IZVOR STRESA U MEDICINSKIH SESTARA - PRIMALJA SVEUČILIŠNE KLINIČKE BOLNICE MOSTAR

UVOD: U znanstvenu uporabu stres prvi puta ulazi u kontekstu fizikalnih znanosti u 17. stoljeću, dok se u 19. stoljeću na njega nailazi i u medicini, gdje se o stresu raspravlja kao o uzroku bolesti. Poznato je da brojni stresni čimbenici pridonose povećanom broju psihičkih smetnji i psihosomatskih bolesti kod medicinskih sestara. CILJ: Procijeniti prisutnost i izvor stresa u medicinskih sestara/primalja Klinike za ginekologiju i porodništvo Sveučilišne kliničke bolnice Mostar. METODE: Provedeno je anketno istraživanje (presječna studija) u Klinici za ginekologiju i porodništvo Sveučilišne kliničke bolnice Mostar gdje su se analizirali podaci 33 ispitanika na osnovu upitnika o stresorima na radnom mjestu bolničkih zdravstvenih djelatnika na osnovu 37 anketnih pitanja. Primijenjene su osnovne statističke metode srednje vrijednosti, t-test, deskriptivna statistika. Sve ispitanice su potpisale informirani pristanak. REZULTATI: Istraživanje je pokazalo kako profesionalni i intelektualni zahtjevi, kao posebna kategorija izvora stresa nose najveću povezanost s ukupnim doživljajem stresa. Najveća povezanost pojedinačnih kategorija stresa je između profesionalnih i intelektualnih zahtjeva, opasnosti i štetnosti na poslu. Izvori stresa u medicinskih sestara najviše su izraženi u kategoriji javnih kritika i sudske tužbe, smjenskoga rada te organizacije i financija, a najmanji su uzrok stresa u kategoriji sukoba i komunikacije. ZAKLJUČAK: Izvori stresa u medicinskih sestara/primalja najizraženiji su u slučaju javnih kritika i sudske tužbe, smjenskoga rada, organizacije i financija. Profesionalni i intelektualni zahtjevi nose najveću povezanost s ukupnim doživljajem stresa. Najveća povezanost stresa je između profesionalnih i intelektualnih zahtjeva i opasnosti i štetnosti na poslu

Social reading - the reader on digital margins

Electronic books enrich the reading experience through a range of possibilities digital technology offers, such as commenting or adding content at the margin space, marking interesting chapters and sharing the content with other readers. The phenomenon of social reading emerges with the influence of technology in the sphere of reading books and creates interactions for readers with the content and other readers. The great potential of enriching the reading experience is visible in the digital platforms for social reading, where the interaction and the creation of new content encourages the development of new way of reading and creativity. These activities may contribute to better understanding of the text. This enhances the communication about the text thus revitalizing the content and moves the reading itself from private to public sphere. This paper will show how are the activities in the digital margins transformed into a good indicator of the reading behavior, as well as the importance and usefulness of such for publishers to create new publishing products and services

ASSOCIATION OF ERYTHROCYTE SEDIMENTATION RATE AND FIBRINOGEN CONCENTRATION WITH METABOLIC SYNDROME IN SCHIZOPHRENIC PATIENTS

Introduction: Inflammation can be a process significant to the development of schizophrenia and metabolic disorders that are frequently found in patients suffering from schizophrenia. The aim of this study was to determine the values of erythrocyte sedimentation rate and fibrinogen concentration and to establish their possible association with MS and its components in schizophrenic patients. Subjects and methods: A cross-sectional study was conducted on 200 subjects who were divided into two groups. The study group consisted of schizophrenic patients from the University Clinical Hospital Mostar (n=100), while the control group consisted of healthy subjects who came for systematic medical examinations at the infirmary of the Health Center Mostar (n=100). The diagnosis of MS was made according to NCEP-ATP III criteria, and on that basis subjects from both groups were divided into two subgroups, one with and one without MS. Inflammatory indicators that were determinated were erythrocyte sedimentation rate and fibrinogen concentration. Results: Statistically, MS was significantly more frequent in schizophrenic subjects (46.0%) compared to the control group (29.0%) (p=0.013). Schizophrenic subjects with MS had statistically higher sedimentation rate and fibrinogen concentration compared to the schizophrenic subjects without MS, as well as compared to the control subgroup without MS. The most significant correlations discovered were for the relation of sedimentation rate with systolic (r=0.41) and diastolic (r=0.34) blood pressures. Conclusion: Routine monitoring of erythrocyte sedimentation rate and fibrinogen concentration might have an important role in forecasting MS development and consequent adverse cardiovascular events which are the leading cause of mortality in schizophrenic patients

