ACTIVITIES OF STUDENT SECTION FOR PUBLIC HEALTH "ANDRIJA ŠTAMPAR"

Potaknuti željom da doprinesemo javno-zdravstvenoj aktivnosti među studentima, educiramo zajednicu, doprinesemo društvu te potaknemo raspravu o različitim temama iz područja javnog zdravstva počeli smo 2017. godine s našom vizijom i projektima. Velika motivacija i inspiracija nam je lik i djelo akademika Andrije Štampara čiji ideje želimo provoditi i u ruhu 21. stoljeća. Škola narodnog zdravlja „Andrija Štampar“ je od početka prepoznala našu volju i želju te nas je u potpunosti podržala od samog početka. Dvije godine sudjelujemo u međunarodnom projektu Movember, a ove godine smo organizirali zajedno s partnerima tribinu o muškoj neplodnosti gdje smo dali presjek ove problematike iz različitih perspektiva. Cijepljenje kao jedna od najaktualnijih tema današnjice predmet je i našeg rada. Iz tog razloga smo organizirali tribinu Cijepljenje – kontroverze vs. činjenice gdje smo uz pomoć stručnjaka iz ovog područja prikazali važnost i nužnost cijepljenja za ljudsku populaciju, te ukazali na nedorečenosti i znanstvene nepotkrijepljenosti stavova protivnika cijepljenja. Sudjelovali smo i na stručnom skupu Izazovi procijepljenosti u Republici Hrvatskoj – Kako zaštiti javno zdravlje? gdje smo zajedno ostalim dionicama sustava nastojali pronaći rješenja za izazove s kojima se medicina susreće danas. Svjesni važnosti preventivnog djelovanja, već dvije godine podržavamo međunarodni simpozij Štamparovi dani – Zdravi stilovi života gdje sudjelujemo u javnozdravstvenim akcijama. U želji da studente medicine i opću populaciju upoznamo s načinom financiranja zdravstvenog sustava, troškovima u zdravstvu i činjenicom da svaka dijagnostička pretraga košta, organizirali smo tribinu Koliko košta zdravstvena zaštita?. U sklopu promotivno-preventivnog programa Zdravo sveučilište organizirali smo tribinu Gdje je nestao projekt Sveučilišne bolnice želeći istražiti što se s navedenim projektom događalo tijekom vremena i zašto je stao jedan od strateških ciljeva grada Zagreba i Republike Hrvatske. Također, organizirali smo tribinu zajedno sa Studentskim zborom Medicinskog fakulteta Sveučilišta u Zagrebu, na temu staža - Staž doktora medicine. Na toj tribini govorilo se o problemu koji trenutačno najviše zaokuplja studente medicine. Vrhunac našeg djelovanja je portal Pitaj Andriju!. Projekt je osmišljen po principu „studenti za studente“ kao prvi javnozdravstveni portal namijenjen studentskoj populaciji koja je kao najzdravija populacija često zanemarena unutar zdravstvenog sustava. Držimo i predavanja zdravstvenog odgoja na temu reproduktivnog zdravlja u srednjim školama. Nakon što naši članovi prođu edukaciju o spolno prenosivim bolestima i reproduktivnom zdravlju dolaze u škole gdje učenike educiraju o ovoj važnoj javnozdravstvenoj tematici. Organiziranjem tribine Zdravlje za sve u 21. st. - Rano otkrivanje raka dojke nastojali smo zainteresiranoj populaciji dati odgovore na pitanje o ovoj tematici te predstaviti trenutnu situaciju u Hrvatskoj i svijetu.Inspired by the desire to contribute to public health activities among students, educate the community, contribute to society and encourage discussion on various topics in the field of public health, we started with our vision and projects. Our great motivation and inspiration is the character and work of academician Andrija Štampar whose ideas we want to implement in the 21st century. National School of Public Health "Andrija Štampar" has recognized our will and desire from the beginning and has fully supported us from the outset. We have been participating in the international project Movember for two years and this year we have organized together with our partners a forum on male infertility where we gave a cross-section of this issue from different perspectives. Vaccination as one of the most current issues of nowdays is the subject of our work. For that reason we have organized the Vaccination - controversy vs. facts where we with the help of experts in this field showed the importance and necessity of vaccination for the human population, and pointed out the imprecision and scientific incompetence of the attitudes of the vaccine opponents. We also participated in the expert meeting Challenges of vaccination in the Republic of Croatia - How to protect public health? where along with other members of health system we tried to find solutions to the challenges that medicine is facing today. Aware of the importance of preventive action, we have been supporting for two years the international symposium Štamparovi Dani - Healthy lifestyles where we participate in public health actions. In the wish to acquaint students of medicine and interested citizens with the way of financing the health system, costs in health care and the fact that each diagnostic test costs, we organized a panel discussion How much health care cost?. Within the promotional-preventive program Healthy University we organized a forum Where the project of the University Hospital has gone? and wanted to investigate what happened with the mentioned project over time and where is one of the strategic goals of the city of Zagreb and the Republic of Croatia. We also organized a panel together with the Student Councile of the School of Medicine,University of Zagreb, on the subject of internship – Physician\u27s internship. At this forum, we discuss the problem that currently occupies most of medical students. The peak of our activity is the web site Ask Andrija!. The project was designed according to the principle "students for students" as the first public health portal for the student population, which as the most healthy population is often neglected within the health system. We also hold lectures in high schools. After our members go through education on sexually transmitted diseases and reproductive health, they come to schools where school population are taught about this important public health issue. By organizing event Health for Everyone in the 21st century - Early detection of breast cancer we tried to give answers to the issue on this topic and present the current situation in Croatia and the world

