Kultura zdravih organizacija – radna mjesta prijatelji radnika

Work has numerous health and wellbeing benefits, but it also involves physical hazards and psychological exertion. Today the scale has tipped toward psychosocial factors. Workers’ mental health affects their intellectual, emotional, and social growth, as well as work ability, productivity, and ultimately organisational productivity and competitiveness on the market. Even though companies may have an internal hierarchy that lowers stress at work, there are other formal and informal social processes that can affect (positively or negatively) the cohesion within the work unit. Safety culture of an organisation is a product of individual and group values, opinions, competences, and behavioural patterns that determine how occupational health and safety are implemented. Organisations that nurture positive safety culture understand the importance of health and safety and believe in prevention rather than dealing with consequences. Jobs that are stable, autonomous, and reasonably physically and psychologically demanding are far more likely to lower work-related stress and boost worker satisfaction. In fact, employee empowerment is one of the best ways to achieve good psychosocial health at the workplace.Radni uvjeti, radni okoliš i sam način rada znatno utječu na zdravlje. Danas je relativno malo poslova definirano tjelesnim zahtjevima, a puno više mentalnima i emocionalnima, pri čemu psihosocijalni rizici postaju značajni. Uz brojne pozitivne utjecaje rada na zdravlje i blagostanje, mnogi su radnici izloženi i opasnostima, štetnostima te ergonomskim i psihološkim naprezanjima. Stanje mentalnog zdravlja zaposlenog omogućava razvijanje u emocionalnom, intelektualnom i socijalnom pogledu te ima odlučujuće učinke na radnu sposobnost, zahvaćajući ne samo način i ishode njegova rada nego i ishode poslovanja tvrtke ili ustanove, određujući njenu kompetitivnost na tržištu. Unatoč dobroj organiziranosti upravnih tijela tvrtke, što umanjuje stres na radu, neformalni društveni procesi utječu (pozitivno ili negativno) na koheziju unutar radnih jedinica i na osjećaj povezanosti radnika i organizacije. Kultura sigurnosti neke organizacije rezultat je individualnih i grupnih vrijednosti, stavova, kompetencija i oblika ponašanja. To, pak, određuje odlučnost i način vođenja programa za očuvanje zdravlja i za sigurnost u organizaciji. Značajke organizacija koje imaju pozitivnu kulturu sigurnosti su zajednička percepcija važnosti sigurnosti te pouzdanost u preventivne mjere. Rad koji omogućuje autonomiju, kontrolu nad svojim radnim zaduženjima, razumne tjelesne i psihološke zahtjeve te sigurnost od iznenadnih otkaza dovode do većeg zadovoljstva radnika i smanjuju stres na radnome mjestu. Danas se sve više ističe važnost različitosti na radnome mjestu. Potrebno je istaknuti kako je upravo osnaživanje zaposlenika jedan od najvažnijih načina očuvanja psihosocijalnog zdravlj

Are Patients Ready for Lesbian, Gay and Bisexual Family Physicians - A Croatian Study

Discrimination and harassment of lesbian, gay and bisexual (LGB) physicians from their colleagues and superiors are known. However there is little knowledge about the patients’ attitudes and discrimination toward physicians. A cross sectional Internet survey was conducted in urban Croatian regions. The participants were asked to answer questions regarding their socio-demographic status, the Attitudes Towards Lesbians and Gay Men Scale (ATLG), and whether they would refuse to see a LGB physician and, if so, why. Of the 1004 participants, 8.8% said they would refuse a male GB physician while 7.9% would refuse a female LB physician, and 7.3% would refuse both. The two most common reasons for discriminating were: “disaccord with political or religious beliefs” and “fear of being sexually harassed”. A logistical regression model showed that male sex, higher ATLG score and higher age were associated with more refusals of male GB physicians. Also higher age, higher ATLG score were associated with more refusals of female LB physicians, while personal contact with LGB people was associated with less refusals of both groups. The observed prevalence of discrimination is significant. The results suggest that discrimination is based on emotional reasons and stereotypical beliefs. Educational efforts should be directed towards changing misconceptions about LGB people

Occupational Therapy with People Aff ected by Chronic Obstructive Pulmonary Disease

Kronična opstruktivna plućna bolest peti je uzrok smrti u svijetu, s tendencijom porasta. Bolest je karakterizirana stabilnim fazama i fazama akutnih egzacerbacija s dispnejom najprije prilikom napora, a poslije i u mirovanju. Oboljeli postepeno bivaju fizički sve manje sposobni, imaju i psihičke probleme, a kvaliteta života im je narušena nemogućnošću obavljanja osnovnih aktivnosti svakodnevnoga života kao što su hranjenje, oblačenje, održavanje osobne higijene, briga za vlastiti izgled, kretanje, kuhanje, uzimanje lijekova, telefoniranje, upotreba novca, prijevoz, obavljanje kućanskih poslova i drugo. Radnoterapijska procjena i tretman osoba s plućnom disfunkcijom promiču izvođenje i zadovoljstvo obavljanja osnovnih i složenih aktivnosti svakodnevnoga života kao što su samozbrinjavanje, produktivnost i razonoda te samim time utječe na poboljšanje kvalitete života.Chronic obstructive pulmonary disease is the fifth cause of death worldwide which records a growing trend. It is characterized by stable periods and by acute exacerbations with progressive dyspnoea, which is first exercise induced and then occurs even at rest. Patients with chronic obstructive pulmonary disease gradually become less physically capable, suffer from mental problems, and their quality of life is impaired by the impossibility to perform regular daily activities such as: eating; maintaining personal hygiene; caring about appearance; preparing meals; taking medications; using telephone, money and transportation; doing household chores, and others. Occupational therapy assessment and treatment of people with pulmonary dysfunction contributes to improved performance of basic and complex daily activities, such as self-care, work and leisure, and thus aff ects and improves quality of life

