Quality of life and mental health in women affected by breast cancer

Rak dojke je zloćudna i smrtonosna bolest i ujedno i najčešći oblik raka u žena. Postavljanje dijagnoze snažno utječe na ženino mentalno zdravlje. Žene se moraju suočiti sa mnogim strahovima koji nerijetko narušavaju mentalno zdravlje. Nerijetko se kao posljedica tih strahova javljaju anksioznost i depresija. Važan odraz mentalnog zdravlja je i slika o vlastitom tijelu, a do promjene u njenoj percepciji dolazi zbog promjena na tijelu kao posljedice liječenja. Kako je mentalno zdravlje jedan od aspekata kvalitete života, njihova kvaliteta života može biti znatno narušena. Brojni čimbenici imaju utjecaj na kvalitetu života i mentalno zdravlje poput same dijagnoze, tretmana liječenja, koji uključuju operaciju, kemoterapiju, radioterapiju ili hormonsku terapiju, socijalna potpora obitelji i prijatelja te potpora iz udruga za potporu ženama oboljelima od raka dojke. Ovim radom nastoji se objasniti uloga svakog pojedinog čimbenika u kvaliteti života žena oboljelih od raka dojke te pružiti savjete na koji način poboljšati njihovu kvalitetu života putem socijalne potpore

Korelacija koštane mineralne gustoće mjerene kvalitativnim ultrazvukom i dvoenergetskom rendgenskom apsorpciometrijom

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with consequential increase in bone fragility and susceptibility to fracture. Bone mineral density (BMD) is an important determinant factor of fracture risk. Fifty-eight healthy postmenopausal women aged 53-91 years were included in the study. The subjects were divided into three age groups. Heel bone (calcaneus) BMD detected by qualitative ultrasound (QUS) was correlated with lumbar spine and proximal femur BMD detected by dual energy x-ray absorptiometry (DEXA). Also, subject age and anthropometric parameters (body weight and height) were correlated with BMD values in the calcaneus, spine and proximal femur. A chart was made of T-score conversion for lumbar spine according to T-score of heel bone detected by QUS. Calcaneal BMD showed best correlation in group 2 (58-67 yrs) with total femoral BMD (R=0.72) and intertrochanteric area (R=0.719), both statistically significant (p1=0.0007, p1<0.001; p2=0.0008, p2<0.001). There was no significant correlation between any of the calculated BMD values (calcaneus, lumbar spine and proximal femur) and age, body weight or body height. According to our conversion chart, when T-score calculated on ultrasound densitometry is equal or below -1 it yields a final T-score of lumbar spine between -1 and -2.5, which according to WHO criteria is diagnosed as osteopenia. This makes ultrasound densitometry an excellent screening method to identify patients at a risk of fracture.Osteoporoza je sistemska skeletna bolest obilježena malom koštanom masom i mikroarhitektonskim pogoršanjem koštanoga tkiva, s posljedičnim porastom krhkosti kostiju i sklonosti za prijelome. Koštana mineralna gustoća (BMD) je važan čimbenik koji određuje rizik od prijeloma. Ispitivanje je provedeno u 58 zdravih žena u postmenopauzi, u dobi od 53 do 91 godine. Ispitanice su bile podijeljene u tri dobne skupine. BMD petne kosti (kalkaneus) izmjerena kvalitativnim ultrazvukom (QUS) korelirana je s BMD lumbalne kralješnice i proksimalnog femura izmjerenom dvoenergijskom rendgenskom apsorpciometrijom (DEXA). Također su dob i antropometrijski parametri (tjelesna težina i visina) korelirani s vrijednostima BMD za kalkaneus, kralješnicu i proksimalni femur. Izrađena je vlastita tablica za konverziju T-vrijednosti za lumbalnu kralješnicu prema T-vrijednosti za petnu kost izmjerenima pomoću QUS. Najbolja korelacija za BMD kalkaneusa nađena je u 2. skupini (58-67 godina) s ukupnim BMD femura (R=0,72) i intertrohanterskog područja (R=0,719), obje statistički značajne (p1=0,0007, p1<0,001; p2=0,0008, p2<0,001). Nije bilo značajne korelacije između bilo koje izračunate vrijednosti BMD (kalkaneus, lumbalna kralješnica i proksimalni femur) i dobi, tjelesne težine i tjelesne visine. Prema vlastitoj tablici konverzije, kada je T-vrijednost izračunat ultrazvučnom denzitometrijom jednak ili ispod -1, to daje konačnu T-vrijednost za lumbalnu kralješnicu između -1 i -2,5, što se prema kriterijima SZO dijagnosticira kao osteopenija. To čini ultrazvučnu denzitometriju izvrsnom metodom probira za prepoznavanje bolesnika s rizikom od prijeloma