Rezultati liječenja bolesnika s metastatskim rakom bubrega nivolumabom – donacijskim programom na ime bolesnika (npp) u Kliničkom bolničkom centru Zagreb

Field of metastatic renal cell cancer (mRCC) treatments is now evolving at a rapid and unprecedented pace. Nivolumab prolongs survival in patients with metastatic kidney cancer with a favorable safety profile as demonstrated in the Check-Mate 025 clinical trial. Nivolumab compared to everolimus prolonged survival in patients with mRCC while exibiting favorbale safety profile. In this study we present the results of nivolumab treatment in patients with mRCC within named patient program (NPP) at UHC Zagreb. In 30% of included patients survival was longer than 30 months and 16.6% patients had a complete response.Područje liječenja metastatskog raka bubrega (mRCC) je područje ubrzanog razvoja terapijskih mogućnosti. Nivolumab produljuje preživljenje bolesnika s metastatskim rakom bubrega uz dobar sigurnosni profil što je pokazano u kliničkoj studiji CheckMate025. Nivolumab u usporedbi s everolimusom produljuje preživljenje kod bolesnika sa mRCC uz povoljni sigurnosni profil lijeka. U ovoj analizi smo prikazali rezultate liječenja bolesnika nivolumabom u NPP u Kliničkom bolničkom centru Zagreb tijekom 2016. do 2018. 30% bolesnika ima preživljenje dulje od 30 mjeseci, a 16.6% je imalo kompletni odgovor na terapiju

