form the basis of
Pythagoraās Theorem have occurred in the area and time of
the Vu~edol Culture, whose origins are on Croatian territory,
and from here they spread to the East and West in the exact
direction pointed out by Van der Waerden.In seinem Buch Geometry and Algebra in Ancient Civilization
lokalisiert Van der Waerden die AnfƤnge der
mathematischen Wissenschaften im mitteleuropƤischen
Raum, in der Zeit zwischen 3000 und 2500 v.Chr. Van der
Waerden fĆ¼hrt an, dass schon zu jener Zeit die
Rechnungsweise bekannt war, die spƤter als pythagoreischer
Lehrsatz definiert wurde; man wusste nƤmlich bereits, wie
man geometrische Kƶrper zu zeichnen hatte, deren
SeitenlƤngen sich wie ganze Zahlen zueinander verhalten.
Diese Erkenntnisse breiteten sich bis nach England und
Schottland im Westen sowie bis in den Nahen Osten, Indien
und China aus. In der Zeit, die Van der Waerden fĆ¼r die
Entstehungszeit der genannten mathematischen Erkenntnisse
in Zentraleuropa hƤlt, entwickelte sich im Bereich zwischen
dem Adriatischen Meer, den Karpaten und den Alpen die
aeneolithische Vu~edol-Kultur, die von etwa 3000 bis 2200
v.Chr. dauerte. Die Untersuchungsergebnisse lieĆen den
Schluss zu, dass die ersten Siedlungen von Zuwanderern aus
PalƤstina und Kleinasien errichtet worden waren. AuĆerdem
mussten die Menschen der Vu~edol-Kultur mit Beginn der
Holzbauweise zu mathematischen Erkenntnissen kommen,
die nicht notwendig gewesen waren, solange man noch Stein
zur Errichtung der Behausungen verwendete. In der
Menschengemeinschaft jener Zeit gab es bestimmte Rituale,
die an astronomische Ereignisse gebunden waren;
HeiligtĆ¼mer wurden nach bestimmten mathematischen
Regeln angelegt. Die bekannte geometrische Zeichnung, in
der alle Seiten eines Vierecks, eines Dreiecks, ferner die
Diagonalen eines Vierecks und die Hƶhen eines Dreiecks ganze Zahlen darstellen, wird zum Symbol, das sich auf dem
Raum Kroatiens durch drei Jahrtausende erhalten hat. Die
Merkmale dieses Symbols lassen den Schluss zu, dass
denjenigen, die es entworfen haben, das Prinzip des
pythagoreischen Lehrsatzes bekannt war. Daher kann man
schlieĆen, dass die auf dem Raum Kroatiens in der Vu~edol-
Kultur zwischen 3000 und 2500 v.Chr. gewonnenen
Erkenntnisse sowie das heutige Wissen Ć¼ber den
Zeitabschnitt, der der Vu~edol-Kultur unmittelbar vorausging,
den Standpunkt B. L. van der Waerdens Ć¼ber die AnfƤnge
der mathematischen Wissenschaften bestƤtigen.
