CHILDREN AND CONFLICTS: CHILDREN AS INSTRUMENTS AND OBJECTS OF INTERNATIONAL SECURITY

Djeca su prisutna u međunarodnoj politici tijekom cijele povijesti. Međutim, njihova uloga u politici rata i mira mijenjala se s promjenom predodžbi koje su odrasli imali o vrijednosti djetinjstva. Moderna koncepcija djetinjstva kao perioda nevinosti i ranjivosti koju treba zaštititi dala je djeci meku moć i učinila ih instrumentima političke i ratne propagande kroz brojne uloge, poput uloga simbola nacionalnog identiteta, ikona rata, zona mira, sredstava legitimizacije nasilja i druge. Ranjivost odraslih spram djece, više nego ranjivost same djece, generirala je politički kapital djetinjstva i omogućila njegovo korištenje kao sredstva manipulacije odraslima. Djeca su također direktno uključena u oružane sukobe, kao žrtve i kao počinitelji. Djetinjstvo na taj način postaje objekt međunarodne sigurnosti. Oko 350 milijuna djece danas živi u zonama oružanih sukoba, više od jedanaest milijuna njih je u izbjeglištvu, dok 300 tisuća djece služe kao vojnici. Evolucija novih ratova, koju prati trend proliferacije naoružanih skupina, privatizacije nasilja te premještanja ciljeva rata iz političko-ideološke u ekonomsku sferu, omogućila je još intenzivniju eksploataciju djece u sukobima. Napore uložene u stvaranje učinkovite međunarodne pravne zaštite djece potkopavaju brojne kontradikcije u međunarodnom pravu koje otvaraju prostor za pitanje je li učinkovita međunarodna zaštita djece uopće moguća.Children have been present in international politics throughout the whole history of humanity. However, the roles they played in the policy of war and peace has been changing with changes of ideas that adults had about the value and vulnerability of childhood. The modern conception of childhood as a period of innocence and vulnerability that needs protection has given soft power to children and made them instruments of political and war propaganda through numerous roles, such as the symbols of national identity, the icons of war, the peace zones, instruments of legitimizing violence and others. The vulnerability of adults towards children, more than vulnerability of children themselves, has generated political capital of childhood and enabled its use as an instrument of manipulating adults. Children are also directly involved in armed conflicts, either as victims or as perpetrators. Thus, childhood becomes an object of international security. About three hundred and fifty million children currently live in conflict zones, more than eleven million of them are made refugees, and three hundred thousand children serve as soldiers. The evolution of so-called new wars, followed by the trend of proliferation of armed groups, the privatization of violence, and shifting of war goals from political to economic sphere, has enabled even more intensive exploitation of children in conflicts. Great efforts made in creating effective international legal protection of children have been undermined by numerous contradictions in international law which leads to the question whether effective international child protection is even possible

CHILDREN AND CONFLICTS: CHILDREN AS INSTRUMENTS AND OBJECTS OF INTERNATIONAL SECURITY

Djeca su prisutna u međunarodnoj politici tijekom cijele povijesti. Međutim, njihova uloga u politici rata i mira mijenjala se s promjenom predodžbi koje su odrasli imali o vrijednosti djetinjstva. Moderna koncepcija djetinjstva kao perioda nevinosti i ranjivosti koju treba zaštititi dala je djeci meku moć i učinila ih instrumentima političke i ratne propagande kroz brojne uloge, poput uloga simbola nacionalnog identiteta, ikona rata, zona mira, sredstava legitimizacije nasilja i druge. Ranjivost odraslih spram djece, više nego ranjivost same djece, generirala je politički kapital djetinjstva i omogućila njegovo korištenje kao sredstva manipulacije odraslima. Djeca su također direktno uključena u oružane sukobe, kao žrtve i kao počinitelji. Djetinjstvo na taj način postaje objekt međunarodne sigurnosti. Oko 350 milijuna djece danas živi u zonama oružanih sukoba, više od jedanaest milijuna njih je u izbjeglištvu, dok 300 tisuća djece služe kao vojnici. Evolucija novih ratova, koju prati trend proliferacije naoružanih skupina, privatizacije nasilja te premještanja ciljeva rata iz političko-ideološke u ekonomsku sferu, omogućila je još intenzivniju eksploataciju djece u sukobima. Napore uložene u stvaranje učinkovite međunarodne pravne zaštite djece potkopavaju brojne kontradikcije u međunarodnom pravu koje otvaraju prostor za pitanje je li učinkovita međunarodna zaštita djece uopće moguća.Children have been present in international politics throughout the whole history of humanity. However, the roles they played in the policy of war and peace has been changing with changes of ideas that adults had about the value and vulnerability of childhood. The modern conception of childhood as a period of innocence and vulnerability that needs protection has given soft power to children and made them instruments of political and war propaganda through numerous roles, such as the symbols of national identity, the icons of war, the peace zones, instruments of legitimizing violence and others. The vulnerability of adults towards children, more than vulnerability of children themselves, has generated political capital of childhood and enabled its use as an instrument of manipulating adults. Children are also directly involved in armed conflicts, either as victims or as perpetrators. Thus, childhood becomes an object of international security. About three hundred and fifty million children currently live in conflict zones, more than eleven million of them are made refugees, and three hundred thousand children serve as soldiers. The evolution of so-called new wars, followed by the trend of proliferation of armed groups, the privatization of violence, and shifting of war goals from political to economic sphere, has enabled even more intensive exploitation of children in conflicts. Great efforts made in creating effective international legal protection of children have been undermined by numerous contradictions in international law which leads to the question whether effective international child protection is even possible

E-konzultacija s pacijentom

Razvojem novih tehnologija, osobito informacijskih i komunikacijskih, organizacija rada u ordinacijama obiteljske medicine nadograđuje se potpuno novim oblicima komunikacije i rada s pacijentima, a takav primjer je i tzv. e-konzultacija, odnosno komunikacija s pacijentom putom elektroničke pošte.  Radim u ordinaciji smještenoj u centru grada Zagreba, s populacijom u kojoj je priličan broj informatički pismenih pacijenata, a druga važna činjenica o mojoj populaciji jest da znatan broj njih poslovno izbiva iz zemlje i po nekoliko mjeseci. Uporaba elektroničke komunikacije s mojim pacijentima se uspostavila na neki način spontano, iz potrebe pacijenata s kroničnim bolestima da ostanu sa mnom u kontaktu i tijekom njihovog izbivanja u inozemstvu. Moje je iskustvo da ovaj oblik rada s pacijentima ima svoje značajno mjesto u organizaciji rada u ordinaciji obiteljske medicine, te se javlja potreba da se ovaj oblik rada može i evidentirati u našim izvješćima o radu kroz nadopunu tzv. Plave knjige postupaka novim šiframa

ACUTE PANCREATITIS IN FAMILY PHYSICIAN PRACTICE

Akutni pankreatitis (AP) je ozbiljna bolest, defi nirana kao akutni upalni proces gušterače koji može dovesti do oštećenja okolnih tkiva i drugih organskih sustava. To je skup dinamičnih, lokalnih i sistemskih patofi zioloških promjena, nastalih iznenadnim prodorom litičkih pankreasnih enzima u žlijezdani parenhim. AP je upalni proces u kojem dolazi do autodigestije tkiva gušterače uzrokovane preuranjenom aktivacijom zimogena u aktivne proteolitičke enzime. Najčešći etiološki uzročnici su bilijarne bolesti i višegodišnji abusus alkohola. Kliničkom slikom dominiraju jaki bolovi u gornjem dijelu abdomena. Ovisno o težini kliničke slike AP se može javljati sa slikom lokalnih i sustavnih komplikacija, te oštećenjima udaljenih organa. Kod većine pacijenata s AP prate se višestruko povišene vrijednosti serumskih koncentracija pankreatičnih enzima, amilaza i lipaza. AP može imati značajno različit tijek bolesti, ujedno i prognozu bolesti; od blagog intersticijskog do teškog nekrotičnog oblika, s mogućim letalnih ishodom. Stoga je razumljiva važnost što ranije procjene težine bolesti koristeći se različitim prognostičkim parametrima. Klinička slika blagog AP je većinom bez značajnijih komplikacija, uz očekivanu potpunu restituciju. Liječenje AP je konzervativno i/ili kirurško. Konzervativno liječenje podrazumijeva medikamentno suzbijanje boli, osiguravanje primjerene hidracije i nutricije, te sprječavanje komplikacija.Acute pancreatitis (AP) is a serious illness, defi ned as acute infl ammation of the pancreas, which can result in damage to the surrounding tissue and other organ systems. It is considered as a set of dynamic, local and systemic pathophysiological changes, caused by sudden rush of lithic pancreatic enzymes into glandular parenchyma. AP is an infl ammatory process caused by autodigestion of pancreatic tissue due to early activation of the zymogen into the active proteolytic enzyme. The most common causes are biliary disease and alcohol abuse. Clinical presentation is predominated by severe upper abdominal pain. Depending on the disease severity, it may be associated with systemic complications and damage to distant organs. The majority of patients have multiply elevated serum concentrations of pancreatic enzymes, amylase and lipase. AP may have a variable course and prognosis, from mild to severe forms and potentially lethal disease; therefore, early assessment using different prognostic parameters is of utmost importance. Clinical signs vary from mild interstitial pancreatitis to severe pancreatitis with necrosis and associated multiple organ failure. The clinical course of mild AP is generally without complications and full recovery is expected. Treatment is conservative and/or surgical, and consists of pain control, fl uid replacement, nutritional support, and prevention of complications

Elektronička prijava zaraznih bolesti

Potaknuta konkretnim zamolbama da se Prijave zaraznih bolesti iz naših ordinacija primarne zdravstvene zaštite (PZZ) dostavljaju što žurnije, želim ukazati da trenutačno doista raspolažemo sustavom koji to može osigurati. Korištenjem smart kartica i priključivanjem na Centralni zdravstveni informacijski sustav (CEZIH) osigurano je prikupljanje podataka za potrebe epidemiološke službe bez dodatnog administrativnog opterećenja liječnika u PZZ. Nadalje, kako se sustav CEZIH-a smatra kvalitetno zaštićenim od gubitka povjerljivosti podataka, time se dodatno potvrđuje ispravnost razmišljanja o njegovoj boljoj iskoristivosti

Elektronička prijava zaraznih bolesti

Potaknuta konkretnim zamolbama da se Prijave zaraznih bolesti iz naših ordinacija primarne zdravstvene zaštite (PZZ) dostavljaju što žurnije, želim ukazati da trenutačno doista raspolažemo sustavom koji to može osigurati. Korištenjem smart kartica i priključivanjem na Centralni zdravstveni informacijski sustav (CEZIH) osigurano je prikupljanje podataka za potrebe epidemiološke službe bez dodatnog administrativnog opterećenja liječnika u PZZ. Nadalje, kako se sustav CEZIH-a smatra kvalitetno zaštićenim od gubitka povjerljivosti podataka, time se dodatno potvrđuje ispravnost razmišljanja o njegovoj boljoj iskoristivosti

Measurement of palliative care competencies using PALCOM instrument

Introduction: An essential component of any profession is competent and confident staff. In palliative care, a wellrounded approach and versatile knowledge of staff and students are of great importance. Measuring these competencies is very important for the development of palliative care and health care. Methods: Measurement of competencies in palliative care by analyzing existing instruments and questions in palliative care. Process of developing a new instrument for measurement of competencies in palliative care PALCOM, using cross-sectional methodology with nurses from Bosnia and Herzegovina. Results: The results are presenting findings of research done with nurses from BIH using two main variables: Years of work experience and level of education of the participants. Main difference is between the two competencies: Pain assessment and management, education, and care for the patient’s family regarding the level of education. Conclusion: The need for measuring competencies is evident in the daily evolution of palliative care, community-based palliative care, hospice care, and subspecialized palliative care. There is no questionnaire that can measure all competencies, but the use of the general competencies in the PALCOM questionnaire can cover this area with the measurement of different domains and the competencies specific to these domains

The relationship of limited mobility of the cervical spinewith postural and mental reactions of students

Introduction: Previous studies have found that, in addition to the general factors for the occurrence of pain and reduced mobility of the cervical spine, the use of electronic devices promotes these, the excessive use of which can also lead to the occurrence of depressive symptoms in students. The aim of this study was to determine the mobility limitation of the cervical spine in students with reported neck pain, to determine the degree of disability and depression due to neck pain, to determine the correlation of mobility limitation of the cervical spine with the degree of disability and depression of students, and to determine the correlation of the degree of disability with the degree of depression. Methods: The research was conducted as a cross-sectional study from May to July 2021 at the University of Zenica in four faculties. The study used the General Questionnaire and two standardized questionnaires to assess disability due to neck pain (Index of Disability due to Neck Pain) and the degree of depression (patient health questionnaire). Results: A total of 147 students with reported neck pain participated in the study. A limitation of mobility was found in 30.6% of the students in flexion, 25.2% in rotation, 23.8% in lateral flexion, and 20.4% on extension. Mild disability due to neck pain was found in 58.5% of students, moderate in 23.8%, and severe in 2.7%. 45.6% of the students had mild depression, 18.4% had moderate depression, and 5.4% had severe depression.Conclusion: Restricted flexion and rotation are more common than restricted lateral flexion and extension of the cervical spine. About half of the students who reported neck pain had a mild degree of disability and mild depression. A strong positive correlation was found between the degree of disability and depression in students with neck pain

Trends in Referrals from Croatian Family Practice in Relation to Specialists’ Consultations: A Longitudinal Observational Study from 1995 to 2012

Drug prescribing and referrals to specialists’ consultations, as the indicators of the quality of health care, were not so often monitored in Croatian family medicine. The aims of the study are to determine the trends of referrals from family doctors to specialists’ consultations and the trends of specialists’ consultations utilization. The study is based on routinely collected data from the Croatian Health Service Yearbooks, 1995–2012. The results indicate that from 1995 to 2012 the visits to family doctors almost doubled, while the number of referrals increased by 60%. The referral rate only slightly increased, from 24 to 29% of the total number of visits. The number of specialists’ consultations showed continuous growth and exceeded the number of referrals. The observed trends are not sufficient to explain referral patterns and utilization of specialists’ services; therefore, a far more complex research is required

Efekti antiagregacijske i antikoagulacijske terapije trombofilija u trudnoći

Uvod: Trombofilija povećava rizik od ponovnog pobačaja i drugih ozbiljnih opstetričkih komplikacija kao što je preeklampsija, abrupcija posteljice i zastoj u rastu fetusa. Cilj: istražiti učinkovitost antiagregacijske i antikoagulacijske terapije u odnosu na: pojavu i težinu opstretičkih komplikacija i ishod trudnoće. Ispitanice i metode: Multicentrična retrospektivno/prospektivna studija. Istraživanje je provedeno u razdoblju 2018-2021. godine na područiju Zeničko-dobojske županije, Federacija Bosne i Hercegovine. Laboratorijske analize obavljene su u Kantonalnoj bolnici Zenica (Ginekološko-akušerski odjel) i Općoj bolnici Tešanj (Ginekološko-akušerski odjel). U istraživanje je uključeno 180 ispitanica. Formirane su dvije osnovne skupine: radna (skupina ispitanica) i kontrolna skupina. Radnu skupinu činilo je ukupno 120 ispitanica (N=120). Kontrolnu skupinu činilo je ukupno 60 ispitanica (N=60). Rezultati:Primjena antikoagulacijske terapije u profilaktičkim i terapijskim dozama utjecala je na smanjenje učestalosti i težine komplikacija, pozitivan učinak u postizanju terminske trudnoće, te pozitivan učinak u profilaksi tromboembolijskih bolesti. Primjenom antiagregacijske terapije postignut je pozitivan učinak profilakse tromboze, ali ne i smanjenje broja komplikacija. Zaključak:Utvrđen je bolji učinak antikoagulacijske u odnosu na antiagregacijsku terapiju u postizanju terminske trudnoće, smanjenja broja komplikacija i tromboze