Kvaliteta života povezana sa zdravljem u bolesnika s primarnim glaukomom otvorenog kuta

The purpose of this research was to evaluate the relationship between general health-related quality of life (GHRQL) and sociodemographic factors in primary open-angle glaucoma (POAG) patients. A prospective cross-sectional study included 207 glaucoma patients. GHRQL was determined via two self-administered questionnaires: the 36-Item Short Form Survey (SF-36) and the EuroQol-5D (EQ-5D) questionnaire. Male and 50- to 69-year-old glaucoma patients, followed by patients who regularly used antiglaucoma therapy and those without progression of glaucoma reported a significantly higher quality of life as measured by the EQ-5D index and the EQ-5D visual analog scale (VAS) (p<0.05 all). Similarly, the Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-36 had significantly higher values for these patients (p<0.05 all). Furthermore, glaucoma patients with higher education and economic status, glaucoma patients who lived in rural areas, and those who were married achieved higher scores on EQ-5D and SF-36. In conclusion, progression of the disease, female sex, older age, lower education and economic status, urban area and unmarried status negatively affect quality of life in glaucoma patients.Svrha ovoga istraživanja bila je utvrditi odnos između kvalitete života povezane s općim zdravljem (GHRQL) i sociodemografskih čimbenika u bolesnika s primarnim glaukomom otvorenog kuta (POAG). Riječ je o presječnoj studiji u kojoj je sudjelovalo 207 bolesnika s POAG. GHRQL mjerena je pomoću dva upitnika: kratkog upitnika zdravstvenog statusa s 36 pitanja (SF-36) i upitnika EuroQol-5D (EQ-5D). Muškarci i bolesnici s glaukomom u dobi od 50-69 godina, zatim bolesnici koji su redovito koristili antiglaukomsku terapiju i oni bez progresije glaukoma izvijestili su o znatno višoj kvaliteti života mjerenoj indeksom EQ-5D i vizualnom analognom ljestvicom EQ-5D (VAS) (p<0,05 za sve usporedbe). Slično tome, Sažetak fizičkih komponenata (PCS) i Sažetak mentalnih komponenata (MCS) upitnika SF-36 imali su značajno veće vrijednosti za ove bolesnike (p<0,05 za sve usporedbe). Nadalje, ispitanici s visokim stupnjem obrazovanja i ekonomskim statusom, ispitanici koji žive u ruralnim područjima i oni koji su u braku postigli su veće rezultate na EQ-5D i SF-36. Zaključno, napredovanje bolesti, ženski spol, starija životna dob, niži stupanj obrazovanja i ekonomski status, urbano područje življenja i samoća negativno utječu na kvalitetu života bolesnika s glaukomom

Non-Financial Reporting as Part of Sustainability Accounting With the Examples of Good Practices

Doing business today for a conscious entrepreneur is not only focused on profit but also on the social, environmental, and economic aspects of doing business together with the sustainable development. Therefore, non-financial reporting for involved stakeholders is a new source of information based on which key decisions will be made related to the further development of the company itself. It contains information on relevant measures that affect the development of business and its results, the effects of business from the environmental and social aspect, the necessary tools to understand the development, business results and position of the company and the effects of its activities. In the European Union, non-financial reporting became mandatory from 1 January 2017 for all large publicinterest companies with more than 500 employees. The legal framework and the market are putting strong pressure on the development of sustainability accounting that is becoming more and more accepted in modern business practice

Non-Financial Reporting as Part of Sustainability Accounting With the Examples of Good Practices

Doing business today for a conscious entrepreneur is not only focused on profit but also on the social, environmental, and economic aspects of doing business together with the sustainable development. Therefore, non-financial reporting for involved stakeholders is a new source of information based on which key decisions will be made related to the further development of the company itself. It contains information on relevant measures that affect the development of business and its results, the effects of business from the environmental and social aspect, the necessary tools to understand the development, business results and position of the company and the effects of its activities. In the European Union, non-financial reporting became mandatory from 1 January 2017 for all large publicinterest companies with more than 500 employees. The legal framework and the market are putting strong pressure on the development of sustainability accounting that is becoming more and more accepted in modern business practice