EPIDEMIOLOŠKE KARAKTERISTIKE COVID-A 19

Izbijanje koronavirusne bolesti (COVID-19) 2019. godine, uzrokovano teškim akutnim respiratornim sindromom (SARS) koronavirusom 2 (SARS-CoV-2), prema dosadašnjim podacima je prouzrokovalo smrt kod preko 250 000 ljudi i zarazilo preko 3,6 milijuna ljudi diljem svijeta. Provedene su sve znane i raspoložive mjere za smanjenje prijenosa COVID-19 infekcije s osobe na osobu, kako bi se virus stavio pod kontrolu širenje. Nebrojeno puta se naglašavalo kako bi posebnu pozornost i napore trebalo dati na zaštiti ili smanjenju prijenosa u osjetljivoj populaciji, uključujući kronične bolesnike, imunokompromitirane osobe, djecu, zdravstvene djelatnike i osobe starije životne dobi. Kao odgovor na brzo rastući broj publikacija o aktualnoj bolesti o kojoj se još uvijek ne zna mnogo, ovim člankom se želi prikazati sveobuhvatni pregled dosadašnjih relevantnih studija

THE EFFECT OF SHIFT WORK ON THE OVERALL HEALTH STATUS OF HOSPITAL-EMPLOYED NURSING STAFF IN BOSNIA AND HERZEGOVINA: A CROSS-SECTIONAL STUDY

Background: Nursing is a profession frequently organized around shift work in order to guarantee the continuity of care throughout the 24 hours. However, working in shifts is coupled with the desynchronization of circadian rhythms and may result in adverse effects on nurses heath.Our previous work has demonstrated the presence of increased stress levels, reduced coping abilities and diminished life enjoyment in shift work nurses in comparison to those working only in accordance with the daily schedule. Here we aimed to appraise the effects of shift work on their overall health status. Subjects and methods: We used a comparative cross-sectional approach on a sample of 157 hospital nursing professionals at the University Clinical Hospital Mostar. Study subjects were divided into two groups: a total of 51% study subjects were included in a specific type of shift work (i.e., 12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while the remaining 49% adhered to the conventional 7-hour daily schedule. The instrument used was a Standard Shiftwork Index (SSI), together with a comprehensive appraisal of socio-demographic characteristics. Descriptive and inferential statistical methods were applied, and statistical significance was set at p0.05 (two-sided). Results: The results have shown that nurses in shift work were significantly more burdened with gastrointestinal disturbances (p<0.001); more specifically, there was a higher frequency of appetite loss (p=0.003), heartburn (p=0.03), nausea (p<0.01) and weight gain (p=0.05) when compared to nursing professionals in the day shift. Conversely, there were no statistically significant differences in cardiovascular health between these two groups. In addition, nurses in shift work more frequently presented with headaches (p=0.001) and varicose veins of lower extremities (p=0.037) in comparison to nurses working only in accordance with the daily schedule. Conclusions: Shift work can adversely influence psychophysical homeostasis, resulting not only in substandard performance of nursing staff, but also potentially hazardous effects on their overall health status. More specifically, we recognized shift work as a substantial risk factor for gastrointestinal and metabolic disorders in nurses; likewise, the increased prevalence of headaches may consequently have a detrimental effect on social and family relationships. All of this should be tackled in a holistic and organized way, together with any additional psychological/sleep issues

Zadovoljstvo bolesnika kvalitetom pruženih usluga u internističkim djelatnostima u Sveučilišnoj kliničkoj bolnici Mostar Patient satisfaction with the quality of services provided in Internal Medicine Departament at the University Clinical Hospital Mostar

Kvaliteta pruženih usluga proces je utvrđivanja zadovoljstva bolesnika zdravstvenim uslugama, uočavanja nedostataka i njihova provođenja. Utvrđivanje zadovoljstva bolesnika pruženim uslugama u zdravstvenim ustanovama koristan je podatak čija je svrha unaprijediti i poboljšati kvalitetu zdravstvenih usluga. U idealnom društvu svi bi bili podjednako zadovoljni, ali u stvarnom životu to nije moguće i stoga je kvaliteta zdravstvene zaštite kompleksna i sporo napreduje. Sudionici su u poboljšavanju kvalitete i sigurnosti zdravstvenih usluga: zdravstveni djelatnici, zdravstveni suradnici, korisnici zdravstvenih usluga, zdravstvene ustanove, zavodi za javno zdravstvo, komore i udruženja zdravstvenih djelatnika, te ministarstvo zdravstva. Zadovoljstvo bolesnika pruženom zdravstvenom uslugom jedan je od glavnih kriterija koji upućuju na razinu postignute kvalitete [1,2]. Cilj je provedenog istraživanja ispitati razinu zadovoljstva kod hospitaliziranih bolesnika u Sveučilišnoj kliničkoj bolnici (SKB) Mostar. U istraživanje su uključena 182 bolesnika, hospitalizirana u periodu od mjeseca travnja do kolovoza 2017. godine. Uporabom anketnog upitnika izrađenogu Agenciji za kontrolu kvalitete u zdravstvu i socijalne skrbi [engl. Hospital Consumer Assessment of Healthcare Providers And Systems] ispitano je njihovo zadovoljstvo. Podaci su obrađeni u statističkom paketu ANOVA (Analiza varijance), Microsoft Excel Data Analysis, Tools-am. Svi aspekti zadovoljstva kvalitetom pruženih zdravstvenih usluga međusobno su pozitivno povezani. Obradom podataka nameće se zaključak kako bi bolja organizacija rada na odjelima i fokusiranje na potrebe bolesnika, uvažavajući njihova očekivanja, bili važni za osjećaj zadovoljstva bolesnika