DIFFERENCES IN DRUG CONSUMPTION BETWEEN CITY OF ZAGREB AND POŽEGA-SLAVONIA COUNTY FROM 2010 TO 2017

Uvod: Racionalna potrošnja lijekova preduvjet je održivog i učinkovitog zdravstvenog sustava. Praćenjem kretanja potrošnje lijekova možemo analizirati njihov status te na taj način evaluirati stanje pojedine skupine lijekova. Cilj: Cilj ovog rada bio je usporediti potrošnju lijekova u Gradu Zagrebu i Požeško-slavonskoj županiji te analizirati razlike u potrošnji. Metode: Korištenjem podataka Hrvatske agencije za lijekove i medicinske proizvode (HALMED) analizirali smo potrošnju lijekova prema anatomsko-terapijsko-kemijskoj (ATK) klasifikaciji izraženu u definiranoj dnevnoj dozi na 1000 stanovnika po danu (DDD/1000/dan) i novčano (HRK). Skupine lijekova koje su analizirane su sljedeće: lijekovi koji djeluju na probavni sustav i mijenu tvari (ATK skupina A), kardiovaskularni sustav (ATK skupina C), lijekovi za liječenje sustavne infekcije (ATK skupina J) i za respiratorni sustav (ATK skupina R). Rezultati: Grad Zagreb bilježi rast potrošnje lijekova koji djeluju na probavni sustav i mijenu tvari sa 118.10 DDD 2010. godina na 179.39 DDD 2017. godine. Novčano, potrošnja je porasla s 105,062,656 HRK na 135,642,231 HRK. U istom razdoblju u Požeško-Slavonskoj županiji zabilježen je pad potrošnje iste skupine lijekova s 158.72 DDD na 130.49 DDD. Izraženo u kunama, ostvaren je pad s 8,768,315 HRK na 8,013,176 HRK. U Gradu Zagreb je od 2010. do 2017. godine zabilježen je blagi pad potrošnje lijekova koji djeluju na kardiovaskularni sustav s 368.44 DDD na 354.07 DDD. U financijskom smislu ostvareno je smanjeno opterećenje s 174,866,121 HRK na 138,363,227 HRK. U istom razdoblju u Požeško-Slavonskoj županiji smanjena je potrošnja s 518.77 DDD na 249.97 DDD. Izraženo u kunama, potrošnja je smanjena s 14,873,979 HRK na 10,114,315 HRK. Potrošnja lijekova za liječenje sustavnih infekcija ostala je stabilna tijekom vremena u Gradu Zagrebu - 21.59 DDD, odnosno 22.93 DDD. Međutim, financijsko opterećenje je značajno poraslo s 40,579,840 HRK na 114,858,971 HRK. U Požeško-Slavonskoj županiji njihova potrošnja je prepolovljena, s 26.06 DDD na 18.14 DDD te s 3,153,539 HRK na 1,888,795 HRK. U Gradu Zagrebu zabilježen je porast potrošnje lijekova koji djeluju na respiratorni sustav s 55.59 DDD na 64.65 DDD. Prevedeno u novac, potrošnja je porasla sa 60,643,520 HRK na 67,842,946 HRK. Požeško-Slavonska županija bilježi pad potrošnje iste skupine lijekova s 64.23 DDD na 53.69 DDD, odnosno s 4,682,399 HRK na 3,921,239 HRK. Zaključak: Grad Zagreb bilježi rast potrošnje 3 skupine lijekova i u DDD i u HRK. Pala je samo potrošnja lijekova koji djeluju na kardiovaskularni sustav. Za razliku od toga, Požeško-Slavonska županija bilježi pad u sve 4 skupine lijekova u oba parametra. 2010. godine potrošnja sve 4 ATK skupine lijekova u Požeško-slavonskoj županiji izražena u DDD bila je veća nego u Gradu Zagrebu, dok je 2017. godina ona manja u svim promatranim skupinama.Introduction: Rational drug consumption is essential for a sustainable and efficient health system. By monitoring drug consumption trends, we can analyze and evaluate the state of a particular group of drugs. Aim: The aim of this paper was to compare drug consumption in the City of Zagreb and Požega-Slavonia County and analyze the differences in consumption. Methods: Data were acquired from the Agency for Medicinal Products and Medical Devices of Croatia (HALMED). We analyzed the consumption of drugs according to The Anatomical Therapeutic Chemical (ATC) Classification System and expressed in the defined daily doses per 1000 inhabitants per day (DDD/1000/day) and money (HRK). The following groups of drugs were analyzed: drugs affecting the alimentary tract and metabolism (ATC group A), cardiovascular system (ATC group C), antiinfectives for systemic use (ATC group J) and drugs affecting the respiratory system (ATC group R). Results: City of Zagreb documented a rise in the consumption of drugs that affect alimentary tract and metabolism, from 118.10 DDD in 2010 to 179.39 DDD in 2017. In terms of money, consumption increased from HRK 105,062,656 to HRK 135,642,231. During the same period, in the Požega-Slavonia County, there was a decrease in consumption of the same drug group from 158.72 DDD to 130.49 DDD. Expressed in HRK, a decrease from HRK 8,768,315 to HRK 8,013,176 was recorded. In the City of Zagreb, from 2010 to 2017, there was a slight decrease in the consumption of drugs that affect the cardiovascular system, from 368.44 DDD to 354.07 DDD. In financial terms, there was a cost reduction from HRK 174,866,121 to HRK 138,363,227. In the same period, consumption in Požega-Slavonia County decreased from 518.77 DDD to 249.97 DDD. In Croatian kunas, the cost decreased from HRK 14,873,979 to HRK 10,114,315. The consumption of antiinfectives for systemic use remained stable over the observed time period in the City of Zagreb –21.59 DDD in 2010 to 22.93 DDD to 2017. However, the financial burden increased significantly from HRK 40,579,840 to HRK 114,858,971 respectively. In the County of Požega-Slavonia the consumption and cost were reduced almost 50%, from 26.06 DDD to 18.14 DDD and from 3.153.539 HRK to 1.888.795 HRK respectively. In the City of Zagreb there was an increase in the consumption of drugs affecting the respiratory system, from 55.59 DDD to 64.65 DDD. Converted into money, consumption increased from HRK 60,643,520 to HRK 67,842,946. County of Požega-Slavonia recorded a decrease in consumption of the same drug group from 64.23 DDD to 53.69 DDD and from 4.682.399 HRK to 3.9221.239 HRK respectively. Conclusion: The City of Zagreb documented an increase in consumption in 3 groups of drugs, both in DDD and HRK. Only the consumption of drugs affecting the cardiovascular system was reduced. On the other hand, Požega-Slavonia County decreased consumption in all 4 groups of drugs in both parameters. In 2010, the consumption of all 4 ATC drug groups in Požega-Slavonia County expressed in DDD was higher than in the City of Zagreb, while in 2017 it was lower in all analyzed groups