Interkulturalnost kao cilj učenja stranoga jezika u ranoj i predškolskoj dobi

Rad opisuje mogućnosti i korisnost implementacije interkulturalnih sadržaja u proces učenja stranoga jezika u ranoj i predškolskoj dobi. Proces učenja stranog jezika nije ograničen na lingvističku kompetenciju, već podrazumijeva i usvajanje interkulturalne komunikacijske kompetencije odnosno "kulturne svjesnosti". U kontekstu ranog učenja stranoga jezika, glavni cilj interkulturalnog obrazovanja u djece je razviti svijest o vlastitom nacionalnom identitetu te toleranciji prema kulturama koje su drugačije od njihove. Interkulturalnost predstavlja temelj za sprečavanje formiranja kulturnih stereotipa te za razvijanje socijalnih vrijednosti kao što su otvorenost i poštovanje prema različitosti.This paper describes the possibilities and usefulness of the implementation of intercultural content in the process of foreign language learning in early and preschool age. The process of learning a foreign language is not limited to linguistic competency, but also means the adoption of intercultural communicative competence i.e. cultural awareness. In the context of early foreign language learning, the main goal of intercultural education is to develop awareness of their own national identity and tolerance for cultures that are different from theirs. Interculturality is the basis for the prevention of the formation of cultural stereotypes and for the development of social values such as openness and respect for diversity

Quality of life and mental health in women affected by breast cancer

Rak dojke je zloćudna i smrtonosna bolest i ujedno i najčešći oblik raka u žena. Postavljanje dijagnoze snažno utječe na ženino mentalno zdravlje. Žene se moraju suočiti sa mnogim strahovima koji nerijetko narušavaju mentalno zdravlje. Nerijetko se kao posljedica tih strahova javljaju anksioznost i depresija. Važan odraz mentalnog zdravlja je i slika o vlastitom tijelu, a do promjene u njenoj percepciji dolazi zbog promjena na tijelu kao posljedice liječenja. Kako je mentalno zdravlje jedan od aspekata kvalitete života, njihova kvaliteta života može biti znatno narušena. Brojni čimbenici imaju utjecaj na kvalitetu života i mentalno zdravlje poput same dijagnoze, tretmana liječenja, koji uključuju operaciju, kemoterapiju, radioterapiju ili hormonsku terapiju, socijalna potpora obitelji i prijatelja te potpora iz udruga za potporu ženama oboljelima od raka dojke. Ovim radom nastoji se objasniti uloga svakog pojedinog čimbenika u kvaliteti života žena oboljelih od raka dojke te pružiti savjete na koji način poboljšati njihovu kvalitetu života putem socijalne potpore

Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba višeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]

This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage

Gray-scale and color duplex Doppler ultrasound of hand joints in the evaluation of disease activity and treatment in rheumatoid arthritis

Aim To evaluate the role of gray-scale and color duplex- Doppler ultrasound (CDUS) in diagnosis of changes of hand joints and assessment of treatment efficacy in patients with rheumatoid arthritis (RA) by comparing qualitative and quantitative US parameters with clinical and laboratory indicators of disease activity. Methods Ulnocarpal (UC), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints in 30 patients with RA were examined by gray-scale and CDUS before and after six months of treatment. Morphologic and quantitative Doppler findings (synovial thickness, effusion quantity, vascularization degree, resistance index, velocities) were compared with clinical indicators of disease progression: disease activity score (DAS 28), Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP). Results Clinical indicators changed significantly after treatment: ESR from 38.1 ± 22.4 mm/h to 27.8 ± 20.9 mm/h (P = 0.013), DAS 28 from 5.47 ± 1.56 to 3.87 ± 1.65 (P < 0.001), and HAQ from 1.26 ± 0.66 to 0.92 ± 0.74 (P = 0.030), indicating therapeutic effectiveness. In all MCP and UC joints we observed a significant change in at least one US parameter, in 6 out of 12 joints we observed a significant change in ≥2 parameters, and in 2 UC joints we observed significant changes in ≥3 parameters. The new finding was that the cut-off values of resistance index of 0.40 at baseline and of 0.55 after the treatment indicated the presence of active disease and the efficacy of treatment, respectively; also it was noticed that PIP joints can be omitted from examination protocol. Conclusion Gray scale and CDUS are useful in diagnosis of changes in UC and MCP joints of patients with RA and in monitoring the treatment efficacy

Interkulturalnost kao cilj učenja stranoga jezika u ranoj i predškolskoj dobi

Rad opisuje mogućnosti i korisnost implementacije interkulturalnih sadržaja u proces učenja stranoga jezika u ranoj i predškolskoj dobi. Proces učenja stranog jezika nije ograničen na lingvističku kompetenciju, već podrazumijeva i usvajanje interkulturalne komunikacijske kompetencije odnosno "kulturne svjesnosti". U kontekstu ranog učenja stranoga jezika, glavni cilj interkulturalnog obrazovanja u djece je razviti svijest o vlastitom nacionalnom identitetu te toleranciji prema kulturama koje su drugačije od njihove. Interkulturalnost predstavlja temelj za sprečavanje formiranja kulturnih stereotipa te za razvijanje socijalnih vrijednosti kao što su otvorenost i poštovanje prema različitosti.This paper describes the possibilities and usefulness of the implementation of intercultural content in the process of foreign language learning in early and preschool age. The process of learning a foreign language is not limited to linguistic competency, but also means the adoption of intercultural communicative competence i.e. cultural awareness. In the context of early foreign language learning, the main goal of intercultural education is to develop awareness of their own national identity and tolerance for cultures that are different from theirs. Interculturality is the basis for the prevention of the formation of cultural stereotypes and for the development of social values such as openness and respect for diversity