Die dem pythagoreischen Lehrsatz zugrunde liegenden
Erkenntnisse wurden auf dem Ausdehnungsgebiet und in der
Zeit der Vu~edol-Kultur gewonnen, welche wiederum auf
dem Gebiet des heutigen Kroatien angesiedelt war. Von hier
aus breitete sich dieses Wissen nach Osten und Westen in
ebenjenen Richtungen aus, die auch Van der Waerden
anfĆ¼hrt
TRAGOVI METALA U TLU, KORI I LIÅ ÄU KAO POSLJEDICA RATNIH ZBIVANJA (PRIMJER PRAÅ UME PRAÅ NIK, HRVATSKA)
As a special forest vegetation reserve, the PraÅ”nik rain forest is a highly protected area which owes its protection not only to a unique composition of trees, but also to its geographical position and, to an extent, historical events. It is situated on the Sava River left bank, north of the city of Stara GradiÅ”ka (cca. 3 km). The study area belongs to the southwestern part of Pannonian Basin, specifically the Sava Depression. The aim of this study was to assess a possible impact of war activities in Croatia (23 years ago) when numerous mines were laid in this region and to establish a major and trace metal baseline concentrations for future investigations. Ten topsoil (S) samples were taken randomly with adjacent vegetation (bark and leaves) at each site. Major and trace metal concentrations were measured for all three types of samples using the ICP method. Analysed soils are composed of quartz, micaceous mineral, 14Ć
mineral, plagioclase and mixed layer minerals. All metal values in the sample taken from an ex-mine crater are 2-4 times higher compared to other. Generally, positive statistically significant Kendallās Tau correlation coefficients of trace metals (Cd, Cr, Cu, Ni, and Zn) were found for all combinations of the S (soil), B (bark), and L (leaf) groups. Such results indicate that the war activity have played a certain role in a distribution pattern of soil as well as vegetative trace metal levels.PraÅ”uma PraÅ”nik kao poseban rezervat Å”umske vegetacije visoko je zaÅ”tiÄeno podruÄje, ali ne samo zbog jedinstvenoga sastava drveÄa, veÄ zahvaljujuÄi i geografskomu položaju te u odreÄenoj mjeri povijesnim zbivanjima. Nalazi se na lijevoj obali rijeke Save, oko 3 km sjeverno od Nove GradiÅ”ke. PodruÄje istraživanja pripada jugozapadnomu dijelu Panonskoga bazenskog sustava, podruÄju Savske depresije. Cilj ovoga istraživanja bio je procijeniti moguÄi utjecaj ratnih zbivanja u Hrvatskoj (od prije 23 godine), kada je ovo podruÄje minirano, i utvrditi koncentracije metala. Deset uzoraka tla nasumiÄno je prikupljeno zajedno s korom i liÅ”Äem. Koncentracije glavnih metala i metala u tragovima mjerene su za sve 3 grupe uzoraka ICP metodom. Analizirano tlo sastoji se od kvarca, tinjÄastoga minerala, minerala 14Ć
, plagioklasa i mjeÅ”ovitoga sloja minerala. Sve vrijednosti metala u uzorcima uzetim iz nekadaÅ”njega minskog kratera veÄe su 2 ā 4 puta u odnosu na ostale. StatistiÄkom analizom dobiveni su pozitivni, statistiÄki znaÄajni Kendallovi tau-koeficijenti korelacije tragova metala (Cd, Cr, Cu, Ni, Zn) i za sve kombinacije uzoraka tla, liÅ”Äa i kore. Takvi rezultati upuÄuju na to da je ratna aktivnost odigrala odreÄenu ulogu u distribucijskome uzorku tla i vegetativnim razinama metala u tragovima
Secondary prevention in patients with low-energy hip fracture ā program of the University Clinical Centre āSestre milosrdniceā, Zagreb
OtkriÄe ugljikovodika u kompleksnom strukturno tektonskom sklopu duboke drave (istražna buÅ”otina severovci-1)
Regionalnom analizom āplay-aā hrvatskog dijela Panonskog bazena otkriven je dodatni potencijal unutar strukturne jedinice duboke Drave. Plinsko-kondenzatna polja Molve, Kalinovac i Stari Gradac unutar istražnog prostora Drava-02 smjeÅ”tena su u spuÅ”tenom krilu glavnog potolinskog rasjeda-Dravski rasjed i predstavljaju transpresijski antiklinalni kompleks. SeizmogeoloÅ”ka interpretacija struktura na prostoru geotektonske jedinice duboke Drave na 3D seizmiÄkim podacima (Molve i Molve jug) rezultirala je definiranjem prospekta Severovci. Prospekt predstavlja izduženu antiklinalu s dva maksimuma Äija duža os ima pružanje SZ-JI. Sa