DIFFERENCES IN DRUG CONSUMPTION BETWEEN CITY OF ZAGREB AND POŽEGA-SLAVONIA COUNTY FROM 2010 TO 2017

Uvod: Racionalna potrošnja lijekova preduvjet je održivog i učinkovitog zdravstvenog sustava. Praćenjem kretanja potrošnje lijekova možemo analizirati njihov status te na taj način evaluirati stanje pojedine skupine lijekova. Cilj: Cilj ovog rada bio je usporediti potrošnju lijekova u Gradu Zagrebu i Požeško-slavonskoj županiji te analizirati razlike u potrošnji. Metode: Korištenjem podataka Hrvatske agencije za lijekove i medicinske proizvode (HALMED) analizirali smo potrošnju lijekova prema anatomsko-terapijsko-kemijskoj (ATK) klasifikaciji izraženu u definiranoj dnevnoj dozi na 1000 stanovnika po danu (DDD/1000/dan) i novčano (HRK). Skupine lijekova koje su analizirane su sljedeće: lijekovi koji djeluju na probavni sustav i mijenu tvari (ATK skupina A), kardiovaskularni sustav (ATK skupina C), lijekovi za liječenje sustavne infekcije (ATK skupina J) i za respiratorni sustav (ATK skupina R). Rezultati: Grad Zagreb bilježi rast potrošnje lijekova koji djeluju na probavni sustav i mijenu tvari sa 118.10 DDD 2010. godina na 179.39 DDD 2017. godine. Novčano, potrošnja je porasla s 105,062,656 HRK na 135,642,231 HRK. U istom razdoblju u Požeško-Slavonskoj županiji zabilježen je pad potrošnje iste skupine lijekova s 158.72 DDD na 130.49 DDD. Izraženo u kunama, ostvaren je pad s 8,768,315 HRK na 8,013,176 HRK. U Gradu Zagreb je od 2010. do 2017. godine zabilježen je blagi pad potrošnje lijekova koji djeluju na kardiovaskularni sustav s 368.44 DDD na 354.07 DDD. U financijskom smislu ostvareno je smanjeno opterećenje s 174,866,121 HRK na 138,363,227 HRK. U istom razdoblju u Požeško-Slavonskoj županiji smanjena je potrošnja s 518.77 DDD na 249.97 DDD. Izraženo u kunama, potrošnja je smanjena s 14,873,979 HRK na 10,114,315 HRK. Potrošnja lijekova za liječenje sustavnih infekcija ostala je stabilna tijekom vremena u Gradu Zagrebu - 21.59 DDD, odnosno 22.93 DDD. Međutim, financijsko opterećenje je značajno poraslo s 40,579,840 HRK na 114,858,971 HRK. U Požeško-Slavonskoj županiji njihova potrošnja je prepolovljena, s 26.06 DDD na 18.14 DDD te s 3,153,539 HRK na 1,888,795 HRK. U Gradu Zagrebu zabilježen je porast potrošnje lijekova koji djeluju na respiratorni sustav s 55.59 DDD na 64.65 DDD. Prevedeno u novac, potrošnja je porasla sa 60,643,520 HRK na 67,842,946 HRK. Požeško-Slavonska županija bilježi pad potrošnje iste skupine lijekova s 64.23 DDD na 53.69 DDD, odnosno s 4,682,399 HRK na 3,921,239 HRK. Zaključak: Grad Zagreb bilježi rast potrošnje 3 skupine lijekova i u DDD i u HRK. Pala je samo potrošnja lijekova koji djeluju na kardiovaskularni sustav. Za razliku od toga, Požeško-Slavonska županija bilježi pad u sve 4 skupine lijekova u oba parametra. 2010. godine potrošnja sve 4 ATK skupine lijekova u Požeško-slavonskoj županiji izražena u DDD bila je veća nego u Gradu Zagrebu, dok je 2017. godina ona manja u svim promatranim skupinama.Introduction: Rational drug consumption is essential for a sustainable and efficient health system. By monitoring drug consumption trends, we can analyze and evaluate the state of a particular group of drugs. Aim: The aim of this paper was to compare drug consumption in the City of Zagreb and Požega-Slavonia County and analyze the differences in consumption. Methods: Data were acquired from the Agency for Medicinal Products and Medical Devices of Croatia (HALMED). We analyzed the consumption of drugs according to The Anatomical Therapeutic Chemical (ATC) Classification System and expressed in the defined daily doses per 1000 inhabitants per day (DDD/1000/day) and money (HRK). The following groups of drugs were analyzed: drugs affecting the alimentary tract and metabolism (ATC group A), cardiovascular system (ATC group C), antiinfectives for systemic use (ATC group J) and drugs affecting the respiratory system (ATC group R). Results: City of Zagreb documented a rise in the consumption of drugs that affect alimentary tract and metabolism, from 118.10 DDD in 2010 to 179.39 DDD in 2017. In terms of money, consumption increased from HRK 105,062,656 to HRK 135,642,231. During the same period, in the Požega-Slavonia County, there was a decrease in consumption of the same drug group from 158.72 DDD to 130.49 DDD. Expressed in HRK, a decrease from HRK 8,768,315 to HRK 8,013,176 was recorded. In the City of Zagreb, from 2010 to 2017, there was a slight decrease in the consumption of drugs that affect the cardiovascular system, from 368.44 DDD to 354.07 DDD. In financial terms, there was a cost reduction from HRK 174,866,121 to HRK 138,363,227. In the same period, consumption in Požega-Slavonia County decreased from 518.77 DDD to 249.97 DDD. In Croatian kunas, the cost decreased from HRK 14,873,979 to HRK 10,114,315. The consumption of antiinfectives for systemic use remained stable over the observed time period in the City of Zagreb –21.59 DDD in 2010 to 22.93 DDD to 2017. However, the financial burden increased significantly from HRK 40,579,840 to HRK 114,858,971 respectively. In the County of Požega-Slavonia the consumption and cost were reduced almost 50%, from 26.06 DDD to 18.14 DDD and from 3.153.539 HRK to 1.888.795 HRK respectively. In the City of Zagreb there was an increase in the consumption of drugs affecting the respiratory system, from 55.59 DDD to 64.65 DDD. Converted into money, consumption increased from HRK 60,643,520 to HRK 67,842,946. County of Požega-Slavonia recorded a decrease in consumption of the same drug group from 64.23 DDD to 53.69 DDD and from 4.682.399 HRK to 3.9221.239 HRK respectively. Conclusion: The City of Zagreb documented an increase in consumption in 3 groups of drugs, both in DDD and HRK. Only the consumption of drugs affecting the cardiovascular system was reduced. On the other hand, Požega-Slavonia County decreased consumption in all 4 groups of drugs in both parameters. In 2010, the consumption of all 4 ATC drug groups in Požega-Slavonia County expressed in DDD was higher than in the City of Zagreb, while in 2017 it was lower in all analyzed groups