Gases and the gas laws

Iako su na prvi pogled jednostavni i po svojoj strukturi i za opisati, plinovi su izuzetno važni. Život na Zemlji se velikim djelom odvija u zraku, čije lokane promjene nazivamo „vremenom“. U ovom radu opisani su plinovi, najjednostavniji oblik materije. Opisani su i pokusi koji su doveli do ideje o idealnom plinu i jednadžbi stanja idealnog plina i kako se te ideje lagano mogu proširiti na smjese. Zamišljanje plina kao skupa čestica koje se nasumično gibaju daje objašnjenje zakona idealnog plina. No, taj zakon samo približno vrijedi za realne plinove pa je u ovom radu također opisano zašto se realni plinovi ponašaju drugačije.Although, at first glance they seem simple for their structure and for description, gases are very important. Life on Earth would be unimaginable without air. This undergraduate thesis describes gases, the simplest form of matter. Experiments that led to idea of ideal gas and ideal gas equation and how easily those ideas can be applied on gas mixtures. As we imagine gases as complex of particles which randomly move gives the explanation of the law of ideal gas. However, this law is just about true for real gases, so in this paper it is also described how real gases behave differently

Što zapravo možemo vidjeti primjenom računalno potpomognute analize kod mamografije?

The main goal of this study was to compare the results of computer aided detection (CAD) analysis in screening mammography with the results independently obtained by two radiologists for the same samples and to determine the sensitivity and specificity of CAD for breast lesions. A total of 436 mammograms were analyzed with CAD. For each screening mammogram, the changes in breast tissue recognized by CAD were compared to the interpretations of two radiologists. The sensitivity and specificity of CAD for breast lesions were calculated using contingency table. The sensitivity of CAD for all lesions was 54% and specificity 16%. CAD sensitivity for suspicious lesions only was 86%. CAD sensitivity for microcalcifications was 100% and specificity 45%. CAD mainly ‘mistook’ glandular parenchyma, connective tissue and blood vessels for breast lesions, and blood vessel calcifications and axillary folds for microcalcifications. In this study, we confirmed CAD as an excellent tool for recognizing microcalcifications with 100% sensitivity. However, it should not be used as a stand-alone tool in breast screening mammography due to the high rate of false-positive results.Svrha ovoga istraživanja bila je usporediti rezultate računalno potpomognute analize (computer aided detection, CAD) u probirnoj mamografiji s rezultatima analize dva neovisna radiologa te utvrditi osjetljivost i specifičnost CAD-a za lezije u dojkama. Analizirali smo 436 mamograma pomoću CAD-a i usporedili rezultate s interpretacijom dva neovisna radiologa. Izračunali smo osjetljivost i specifičnost CAD-a za lezije u dojkama putem tablica kontingencije. Osjetljivost CAD-a za otkrivanje svih lezija u dojkama iznosila je 54%, a specifičnost 16%. Osjetljivost CAD-a za sumnjive lezije bila je 86%, a za mikrokalcifikacije 100% uz specifičnost od 45%. CAD je uglavnom pogrešno interpretirao žljezdani parenhim, vezivno tkivo i krvne žile kao tvorbe u dojkama, dok je kalcifikacije u krvim žilama i aksilarni nabor miješao s mikrokalcifikacijama. Ovom studijom smo potvrdili da je CAD izvrstan alat za otkrivanje mikrokalcifikacija s osjetljivošću od 100%. No, ipak se ne bi trebao rabiti kao jedina metoda u probirnoj mamografiji dojki uzimajući u obzir količinu lažno pozitivnih rezultata koja je prilično visoka

Makarska Riviera as a Destination; Comparison of opinions between tourists and locals

Due to the increase of global traveling trends, for a world‟s destinations it became a necessity to differentiate on the market. In the last years tourism industry in Croatia has been expanding. Due to that there is a lack of research done on this topic in Croatia; the purpose of this paper is to assess the following key issues: Quality of Makarska Riviera as a destination and Motivational factors of guests in Makarska Riviera for choosing it as a destination. Paper based questionnaire was delivered to the locals from Makarska Riviera, locals who are working in tourism sector and to the tourists from the area of Makarska Riviera. The results of overall quality, when assessed by three groups showed that quality of services provided is high, with a safety as the most important differentiating factor. Furthermore, the results showed that safety, quality of natural scenery and experiencing of natural and cultural are the most important motivational factors of guests for choosing Makrska Riviera as a destination