sjeveroistoÄne strane struktura je omeÄena normalnim rasjedom za koji se pretpostavljalo da predstavlja barijeru prema eksploatacijskom polju Ferdinandovac. S jugozapadne strane struktura Severovci od susjednih polja Molve, Kalinovac i Stari Gradac odvojena je āStrike slipā rasjedom pružanja SZ-JI istovjetnog kao i glavni potolinski rasjed. Cilj istražnog buÅ”enja bilo je masivno ležiÅ”te, analogno poljima Molve i Kalinovac. LežiÅ”ta na ovom poljima predstavljena su sa 4 litofacijesa: lit. I vapnenci (kalkareniti), lit. II dolomiti (dolomitna breÄa), lit. III kvarciti i lit IV. dijaftoriti. Primarni cilj istražne buÅ”otine Severovci-1 bio je nabuÅ”iti lit. I vapnenci i lit. II dolomiti koji su pretpostavljeni na osnovu analize seizmiÄkih podataka i njihove analogije sa seizmiÄkim podacima na polju Molve. Tijekom buÅ”enja istražne buÅ”otine Severovci-1 (KD 3410 m), u razdoblju od prosinca 2017. do ožujka 2018. godine, registrirano je 46 pojava novog plina Å”to je ukazalo na prisustvo zasiÄenja ugljikovodicima. ToÄan model brzine i strukturna interpretacija rezultirali su zanemarivom razlikom izmeÄu prognozirane i nabuÅ”ene dubine ležiÅ”ta te potvrdili rasjed prema polju Ferdinandovac kao barijeru. BuÅ”otina Severovci-1 nabuÅ”ila je litofacijese I i III (vapnenci i kvarciti) Äiji je udio u proizvodnji ugljikovodika okolnih polja gotovo 70 %. Pojava novih plinova tijekom buÅ”enja, relativne koncentracije do 17,1 %, u trajanju od 40 minuta, kao i analiza karotažnih mjerenja, usmjerili su istraživanje na 4 intervala unutar kvarcita podloge neogena. Sukladno podacima jezgre-1 intervala 3293-3302 m, ležiÅ”e unutar litofacijesa kvarcita je petrografski odreÄeno kao metapjeÅ”Äenjak / metapelit s mjestimiÄno gustim pukotinskim sustavom, visokim sadržajem pirita i UV pozitivnosti. Petrofizikalna XRMI interpretacija dokazala je postojanje ležiÅ”ta s dvojnim porozitetom i prisutnoÅ”Äu dva pukotinska sustava prema regionalnoj analizi naprezanja Å”to je potvrdilo inicijalnu strukturno tektonsku interpretaciju. Analiza jezgre kao i rezultati ispitivanja buÅ”otine ukazuju na slabo propusno ležiÅ”te s poroznoÅ”Äu 3-11 % i propusnoÅ”Äu od 0,1-3 mD, veÄa propusnost vezana je uz pukotinske zone. Stimulacija buÅ”otine koja je izvedena unutar slabo propusnog ležiÅ”ta je poveÄala ukupnu proizvodnju na cca. 53 000 m3/dan uz visoki udio vode (GWR 1800 cm3/m3) u opadanju, te proizvodnju kondenzata od 4 m3/dan. Nakon istražnog buÅ”enja te ispitivanja buÅ”otine dobiveni su podaci o proizvodnji ležiÅ”ta, koliÄinama ugljikovodika, tlaku i radijusu crpljenja, koji su bili potrebni za objavu komercijalnog otkriÄa
PREVENTIVE WORK IN FAMILY MEDICINE ā PROACTIVE APPROACH
Uloga lijeÄnika opÄe/obiteljske medicine u prevenciji bolesti i promociji zdravlja potvrÄena je rezultatima istraživanja te u zdravstvenoj politici. S obzirom na položaj lijeÄnika opÄe/obiteljske medicine u zdravstvenom sustavu i njegov bliski, trajni kontakt s populacijom koja ga je izabrala te s lokalnom zajednicom u kojoj djeluje, razumljivo je da je lijeÄniku opÄe/obiteljske medicine preventivni rad ukljuÄen kao neodvojivi dio redovitog, uobiÄajenog rada u praksi. Skrb za bolesnika u opÄoj medicini je kompleksna i proteže se od intervencija u determinantama zdravlja do palijativne skrbi. Preventivne aktivnosti su viÅ”e ili manje prisutne na svakom odsjeÄku tog procesa. Postoji znaÄajan raskorak izmeÄu znanja lijeÄnika opÄe/obiteljske medicine i postojeÄe prakse u koriÅ”tenju na znanstvenim dokazima utemeljenih preporuka za aktivnosti u promociji zdravlja i prevenciji bolesti. Opisali smo ulogu lijeÄnika opÄe obiteljske medicine u preventivnom radu i prikazali podatke o preventivnima aktivnostima u službi obiteljske medicine u Hrvatskoj. Za pravu ocjenu preventivnog rada obiteljskih lijeÄnika potrebno je raspolagati objektivnim na znanstvenim dokazima utemeljenim podacima koji Äe pokazati Å”to obiteljski lijeÄnici rade u praksi. Zbog toga je nužno da lijeÄnici sistematski bilježe i evaluiraju relevantne preventivne aktivnosti i aktivnosti koje provode u promociji