Wheelchair Users’ Satisfaction with the Prescribed Wheelchairs and Wheelchair Services in Croatia

The authors tried to determine the wheelchair users’ satisfaction with prescribed wheelchairs and wheelchair services in Croatia. An online survey was distributed among members of the Croatian Paraplegic and Tetraplegic Alliance. One hundred-four participants were included in the analyses using non-parametric statistics. Most participants were satisfied with wheelchair dimensions (n=84;81%), functionality (n=80;77%), easiness to use (n=81;78%), comfort (n=69;66%) and wheelchair parts adjustment (n=64;62%). Individuals satisfied with wheelchair characteristics were also more engaged in the activities of everyday living than participants who were not satisfied. Significant activity participation was found in the following activities: bathing/showering (χ2=7.02;df=1;p=0.017), transfers (χ2=8.49;df=1;p=0.01), bladder/bowel management (χ2=17.77;df=1;p<0.001), food preparation (χ2=8.34;df=1;p=0.004), eating (χ2=9.33;df=1;p=0.014) and doing household chores (χ2=13.28;df=1;p<0.001). Fifty-seven participants (54.8%) had received wheelchair assessment and were also predominantly satisfied with the assessment (n=51;90%), selection process (n=49;79%), equipment trial (n=24;80%), education/skills training (n=40;89%) and the fitting process (n=38;86%). Participants who received wheelchair assessment and skills training felt safer when using wheelchairs (χ2=6.13;df=1;p=0.013). Majority of the participants were unsure where to ask for second opinions regarding wheelchair assessment (n=80;77%) and where to seek wheelchair support groups (n=78;75%). Satisfaction with wheelchairs and wheelchair services leads to more involvement in the activities of everyday living and increases feelings of safety

Attitudes towards and knowledge about homosexuality among medical students in Zagreb [Stavovi i znanja o homoseksualnosti u studenata Medicinskog fakulteta u Zagrebu]

The aim of the study was to investigate whether students in their fifth and sixth years of medical school in Zagreb have homophobic attitudes and assess their knowledge about homosexuality. A survey was conducted among fifth and sixth year medical students during the 2009/2010 academic year. The survey consisted of general demographic data, two validated questionnaires--"Knowledge about Homosexuality Questionnaire" and "Heterosexual Attitudes towards Homosexuality Scale"--and questions about personal experiences created for this study. The mean knowledge scores were X = 14.8 out of 20. Furthermore, gender differences in attitudes were observed, indicating less negative attitudes among the female participants. The regression model was significant (ANOVA: Sum of Squares = 38.065; df = 17, Mean Square= 2239, F = 10.6; p < 0.001) with 38% of explained variance. The significant predictor variables that indicate lower attitudes about homosexuality score were female gender (beta= -0.14, p = 0.015), sixth year of study (beta = -0.16, p = 0.009) and more knowledge about homosexuality (beta = -0.48, p < 0.001). Negative attitudes are present among the students; therefore, educational efforts should be included in the curricula of medical schools to diminish the negative perceptions of the lesbian, gay, bisexual and transgender community

Are patients ready for lesbian, gay and bisexual family physicians - a Croatian study [Jesu li pacijenti spremni prihvatiti LGB obiteljske liječnike?]

Discrimination and harassment of lesbian, gay and bisexual (LGB) physicians from their colleagues and superiors are known. However there is little knowledge about the patients’ attitudes and discrimination toward physicians. A cross sectional Internet survey was conducted in urban Croatian regions. The participants were asked to answer questions regarding their socio-demographic status, the Attitudes Towards Lesbians and Gay Men Scale (ATLG), and whether they would refuse to see a LGB physician and, if so, why. Of the 1004 participants, 8.8% said they would refuse a male GB physician while 7.9% would refuse a female LB physician, and 7.3% would refuse both. The two most common reasons for discriminating were: “disaccord with political or religious beliefs” and “fear of being sexually harassed”. A logistical regression model showed that male sex, higher ATLG score and higher age were associated with more refusals of male GB physicians. Also higher age, higher ATLG score were associated with more refusals of female LB physicians, while personal contact with LGB people was associated with less refusals of both groups. The observed prevalence of discrimination is significant. The results suggest that discrimination is based on emotional reasons and stereotypical beliefs. Educational efforts should be directed towards changing misconceptions about LGB people