Safety and efficacy of nivolumab as a second line therapy in metastatic renal cell carcinoma: a retrospective chart review

Aim To assess diseases outcomes and tolerability of reallife second-line nivolumab in a series of metastatic renal cell carcinoma (mRCC) patients. Methods This retrospective chart review involved prospectively monitored patients (named patient program) treated with second-line nivolumab for mRCC at the University Hospital Centre Zagreb from February 2016 to March 2018. Results The study enrolled 30 patients, 5 of whom (16.7%) had a complete response. The mean±standard deviation therapeutic response time to nivolumab treatment was 14.07±8.92 months, with a minimum treatment duration of 2 months and a maximum of 24 months. The median duration of therapy was 17 months (mean: 15.8 months; range: 3-24 months), and 50% (n=15/30) of patients remained alive at the end of follow up. The most common adverse events associated with nivolumab were fatigue (26.67%; n=8/30), anemia (10.0%; n=3/30), adrenal insufficiency (6.67%; n=2/30: G1=1, G2=1), grade 2 pneumonitis (6.67%; n=2/30), grade 2 neuropathy (6.67%; n=2/30), rash (6.67%; n=2/30: G1=1, G2=1), and hepatitis (3.33%; n=1/30). Conclusion The present study indicates acceptable patient responses and tolerability of nivolumab in m