zdravlja, a da se njihovo izvrÅ”enje programa redovito prati, evaluira te profesionalno i financijski vrednuje. Prema tim je principima StruÄna radna skupina za koordinaciju, praÄenje i usmjeravanje reforme u obiteljskoj medicini Ministarstva zdravstva i socijalne skrbi Republike Hrvatske izradila program preventivnih aktivnosti u obteljskoj medicini koji je prikazan u ovom raduThe role of general practitioner/family physician (GP/FP) in disease prevention and health promotion is strongly supported by research and health policies. The position of GPs/FPs in the health care system and their close, sustained contact with their patients and local community makes preventive care an integral part of GP/FP routine work. The spectrum of caring for patients in general practice/family medicine is actually very large, going from intervention on health care determinants to palliative care. The prevention-related activities are more or less present at each step of this āhealthcare continuumā. The significant gaps between GP/FP knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention. We describe the role of GP/FP in preventive care and report data on preventive care activities in the Croatian Family Medicine Service. More objective evidence is needed to see what GPs/FPs actually do in practice. For this reason, it is critical that GPs/FPs systematically record the most relevant preventive and health promotion activities that they perform. Furthermore, their performance of the preventive program should be regularly monitored, evaluated and professionally and financially validated. We present the preventive program based on these principles in Family Medicine Service proposed by the Ministry of Health and Social Welfare Working Group on Reform of Primary Health Care
CROATIAN GUIDELINES FOR THE PHARMACOTHERAPY OF TYPE 2 DIABETES
Uvod: Hrvatsko druÅ”tvo za dijabetes i bolesti metabolizma Hrvatskoga lijeÄniÄkog zbora izradilo je 2011. godine prve nacionalne smjernice o prehrani, edukaciji i samokontroli te farmakoloÅ”kom lijeÄenju Å”eÄerne bolesti tipa 2. Sukladno poveÄanom broju dostupnih lijekova te novim spoznajama o uÄinkovitosti i sigurnosti primjene veÄ ukljuÄenih lijekova, pokazala se potreba za obnovom postojeÄih smjernica za farmakoloÅ”ko lijeÄenje Å”eÄerne bolesti tipa 2 u Republici ĀHrvatskoj. Sudionici: Kao koautori Smjernica navedeni su svi Älanovi Hrvatskog druÅ”tva za dijabetes i bolesti metabolizma Hrvatskoga lijeÄniÄkog zbora, kao i ostalih ukljuÄenih struÄnih druÅ”tava, koji su svojim komentarima i prijedlozima pridonijeli izradi Smjernica. Dokazi: Ove su Smjernice utemeljene na dokazima, prema sustavu GRADE (engl. Grading of Recommendations, Assessment, Development and Evaluation) koji uz razinu dokaza opisuje i snagu preporuke. ZakljuÄci: Individualan pristup temeljen na fizioloÅ”kim principima regulacije glikemije nuždan je u lijeÄenju osoba sa Å”eÄernom bolesti. Ciljeve lijeÄenja i odabir medikamentne terapije treba prilagoditi oboljeloj osobi, uzimajuÄi u obzir životnu dob, trajanje bolesti, oÄekivano trajanje života, rizik od hipoglikemije, komorbiditete, razvijene vaskularne i ostale komplikacije, kao i ostale Äimbenike. Zbog svega navedenoga od nacionalnog je interesa imati praktiÄne, racionalne i provedive smjernice za farmakoloÅ”ko lijeÄenje Å”eÄerne bolesti tipa 2.Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of Ādiabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the Āpharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetesā patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglycemia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes
Hrvatske smjernice za farmakoloÅ”ko lijeÄenje Å”eÄerne bolesti tipa 2 [Croatian guidelines for the pharmacotherapy of type 2 diabetes]
Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the pharmacotherapy of type 2 diabetes in the Republic of Croatia.
Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes' patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglyce- mia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes