Smoking Habit and Nicotine Effects

Smoking is a gained habit with which one starts experimenting at the age of 10, and it usually becomes part of the habit at the age of 20. It is the combination of narcotic addiction and deep-seated smoking habits. Nicotine is the main cause of smoking addiction, and the custom of preparation for smoking itself and smell of cigarettes create addictive behavior among smokers. Today, nicotine is socially most widely accepted legal drug in the world, and its uptake into the organism through the respiratory tract is 10 times stronger than heroin. Addiction and necessity for cigarettes are constant and intense, and the treatment for smoking addicts is long and difficult. Smoking is a worldwide epidemic, which is closely connected to other addictions such as coffee, alcohol, drugs, and gambling

STAVOVI STUDENATA MEDICINE, PRAVA I PSIHOLOGIJE PREMA DISTANAZIJI I PRAVU PACIJENATA NA SUODLUČIVANJE O POSTUPCIMA LIJEČENJA U TERMINALNOJ FAZI BOLESTI

Distanazija se odnosi na primjenu medicinskih zahvata s ciljem održavanja života u slučajevima kada ne postoji nikakva nada za izlječenjem, pri čemu ti postupci mogu dovesti do produljenja patnje i boli kod bolesnika. U ovom istraživanju ispitani su stavovi 370 studenata prve i završnih godina studija medicine, prava i psihologije o distanaziji te o pravu pacijenta na suodlučivanje u procesu liječenja u terminalnoj fazi bolesti. Stavovi studenata prema distanaziji su pretežno pozitivni u slučajevima kada se to liječenje doživljava kao borba za život pacijenta, dok je u slučajevima naglašavanja patnje pacijenta i obitelji stav prema distanaziji blago negativan. Studenti završnih godina studija medicine imaju statistički značajno negativniji stav prema distanaziji od studenata prve godine, te studenata ostalih studija. Sve ispitane skupine studenata imaju pozitivan stav prema pravu pacijenta na suodlučivanje u procesu liječenja, s tim da studenti prve godine medicine imaju relativno najniže procjene. Pozitivan stav prema distanaziji nisko je povezan s većom religioznošću ispitanika (r=-0,308), te vrlo nisko s konzervativnim životnim svjetonazorom (r=0,162), dok je osobno iskustvo tijekom studija vezano uz zahvat koji ne može pomoći pacijentu tek neznatno povezano s negativnijim stavom prema distanaziji (r=0,131). Korelacija između stava prema distanaziji i eutanaziji niska je i negativna (r=-0,354) što može ukazivati na blagu tendenciju da ispitanici odustajanje od distanazije mogu doživljavati kao neki oblik pasivne eutanazije. Rezultati ukazuju na složenost koncepta distanazije i potrebu multidisciplinarnog pristupa ovom problemu

Interventions of Health Visitors in Making a Decision About Breastfeeding

Aim: The aim of this paper was to establish a link between the promotion of breastfeeding and the interventions of the visiting nurse. Methods: The study was conducted in 2012 in the city of Đakovo and the surrounding area. The questionnaire was filled out by mothers after leaving the maternity ward, during the first visit of the community health nurse within the first seven days after the labor. Results: From a total of 154 parturient women who filled in a survey after they had left the hospital, the decision about breastfeeding before the pregnancy was made by 58.4% of examinees. Primiparas from the city were older than primiparas from the surrounding rural area (p<0.001). Mothers received the majority of information about the proper placement of the child on the chest after birth from nurses in the maternity hospital (56.3% of the examinees). The study showed that 57.9% of the examinees had the support of their husband during lactation. The visiting nurses’ first visit was within seven days after delivery at the home of 121 (78.6%) examinees, showing good awareness and collaboration between secondary and primary health care. Conclusion: This research has confirmed that breastfeeding promotion and nursing interventions have a major impact on breastfeeding