ALCOHOL CONSUMPTION AMONG ADOLESCENTS IN THE REPUBLIC OF CROATIA

Konzumacija alkohola među mladima može biti dio eksperimentiranja u sklopu psihološkog razvoja tijekom adolescencije, ali može prijeći u naviku i dovesti do ovisnosti i oštećenja zdravlja. U našoj kulturi predstavlja sociološki prihvatljivo ponašanje i uobičajen je način zabave među mladima. Cilj ovog rada bio je prikazati učestalost i navike konzumacije alkohola među mladima u Republici Hrvatskoj. Pregledom literature utvrđeno je da se prema podatcima Europskog istraživanja o pušenju, pijenju alkohola i uzimanju droga među učenicima (ESPAD) od 1995. do 2015. godine, u Hrvatskoj alkohol percipira lako dostupnim te se posljedično bilježi trend porasta udjela petnaestogodišnjaka koji su najmanje jednom u životu pili alkohol (82% vs 92%). Istovremeno, druge zemlje uključene u istraživanje u prosjeku bilježe trend smanjenja s 90% na 80%. Pet ili više pića za redom (binge drinking) u posljednjih 30 dana 2015. godine konzumiralo je 47% mladih (51% mladića i 42 % djevojaka), čime se Hrvatska smjestila na šesto mjesto od 37 zemalja. Prema vrsti pića, mladići su najčešće konzumirali pivo (57%), a djevojke vino (43%). Rezultati Istraživanja o zdravstvenom ponašanju učenika (HBSC- WHO) 2014. godine u Hrvatskoj, ukazuju da udio učenika u dobi od 11, 13 i 15 godina, koji su se opili 2 ili više puta u životu raste s dobi i u mladića (4%, 12%, 40%) i u djevojaka (1%, 6%, 24%), te se Hrvatska nalazi među prvih pet od 44 zemlje sudionice istraživanja. Mladići su u svim dobnim skupinama skloniji opijanju od djevojaka te se u dobi od 15 godina opija 40% mladića u odnosu na 24% djevojaka. Standardizirano europsko istraživanje o alkoholu (RARHA-SEAS) pokazalo je da je u Hrvatskoj učestalost ekscesivnog epizodičnog pijenja barem jednom mjesečno u posljednjih 12 mjeseci 11%, te da je najviša u dobnoj skupni od 18 do 34 godine i iznosi 17%. Najviše se pilo (jednom tjedno i češće) u vlastitom domu (30%) te s prijateljima, kolegama i poznanicima (30%). Istraživanje među studentima medicine Sveučilišta u Zagrebu, akademske godine 2015./2016., pokazalo je da binge drinking prakticira 72% studenata prve godine (80% mladića i 67% djevojaka). Najveći udio mladića (38%) i djevojaka (37%) pet i više pića za redom konzumirali su šest i više puta u posljednjih 12 mjeseci. Rezultati navedenih istraživanja pokazuju da je konzumacija alkohola među mladima u nas značajan javnozdravstveni problem. Prevencija bi trebala biti usmjerena na pravovremenu edukaciju populacije školske djece i mladih, zdravstveno-odgojne aktivnosti, socijalni marketing i provedbu zakonskih mjera u smislu poštivanja dobne granice za prodaju alkohola.Alcohol consumption among adolescents could be a part of experimentation during psychological development, but also it could become a habit and lead to addiction and diseases. It is socially acceptable behavior in our culture and is a common type of entertainment among adolescents. The aim of this study was to present the habits and prevalence of alcohol consumption among adolescents in Republic of Croatia. 17 Sažeci radova / Abstracts Literature review showed that according to The European School Survey Project on Alcohol and Other Drugs (ESPAD) from 1995 to 2015, alcohol in Croatia is perceived as easily accessible. Consequently there was an increasing trend in proportion of fifteen-year-olds who drank alcohol at least once in last 12 month (from 82% to 92%), while other countries included in the survey showed decreasing trend (from 90% to 80%). Five or more drinks (binge drinking) in the last 30 days in 2015, have consumed 47% of adolescents (51% of boys and 42% of girls) which places Croatia on the sixth place of 37 countries. Boys mostly consumed beer (57%), and girls wine (43%). Results of The Health Behavior in School-aged Children (HBSC), WHO 2014 study in Croatia showed that proportion of adolescents aged 11, 13 and 15 who have been drunk two or more times increases with age in, both, boys (4%, 12%, 40%) and girls (1%, 6%, 24%), which places Croatia among the top five of the 44 participating countries. Boys in all age groups were more prone to drinking than girls (40% vs 24% at age of 15). According to the Standardized European Alcohol Research (RARHA-SEAS) prevalence of excessive episodic drinking in Croatia, at least once a month in the last 12 months, was 11% and was the highest in the age group 18-34 years (17%). Alcohol was consumed most frequently (once a week or more) at home (30%) or with friends, colleagues and acquaintances (30%). Research conducted among first year medical students University of Zagreb in academic year 2015/2016 showed prevalence of binge drinking of 72% (80% in males, and 67% in females). The highest proportion of male (38%) and female (37%) students consumed five or more drinks in a row, six or more times in a last 12 months. Results of this studies show that the consumption of alcohol among adolescents in Croatia is a significant public health problem. Prevention should focus on timely education of adolescents, health-promoting activities, social marketing and the implementation of legal measures in the sense of respecting the age limit for alcohol sales