NEW INSIGHTS INTO SCHIZOPHRENIA: A LOOK AT THE EYE AND RELATED STRUCTURES

Background: Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances. Methods: To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018. Results: Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a - wave activity in the photoreceptors or b - wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus. Conclusion: Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment

HALLUCINATORY EXPERIENCES IN VISUALLY IMPAIRED INDIVIDUALS: CHARLES BONNET SYNDROME – IMPLICATIONS FOR RESEARCH AND CLINICAL PRACTICE

Background: Charles Bonnet syndrome (CBS) refers to visual hallucinations that occur in individuals with preserved cognitive functions associated with visual impairment. Methods: This article reviews occurence of visual hallucinations in subjects with CBS by journals published in English in the Pubmed database in the period 1992-2018. Criteria for selection of appropriate papers were sufficient information and perspicuous view on pathogenesis, epidemiology, clinical presentation and treatment possibilities of CBS. Results: Most commonly, visual hallucinations in patients with CBS are complex, repetitive and stereotyped. Such individuals have preserved insight that those percepts are not real, and there is an absence of secondary explanatory delusions and hallucinations within other modalities. Seeing as the aforementioned percepts do not share all the characteristics of hallucinations, it remains unresolved how they should be referred to. Terms as release hallucinations, one that is reflecting its underlying pathogenesis, or confabulatory hallucinatory experiences have been proposed. Moreover, CBS has also been referred to as phantom vision syndrome and may occur in any ophthalmological disease. It is not particularly connected with loss of function along any level of the visual pathway. Although this syndrome is mostly associated with age-related macular degeneration, glaucoma and cataract, it could be related to almost any other ophthalmological conditions. The incidence of CBS alongside with mostly other ocular pathology is rising as population is ageing. Conclusions: Nonetheless, CBS remains commonly underreported, under recognized and/or misrecognized. Albeit the treatment recommendations and guidelines are not yet fully established, it is important to raise awareness of this specific and distinct condition, which inevitably implicates many differential diagnostic deliberations

Usporedba morfologije glave vidnoga živca u bolesnika s primarnim glaukomom otvorenog kuta i nearteritičkom ishemijskom optičkom neuropatijom

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.Svrha ovoga rada bila je utvrditi oštećenje ganglijskih stanica mrežnice i morfološke promjene glave vidnoga živca u ispitanika s primarnim glaukomom otvorenog kuta (POAG) i nearteritičkom prednjom ishemijskom optičkom neuropatijom (NAION). Prva skupina ispitanika sastojala se od 40 očiju s POAG, druga skupina od 40 očiju s NAION i treća skupina od 40 očiju s refrakcijskom anomalijom (kontrolna skupina).Svim ispitanicima napravljena je automatizirana perimetrija i analiza topografije glave vidnoga živca pomoću konfokalne skenirajuće laserske oftalmoskopije (CSLO)-HRT II. Smanjena mrežnična osjetljivost prevladavala je u bolesnika s POAG, dok su se u bolesnika s NAION defekti očitovali u obliku koncentrično suženog vidnog polja i kvadrantnih ispada. Topografske promjene glave vidnoga živca ispitivane pomoću HRT II ukazale su na to da je u bolesnika s POAG i NAION oštećen jednak broj sektora. Veći broj sektora u gornjem dijelu glave vidnoga živca bio je oštećen u bolesnika s NAION. Morfologija glave vidnoga živca značajno se razlikovala između bolesnika s POAG i NAION, pokazujući veće stanjenje neuroretinalnog ruba i veću dubinu ekskavacije u bolesnika s POAG