„Freemium“ poslovni model u nakladništvu. Novo oblikovanje za potrebe čitatelja digitalnog doba

In a digital environment, the traditional roles of authors and publishers change. The shift of power from authors, publishers and/or content to the platform affects the development of new business models, and shaping the content in the digital environment becomes a major challenge for publishers. The subscription models of the content sale have long been present in other media industries. Editing, design and marketing are the key features that a publisher develops and adapts to changes. The traditional skills of publishers are no longer sufficient. Instead, a continued integration of innovative solutions is needed. The aim of this paper is to explore how the emergence of subscription models influences the development of new publishing products which bring together the author and the publisher in a joint effort to reach a larger number of readers.U digitalnom okružju, autor i nakladnik pod utjecajem trendova mijenjaju svoje tradicionalne uloge. Premještanje moći od autora, nakladnika ili sadržaja do platforme utječe na razvoj novih poslovnih modela. Oblikovanje sadržaja u digitalnom okruženju veliki je izazov nakladnicima. Pretplatnički modeli prodaje sadržaja već su odavno prisutni u drugim medijskim industrijama. Uređivanje, dizajn i marketing ključne su funkcije koje nakladnik razvija i prilagođava promjenama. Tradicionalne vještine nakladnika nisu više dovoljne već je nužna stalna integracija inovativnih rješenja. Pretplata i opseg knjige dobivaju novo značenje u digitalnom okruženju. Cilj je rada istražiti kako pojava pretplatničkih modela utječe na razvoj novih nakladničkih proizvoda koji ujedinjavaju autora i nakladnika u zajedničkom nastojanju da dođu do većeg broja čitatelja

Utjecaj smjenskog rada na metabolizam i cjelodnevni ritam kod medicinskih sestara i tehničara

Providing in-patient nursing care inevitably involves shift work and shift patterns have been identified as an important factor in determining well-being and satisfaction among nurses. Shifts of 12 h or longer have become increasingly common for nurses in hospitals in some European countries. Longer shifts offer a potential to benefit from a compressed working week, with fewer work days and more days off-work, lower commuting costs, and increased flexibility. Most people find shift work less desirable compared to standard working hours. A cross-sectional cohort study was conducted at the Mostar University Hospital in 2019. A total of 157 subjects participated in the study, 22 (14%) of which were male (medical technicians) and 135 (86%) female (nurses). The mean age of study subjects was 33.3 years (min=20, max=54, SD=8.033). Results of this study suggested that nurses working irregular rotating shifts, with more family members to look after and more than 18 years of professional experience were affected by sleep disturbances between shifts. The study showed that shift work nurses had significantly higher levels of cortisol and prolactin compared with first-shift nurses/medical technicians. The results of this study are expected to stimulate further studies of sleep disturbances among shift nurses.Pružanje njege bolesnicima neizbježno uključuje rad u smjenama te su uzorci smjena prepoznati kao važan čimbenik u utvrđivanju blagostanja i zadovoljstva među medicinskim sestrama. Smjene od 12 h ili duže su postale sve češće za medicinske sestre u bolnicama u nekim državama Europe. Duže smjene nude potencijal za iskorištavanje komprimiranog radnog tjedna, s manje radnih dana i više slobodnih dana, manje troškove prijevoza i povećanu fleksibilnost. Većina ljudi smatra rad u smjenama manje poželjnim u usporedbi sa standardnim radnim vremenom. Presječno kohortno istraživanje provedeno je u Sveučilišnoj kliničkoj bolnici Mostar u 2019. godini. Ukupno je 157 osoba sudjelovalo u istraživanju, od čega su 22 (14%) bili muškarci (medicinski tehničari), a 135 (86%) žene (medicinske sestre). Srednja dob ispitanika je bila 33,3 godine (minimum 20, maksimum 54 godine, SD=8,033). Rezultati ovog istraživanja ukazuju na to da se medicinske sestre koje rade u neregularnim kružnim smjenama brinu za više članova obitelji i imaju više od 18 godina profesionalnog iskustva te imaju smetnje sa spavanjem između smjena. Ovo istraživanje je otkrilo da medicinske sestre imaju značajno više razine kortizola i prolaktina u usporedbi s medicinskim sestrama/tehničarima iz prve smjene. Rezultati ovog istraživanja mogli bi biti poticaj za daljnje istraživanje poremećaja sna kod medicinskih sestara iz kružnih smjena