TOBACCO CONSUMPTION AMONG ADOLESCENTS IN THE REPUBLIC OF CROATIA

Uvod: Pušenje među mladima predstavlja ozbiljan javnozdravstveni problem zbog učestalosti i štetnog utjecaja sastava duhanskog dima na zdravlje. Dugoročno pušenje kao rizičan čimbenik povezano je s razvojem brojnih bolesti. U razdoblju odrastanja mladi su skloni eksperimentiranju te često izloženi vršnjačkom pritisku. Cilj: Cilj ovog rada bio je analizom literature prikazati učestalost pušenja među mladima u Republici Hrvatskoj. Metode: Pregledom literature analizirana je učestalost pušenja u Republici Hrvatskoj u usporedbi s ostalim zemljama. Analizirani su podatci Europskog istraživanja o pušenju, pijenju alkohola i uzimanju droga među učenicima (ESPAD) i Istraživanja o zdravstvenom ponašanju učenika (HBSC - WHO). Rezultati: Prema ESPAD istraživanju u 2015. godini u Hrvatskoj je 62% petnaestogodišnjaka (61% mladića i 63% djevojaka) pušilo jednom ili više puta u životu. I u Europi i u Hrvatskoj, bilježi se trend pada učestalosti pušenja među učenicima od 1995. do 2015. godine. U europskim zemljama 1995. pušilo je 67% učenika, a 2015. godine 47%, dok je u Hrvatskoj 1995. pušilo 69% učenika, a 2015. 62%, čime smo i dalje iznad europskog prosjeka. Da su popušili prvu cigaretu do 13. godine izjavilo je 32% učenika, dok je s 14 i više godina taj udio bio 31%. Od 14. godine svakodnevno je pušilo 23% učenika. Prema HBSC – WHO istraživanju 2014. godine, 14% mladića i 5% djevojaka izjavilo je da su počeli pušiti s 11 godina i manje. S 12 i 13 godina je počelo pušiti 19% dječaka i 21% djevojčica, a s 14 i više 20%, odnosno 25%. Istraživanje među studentima prve godine Medicinskog fakulteta Sveučilišta u Zagrebu, akademske godine 2015./2016., pokazalo je da svakodnevno puši 11% mladića i djevojaka, a povremeno njih 17%, odnosno 11%. Dob pušenja prve cigarete za najveći postotak djevojaka je bilo 17 godina (18%), a za mladiće 16 godina (17%). Zaključak: Rezultati navedenih istraživanja ukazuju da pušenje među mladima predstavlja veliki izazov hrvatskom zdravstvenom sustavu. Prevencija bi trebala biti usmjerena na kvalitetnu edukaciju školske populacije, povećanje cijene cigareta i promjene stava društva o društvenoj prihvatljivosti pušenja.Introduction: Smoking among adolescents represents a significant public health problem due to the frequency and adverse effects of tobacco on health. Long-term smoking as a risky factor is associated with the development of many diseases. In the growing age, adolescents tend to experiment and are often exposed to peer pressure. Aim: The aim of this paper was to analyze the frequency of smoking among adolescents in the Republic of Croatia. Methods: By review of the literature we analyzed the frequency of smoking in the Republic of Croatia compared to other countries. The European Report on Smoking, Drinking Alcohol and Other Drugs (ESPAD) and the Health Behavior in School-aged Children (HBSC - WHO) have been analyzed. Results: According to ESPAD research in 2015, 62% of fifteen year olds (61% of boys and 63% of girls) in Croatia smoked one or more times in life. Both in Europe and in Croatia, there is a decreasing trend in smoking among students from 1995 to 2015. In the European countries, in 1995, 67% of students smoked, and in 2015, 47%, while in Croatia, in 1995, 69% of students smoked, and in 2015 62%, which is still above the European average. Age of first cigarette consumption for 32% of adolescents was 13, while for 31% of them was 14 and more. From the age of 14, 23% of adolescents smoke every day. According to the HBSC - WHO survey in 2014, 14% of boys and 5% of girls reported having started smoking at 11 and under. At 12 and 13 years, 19% of boys and 21% of girls started to smoke, with 14 and more 20% and 25% respectively. Research conducted among first year students of School of Medicine, University of Zagreb, in academic year 2015/2016 showed that 11% of boys and girls smoked daily, and occasionally 17% and 11% respectively. Age of first cigarette consumption for the highest percentage of females was 17 years (18%), and for males 16 years (17%). Conclusion: The results of these surveys indicate that smoking among adolescents is a major challenge for the Croatian health care system. Prevention should focus on quality education of the school population, increase in cigarette prices and change of society\u27s attitude towards social acceptability of smoking