NEW INSIGHTS INTO SCHIZOPHRENIA: A LOOK AT THE EYE AND RELATED STRUCTURES

Background: Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances. Methods: To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018. Results: Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a - wave activity in the photoreceptors or b - wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus. Conclusion: Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment

Comparison of Optic Nerve Head Morphology in Patients with Primary Open Angle Glaucoma and Non-Arteritic Anterior Ischemic Optic Neuropathy

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group

Correlation between internalized stigma, perception of discrimination and empowerment in schizophrenia patients

U istraživanju je ispitana veza između internalizirane stigme, percepcije diskriminacije i osnaženja na 80 sudionika oboljelih od shizofrenije. Ispitana je i mogućnost predikcije razine samostigmatizacije na temelju stupnja osnaženja, percepcije diskriminacije, te socijalne podrške, uz osvrt na moderatorski utjecaj socijalne podrške na vezu između ovih ljestvica. Na kraju je utvrđena veza između sociodemografskih karakteristika, te osobnih i socijalnih aspekata bolesti i ovih triju ljestvica. Pearsonovim koeficijentom korelacije utvrđena je značajna, negativna povezanost (r=-0,673) između internalizirane stigme i stupnja osnaženosti, umjerena pozitivna povezanost između razine samostigmatizacije i percepcije diskriminacije (r=0,430), te niža negativna povezanost između stupnja osnaženosti i percepcije diskriminacije (r=-0.380). Stupanj osnaženosti i percepcija diskriminacije pokazali su se kao dobri prediktori razine samostigmatizacije, dok se socijalna podrška pokazala kao moderator veze između samostigmatizacije i percipirane devaluacije. Sudionici s većom socijalnom podrškom pokazuju manju samostigmatizaciju u slučaju niže percepcije devaluacije, dok sudionici s manjom socijalnom podrškom pokazuju višu i stabilniju samostigmatizaciju, čak i kada im je percepcija diskriminacije niska. Kod specifičnih socijalnih aspekata bolesti, sudionici s bliskom osobom u obitelji pokazuju veći stupanj osnaženja od onih koji takvu podršku nemaju. Skupine različitih sociodemografskih karakteristika (spola, stupnja obrazovanja i radnog statusa), te osobnih aspekata bolesti (poznavanja dijagnoze i slaganja s dijagnozom) ne razlikuju se značajno u rezultatima na ovim ljestvicama. Navedeni rezultati ukazuju na mogućnost smanjena razine štetne samostigmatizacije uvođenjem programa osnaženja oboljelih, te programa edukacije javnosti u svrhu smanjenja diskriminacije prema njima. Rezultati također ukazuju na važnost socijalne podrške za oboljele od shizofrenije.This study investigated the correlation between internalized stigma, perception of discrimination and empowerment, on 80 participants suffering from schizophrenia. The predictive power of empowerment, perception of discrimination and social support was also examined, along with the moderation effect of social support. Finally, we tested the effect of demographic characteristics, and personal and social aspects of the illness, on differences in these three scales. We found significant and negative Pearson correlation (r = -0.673) between the level of internalized stigma and the level of empowerment, moderate positive correlation between the level of self-stigma and perception of discrimination (r = 0.430) and low negative correlation between the level of empowerment and perception of discrimination (r = -0.380). Empowerment and perception of discrimination proved to be good indicators of self-stigma, while social support proved to be a moderator of the correlation between self-stigma and perceived devaluation. Participants with greater social support showed lower self-stigma if perception of devaluation was also low, while participants with lower social support showed higher and more stable self-stigma, even when their perception of discrimination was low. When it comes to specific aspects of social support, participants with close family members showed higher levels of empowerment than those who did not have such support. Groups of different socio-demographic characteristics (gender, education level and employment) and personal aspects of the illness (knowledge and agreeing with diagnosis) do not differ significantly in the results on these three scales. These findings indicate that introducing empowering programs and public awareness programs can play a role in reducing harmful internalized stigma among patients with schizophrenia. The results also point to the importance of social support