Unified Algorithm as an Ergonomic Solution for Safe Patient Transfers Unificirani algoritam kao ergonomsko rješenjeza siguran transfer pacijenata

Studies show that nurses have high incidence of low back pain (LBP) due to the physical activities often required to manipulate patients and to the occurrence of sudden awkward lifts in cramped spaces, long hours at the computer terminal, or driving in ambulances. This may lead to lower productivity, high absenteeism and unsatisfactory patient care, and with cost of treating and caring for patients with LBP well over $100 billion annually in the USA alone, makes this a public health concern. Epidemiological studies identified numerous biomechanical factors that cause disc degeneration; exposure to vibrations, prolonged sitting and, especially, high compressive loadings that occur on the L3 disc during lifting, sitting, flexion and hyperextension of the spinal column. This puts certain occupations, such as health care workers, in higher risk group for developing degenerative problems with intervertebral discs. Preventative measures include: avoiding axial torsion, changing positions frequently, using lumbar support and arm rests as well as appropriate lifting techniques with bend knees and straight back. However, these are not always possible in health care settings. Assistive technology (lifting aids, slings, sliding aids etc.) although affordable is still rarely used due to budgetary issues or the unwillingness of the staff to use them. Educational efforts must be directed so that health care workers understand the biomechanical risks associated with their work and how to perform everyday tasks with minimal risk. We propose an easy to follow diagram based on the current literature with instructions how to safely transfer patients from bed to chair, chair to chair, bed to trolley, up from the floor and repositioning in the bed with minimal risk of LBP. Hopefully this will lead to healthier and more productive staff and increase the quality level of health care provided

Workability Management Following Cardiac Transplantation

Transplantacija srca priznata je metoda kirurškog zbrinjavanja krajnjeg stadija zatajivanja srca. Nakon operacije većini je pacijenata poboljšana kvaliteta života te dobrim rehabilitacijskim mjerama može gotovo potpuno povratiti fizičku funkcionalnost, no pitanja socijalne reintegracije obično nisu dovoljno razrađena. Jedan od najboljih načina postizanja reintegracije jest povratak na radno mjesto. Pritom treba riješiti pitanje novonastale radne sposobnosti. U pacijenata sa srčanim transplantatom koristimo se različitim mjerenjima fiziološke funkcije (spiroergometrijom, 24-satnim praćenjem krvnog tlaka i EKG-a itd.), psihološkim testovima (probirom na psihijatrijske komorbiditete) te određivanjem subjektivne radne sposobnosti kako bismo dobili multidimenzionalnu sliku radne sposobnosti. Osnova te sposobnosti jest zdravlje. Radna sposobnost podložna je, dakle, promjenama, ali se uvelike može poboljšati širokim spektrom pravodobno implementiranih rehabilitacijskih mjera. U tekstu je opisan prikaz rehabilitacijskog procesa.Cardiac transplantation is a well-established method of surgical treatment for end stage cardiac failure. After the surgery most patients improve their quality of life and following a good rehabilitation process can achieve full physical functionality they had before experiencing cardiac failure. However, methods of social reintegration have not been fully developed. One of the best ways of returning to social life following a long period of inability is through workplace reintegration. To achieve this goal, issues of work capacity have to be addressed. In patients following cardiac transplantation measurements of various physiological functioning (cardio-respiratory exercise testing, 24h ECG, 24 blood pressure etc), psychological tests (various screening methods for psychiatric comorbidities) and subjective work ability all need to be assessed in order to determine patient’s social and psycho-physical workability. It must be noted that workability can be improved with appropriate rehabilitative measures. This text outlines the rehabilitation process

Associations of handgrip strength with all-cause and cancer mortality in older adults: a prospective cohort study in 28 countries

Background mixed evidence exists on the association between muscle strength and mortality in older adults, in particular for cancer mortality. Aim to examine the dose–response association of objectively handgrip strength with all-cause and cancer mortality. Study Design and Setting data from consecutive waves from the Survey of Health, Ageing and Retirement in Europe comprising 27 European countries and Israel were retrieved. Overall, 54,807 men (45.2%; 128,753 observations) and 66,576 women (54.8%; 159,591 observations) aged 64.0 (SD 9.6) and 63.9 (SD 10.2) years, respectively, were included. Cox regression and Fine-Grey sub-distribution method were conducted. Results during the follow-up period (896,836 person-year), the fully adjusted model showed the lowest significant risk estimates for the highest third of handgrip strength when compared with the first third (reference) in men (hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.34–0.50) and women (HR, 0.38; 95% CI, 0.30–0.49) for all-cause mortality. We identified a maximal threshold for reducing the risk of all-cause mortality for men (42 kg) and women (25 kg), as well as a linear dose–response association in participants aged 65 or over. No robust association for cancer mortality was observed. Conclusion these results indicate an inverse dose–response association between incremental levels of handgrip and all-cause mortality in older adults up to 42 kg for men and 25 kg for women, and a full linear association for participants aged 65 years or over. These findings warrant preventive strategies for older adults with low levels of handgrip strength