TEN YEARS OF PROFESSIONAL-EDUCATIONAL SYMPOSIUM „ŠTAMPAR\u27S DAYS“

Suvremeni stil života od ljudi sve češće zahtijeva zanemarivanje osnovnih zdravstvenih potreba u svrhu bržeg napredovanja na radnom mjestu, zadovoljavanja potreba socijalne okoline te podmirivanja svih onih obaveza koje nam moderno društvo sa sobom donosi. Brojne negativne strane modernih životnih stilova narušavaju zdravlje, a to su prije svega nezdrava i neuravnotežena prehrana, pretjeran unos soli, nedovoljan odmor i san, nedostatna tjelesna aktivnost, pušenje, pretjerana konzumacija alkohola te prekomjerna izloženost stresu. Vođena navedenim problemima, skupina studenata medicine i mladih liječnika 2009. godine okupila se u Udruzi narodnog zdravlja „Andrija Štampar“ s ciljem promocije javnozdravstvenih težnji i načela Andrije Štampara, posebice onoga koje govori kako je glavno mjesto liječničkog djelovanja tamo gdje ljudi žive, a ne ordinacija. Iste godine Udruga je započela s organizacijom Stručno-edukacijskog simpozija „Štamparovi dani“ koji se tijekom devet godina prometnuo u nezaobilazan događaj koji iz godine u godinu posjećuju brojni stručnjaci, mladi liječnici te studenti iz Republike Hrvatske i inozemstva s idejom razmjene javnozdravstvenih misli, kontinuirane stručne izobrazbe i promocije zdravlja i zdravih stilova života. „Štamparove dane“ i rad Udruge su do sada prepoznale i podržale brojne relevantne institucije, a u budućnosti se očekuju i brojne druge suradnje koje će za cilj imati povratak temeljnim javnozdravstvenim postulatima te promociju zdravlja i zdravih stilova života.The modern lifestyle often requires neglecting basic health needs for the purpose of faster progress in the workplace, meeting the needs of the social environment, and fulfilling the obligations that the modern society carries with it. Many negative aspects of modern lifestyles impair health, especially unhealthy and unbalanced diet, excessive salt intake, insufficient rest and sleep, lack of physical activity, smoking, excessive alcohol consumption and excessive exposure to stress. Guided by these problems, a group of medical students and young doctors gathered in the Association of People’s Health Andrija Štampar back in 2009, in order to promote public health aspirations and principles of Andrija Štampar, especially the one that says that the most important places of medical activity are places where people live, not offices. That same year, the Association started to organize the Professional-educational Symposium “Štamparovi dani” that turned into an unavoidable annual event which has already been visited by many experts, young physicians and students from all over the Croatia and abroad with the idea of sharing their public health thinking, practising continuous professional education, health promotion and healthy lifestyles. “Štampar days” and the work of the Association have so far been recognized and supported by number of relevant institutions. Many other collaborations are expected in the future, especially those which will aim to return to basic postulates of public health, health promotion, and healthy lifestyles