ASSESSMENT OF NUTRITIONAL RISKS IN HOSPITALISED PATIENTS

Otkrivanje pothranjenosti u bolesnika važan je zadatak jer pothranjenost utječe na morbiditet, mortalitet, dužinu hospitalizacije i troškove liječenja. Cilj rada bio je jednostavnim i brzim testom otkriti koliko se hospitaliziranih bolesnika nalazi u nutritivnom riziku. Ispitana su 843 bolesnika hospitalizirana na Klinici za internu medicinu lokaliteta Rijeke od 1. studenoga 2001. do 1. listopada 2003. Za procjenu nutritivnog rizika koristili smo Nottingham Screening Tool (NST) koji boduje indeks tjelesne mase (engl. body mass index – BMI), gubitak težine u zadnja tri mjeseca, uzimanje hrane mjesec dana prije hospitalizacije i težinu osnovne bolesti. Od ukupnog broja ispitanika, 48% se nije nalazilo u nutritivnom riziku, 27% je zahtijevalo praćenje i reevaluaciju, a 25% nutritivnu potporu. U skupini bolesnika s malignom bolešću, čak se 75% bolesnika nalazilo u nutritivnom riziku, što je statistički značajno češće (p<0, 001) u odnosu prema skupini nemalignih bolesnika. Dobiveni rezultati nalažu evaluaciju nutritivnog statusa pri prijemu u bolnicu jer adekvatnim tretmanom pothranjenosti možemo utjecati na tok i troškove liječenja.Revealing nutrition status in patients is an important task because malnutrition influences morbidity, mortality, the length of hospital stay and costs. The aim of the study was to find out how many hospitalised patients are at a nutritional risk, with a fast and simple test. We examined patients hospitalised at the Internal Clinic of the Clinical Hospital Centre Rijeka in the period from November 1st 2001 till October 1st 2003. To assess the nutritional risk we used the Nottingham Screening Tool (NST) which scores body mass index (BMI), recent body weight loss, food intake before the hospitalisation and the severity of illness. We examined 843 patients. Only 48% were not at nutritional risk, 27% demanded monitoring and re-evaluation, and 25% were referred to dietetic advice. Of those 23% with malignancies, 75% were at nutritional risk. In comparison with non-malignant patients, the result was statistically significant (p<0,001). There is a significant malnutrition risk in hospitalised patients, especially in malignant ones. NST is a fast and efficient test for assessing the malnutrition risk. Malnutrition has to be evaluated and treated with nutrition support measure

Palliative Care and Medical-spiritual Needs of Terminally Patients

Posljednjih se godina, nemoćnošću medicine da djelotvorno odgovori na sve veći broj smrtonosnih ishoda bolesti, javlja snažna potreba za uspostavom palijativne medicine, pokreta hospicija i terapeutske primjene duhovne skrbi, kako bi se bolesnicima s progresivnim neizlječivim bolestima omogućilo holističko ublažavanje tjelesne boli i psihološke patnje medicinskom i duhovnom skrbi, kojima bi se poboljšala preostala kvaliteta života i omogućilo dostojanstveno umiranje. S tim ciljem, ovaj članak opisuje osnovne značajke, organizacijske oblike, zakonodavne okvire, potrebu uspostave i pristup palijativne medicine uvažavajući medicinske i duhovne potrebe terminalnih bolesnika.According to the powerlessness of medicine to respond effectively to the growing number of lethal outcomes of the diseases, in recent years occurred an intense need for the establishment of palliative medicine, hospice movement and therapeutic applications of spiritual care. The purpose of these was to allow holistic relieve of physical pain and psychological suffering with the medical and spiritual care for the patients with progressive incurable diseases, to enhance the quality of remaining life and the allowance of dignified dying. To achieve that aim, this article describes the basic features, organizational forms, legal framework, the establishment and access to palliative care, while taking into account the medical and spiritual needs of terminal patients

DEPRESSION AND SUICIDALITY DURING PREGNANCY

Background: Pregnant women experience a set of biological and psychological disturbances. The aim of this study was to assess the appearance of depressive symptoms and suicidal thoughts in pregnant women during the third trimester of pregnancy. Subjects and methods: A total of 110 pregnant women were included in the study. All of them filled out an anonymous questionnaire about sociodemographic data, Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Results: Study participants were between 18-46 years of age. 45.45% of the pregnant women were between 37 and 39 weeks pregnant. According to the EPDS, the risk for perinatal depression was observed in 29 (23.36%) pregnant women: 15 (13.64%) of them had a total score on EPDS from 10-12, and 14 (12.72%) had a total score of 13-20. A higher score on both Beck scales was characteristic for pregnant women with a higher risk for the development of perinatal depression based on the results on EPDS. The prevalence of suicidal thoughts was 2.73%. Conclusions: Perinatal depression is a state which should be given more attention. The recognition of perinatal depression during pregnancy allows health medical workers to observe pregnant women at risk and then to make preventive and clinical interventions. The risk for perinatal depression is higher in pregnant women with more expressed depressive and anxiety symptoms. Pregnant women with suicidal thoughts are more anxious and depressed

ASSESSMENT OF NUTRITIONAL RISKS IN HOSPITALISED PATIENTS

Otkrivanje pothranjenosti u bolesnika važan je zadatak jer pothranjenost utječe na morbiditet, mortalitet, dužinu hospitalizacije i troškove liječenja. Cilj rada bio je jednostavnim i brzim testom otkriti koliko se hospitaliziranih bolesnika nalazi u nutritivnom riziku. Ispitana su 843 bolesnika hospitalizirana na Klinici za internu medicinu lokaliteta Rijeke od 1. studenoga 2001. do 1. listopada 2003. Za procjenu nutritivnog rizika koristili smo Nottingham Screening Tool (NST) koji boduje indeks tjelesne mase (engl. body mass index – BMI), gubitak težine u zadnja tri mjeseca, uzimanje hrane mjesec dana prije hospitalizacije i težinu osnovne bolesti. Od ukupnog broja ispitanika, 48% se nije nalazilo u nutritivnom riziku, 27% je zahtijevalo praćenje i reevaluaciju, a 25% nutritivnu potporu. U skupini bolesnika s malignom bolešću, čak se 75% bolesnika nalazilo u nutritivnom riziku, što je statistički značajno češće (p<0, 001) u odnosu prema skupini nemalignih bolesnika. Dobiveni rezultati nalažu evaluaciju nutritivnog statusa pri prijemu u bolnicu jer adekvatnim tretmanom pothranjenosti možemo utjecati na tok i troškove liječenja.Revealing nutrition status in patients is an important task because malnutrition influences morbidity, mortality, the length of hospital stay and costs. The aim of the study was to find out how many hospitalised patients are at a nutritional risk, with a fast and simple test. We examined patients hospitalised at the Internal Clinic of the Clinical Hospital Centre Rijeka in the period from November 1st 2001 till October 1st 2003. To assess the nutritional risk we used the Nottingham Screening Tool (NST) which scores body mass index (BMI), recent body weight loss, food intake before the hospitalisation and the severity of illness. We examined 843 patients. Only 48% were not at nutritional risk, 27% demanded monitoring and re-evaluation, and 25% were referred to dietetic advice. Of those 23% with malignancies, 75% were at nutritional risk. In comparison with non-malignant patients, the result was statistically significant (p<0,001). There is a significant malnutrition risk in hospitalised patients, especially in malignant ones. NST is a fast and efficient test for assessing the malnutrition risk. Malnutrition has to be evaluated and treated with nutrition support measure

Palliative Care and Medical-spiritual Needs of Terminally Patients

Posljednjih se godina, nemoćnošću medicine da djelotvorno odgovori na sve veći broj smrtonosnih ishoda bolesti, javlja snažna potreba za uspostavom palijativne medicine, pokreta hospicija i terapeutske primjene duhovne skrbi, kako bi se bolesnicima s progresivnim neizlječivim bolestima omogućilo holističko ublažavanje tjelesne boli i psihološke patnje medicinskom i duhovnom skrbi, kojima bi se poboljšala preostala kvaliteta života i omogućilo dostojanstveno umiranje. S tim ciljem, ovaj članak opisuje osnovne značajke, organizacijske oblike, zakonodavne okvire, potrebu uspostave i pristup palijativne medicine uvažavajući medicinske i duhovne potrebe terminalnih bolesnika.According to the powerlessness of medicine to respond effectively to the growing number of lethal outcomes of the diseases, in recent years occurred an intense need for the establishment of palliative medicine, hospice movement and therapeutic applications of spiritual care. The purpose of these was to allow holistic relieve of physical pain and psychological suffering with the medical and spiritual care for the patients with progressive incurable diseases, to enhance the quality of remaining life and the allowance of dignified dying. To achieve that aim, this article describes the basic features, organizational forms, legal framework, the establishment and access to palliative care, while taking into account the medical and spiritual needs of terminal patients

Utjecaj rizičnih i zaštitnih obiteljiskih, društvenih i crkvenih čimbenika na rast i razvoj djece

Facing the strong influence of family, society and the Church on child’s growth and development, this paper draws attention to their potentially destructive reflection and focuses on positive factors indicating appropriate circumstances of growing up.U radu se daje pregled nepovoljnih uvjeta rasta i razvoja djece u obitelji te se ukazuje na zaštitnički milje obiteljskoga ozračja na odgoj djece. Na rast i razvoj djece uz obitelj, zaštitnički ili destruktivno, mogu utjecati brojne društvene okolnosti i socijalni čimbenici. Također, razmatra se mogućnost primjene reformiranih religiozno-pastoralnih modela rada s primjerenim sadržajima u okviru Crkve kako bi se osigurao prikladan rast i razvoj djeteta, posebno djece s posebnim potrebama i poteškoćama u razvoju. Suočeni sa snažnim utjecajem obitelji, društva i Crkve na rast i razvoj djeteta, ovaj rad upozorava na njihov potencijalno rizičan odraz i ukazuje na pozitivne čimbenike primjerene okolnostima odrastanja

Utjecaj rizičnih i zaštitnih obiteljiskih, društvenih i crkvenih čimbenika na rast i razvoj djece

Facing the strong influence of family, society and the Church on child’s growth and development, this paper draws attention to their potentially destructive reflection and focuses on positive factors indicating appropriate circumstances of growing up.U radu se daje pregled nepovoljnih uvjeta rasta i razvoja djece u obitelji te se ukazuje na zaštitnički milje obiteljskoga ozračja na odgoj djece. Na rast i razvoj djece uz obitelj, zaštitnički ili destruktivno, mogu utjecati brojne društvene okolnosti i socijalni čimbenici. Također, razmatra se mogućnost primjene reformiranih religiozno-pastoralnih modela rada s primjerenim sadržajima u okviru Crkve kako bi se osigurao prikladan rast i razvoj djeteta, posebno djece s posebnim potrebama i poteškoćama u razvoju. Suočeni sa snažnim utjecajem obitelji, društva i Crkve na rast i razvoj djeteta, ovaj rad upozorava na njihov potencijalno rizičan odraz i ukazuje na pozitivne čimbenike primjerene okolnostima odrastanja