Postoji li razlika u perinatalnom ishodu jednoplodnih i blizanačkih trudnoća nakon medicinski potpomognute oplodnje

The aim of the study was to compare perinatal outcome of singleton and twin pregnancies conceived after assisted reproductive technologies (ART ). This retrospective study included singleton and twin pregnancies conceived after ART in the period from January 1, 2007 until December 31, 2008. The study variables were maternal age (years), parity, body mass index (BMI; kg/m2), week (≤366/7 and ≥37) and mode of delivery (vaginal and cesarean section), birth weight (grams) and APGAR score (≤7; 8-10). During the study period, there were 195 pregnancies after ART that fulfilled inclusion criteria. We found no between-group difference in parity (χ2=0.0133; P=0.9081), but such difference was found in mean age (t=2.0486; p=0.0419) and BMI (χ2=31.038; P=0.001). A statistically significant difference was recorded in preterm delivery rate (χ2=25.539; P=0.001), average duration of pregnancy (t=12.8591; p=0.001), average birth weight (t=10.5446; P=0.001) and mode of delivery (χ2=13,691; P=0.001). A statistically significant difference was found in low birth weight babies (χ2=102.02; P=0.001) and APGAR score (χ2=19.96; P=0.001), but there was no difference in the prevalence of small for gestational age babies (χ2=0.90629; P=0.635). In conclusion, this study indicated the perinatal outcome after ART to be considerably poorer in twins than in singletons.Cilj ove studije bio je istražiti razliku u perinatalnom ishodu jednoplodnih i blizanačkih trudnoća nakon medicinski potpomognute oplodnje (MPO). Ispitana je medicinska dokumentacija jednoplodnih i blizanačkih trudnoća u žena koje su rodile živorođenu djecu nakon MPO u dvogodišnjem razdoblju u Klinici za ženske bolesti i porode, KBC Split, od 1. siječnja 2007. do 31. prosinca 2008. godine. Istraživane varijable bile su dob, paritet, indeks tjelesne mase (kg/m2), navršeni tjedan poroda (prijevremeni ≤366/7 i terminski ≥37), način dovršetka porođaja (vaginalno i carski rez), porođajna masa djeteta (grami), trofičnost djeteta (hipertrofično, eutrofično i hipotrofično) i APGAR zbroj novorođenčeta (≤7, 8-10). U promatranom razdoblju 195 trudnica je rodilo nakon neke od metoda MPO. Između rodilja s jednoplodnom i blizanačkom trudnoćom koje su zanijele nekom metodom MPO nije bilo razlike u paritetu (χ2=0,0133; P=0,9081), dok su razlike pronađene u prosječnoj dobi (t=2,0486; p=0,0419) i indeksu tjelesne mase (χ2=31,038; p=0,001). Statistički značajna razlika nađena je u učestalosti prijevremenog poroda (χ2=25,539; P=0,001), prosječnom trajanju trudnoće (t=12,8591; p=0,001) i prosječnoj porodnoj masi djece (t=10,5446; P=0,001). Blizanačke trudnoće u usporedbi s jednoplodnim trudnoćama nakon MPO češće se dovršavaju carskim rezom (χ2=13,691; P=0,001). Pronađena je statistički značajna razlika između istraživanih skupina u rađanju djece niske porodne mase (<2500 g) (χ2=102,02; P=0,001) i APGAR zbroju novorođenčadi (χ2=19,96; P=0,001). Nije bilo statistički značajne razlike u učestalosti rađanja hipotrofične djece između istraživanih skupina (χ2=0,90629; P=0,635). U zaključku, perinatalni ishod nakon MPO je lošiji u blizanačkih nego u jednoplodnih trudnoća

What can be hidden behind the diagnosis of asthma?

Astma je kronična upalna bolest koja se klinički očituje reverzibilnom bronhalnom opstrukcijom. Kašalj i piskanje (engl. wheezing) su učestali simptomi u dječjoj dobi, ali ne označavaju uvijek tešku bolest. Iako je astma najčešći uzrok kašlja, teškog disanja i dispneje u djece i odraslih, dijagnoza astme se često neprimjereno pripisuje simptomima drugih bolesti. Pažljivo uzeta anamneza, prisutnost zvučnih fenomena, spirometrija i mjerenje acidobaznog statusa pružaju nam korisne podatke za rješavanje različitih uzroka i izbjegavanje neprikladnog liječenja kliničkih manifestacija bolesti koje nalikuju na astmu.Bronchial asthma is defined as a chronic inflammatory disease resulting in a reversible and variable bronchial obstruction. Cough and wheeze are common symptoms in childhood, but mostly do not signify a serious illness. Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations

Tourism valorisation of Croatian homeland war heritage in Zadar county

Turizam u današnje vrijeme predstavlja vrlo popularnu aktivnost koju u modernom i razvijenom svijetu u slobodno vrijeme provodi veliki broj ljudi. Turizam može biti domaći ili međunarodni, odnosno svjetski, a također za neke države predstavlja i glavni izvor prihoda. U svjetskom turizmu se povremeno događaju i padovi koji su uzrokovani određenim globalnim problemima, primjerice ratovima, gospodarskim krizama ili pandemijama. Turističko tržište je tržište specifične vrste na kojem se, kao i na ostalim tržištima, susreću ponuda i potražnja. Ratni turizam ulazi u područje tzv. mračnog turizma. Mračni turizam je vrsta turizma koji zapravo postoji još od srednjeg vijeka, no tek početkom 21. stoljeća je službeno uključen u turističke oblike i definiran. Turizam temeljen na ratnoj baštini ulazi u mračni turizam. Mračni turizam je turizam koji je obilježen tematikom putovanja koja je vezana uz nasilje, smrt, stradanje i patnju ljudi. Memorijalni ili ratni turizam je jedan od specifičnih oblika turizma koji se po mnogim stvarima razlikuje od svih ostalih oblika specifičnog i masovnog turizma.Nowadays, tourism is a very popular activity that is carried out in their free time by a large number of people in the modern and developed world. Tourism can be domestic or international, or worldwide, and it is also the main source of income for some countries. In world tourism, there are occasional declines caused by certain global problems, for example wars, economic crises or pandemics. The tourist market is a market of a specific type where, like in other markets, supply and demand meet. War tourism enters the area of the so-called dark tourism. Dark tourism is a type of tourism that has actually existed since the Middle Ages, but it was officially included in tourist forms and defined only at the beginning of the 21st century. War heritage-based tourism falls under cathegory of dark tourism. Dark tourism is tourism that is marked by travel themes that are related to violence, death, suffering and human suffering. Memorial or war tourism is one of the specific forms of tourism that differs in many respects from all other forms of specific and mass tourism

Professional associations from the perception of information science students

Profesionalna udruženja neprofitne su, neovisne i nevladine organizacije čiji primarni cilj nije ostvarivanje profita, već ostvarivanje pozitivnih promjena u zajednici. Unutar profesionalnih udruženja okupljaju se istomišljenici s ciljem da ojačaju i poboljšaju svoju struku. Profesionalna udruženja osnivaju se od strane najmanje tri osnivača i djeluju prema načelima neprofitnosti, neovisnosti, dobrotvornosti i samostalnosti. U ovom diplomskom radu predstavljena su neka od najznačajnijih inozemnih i hrvatskih profesionalnih udruženja. Cilj istraživanja u okviru ovog rada je istražiti koliko su studenti upoznati s profesionalnim udruženjima u knjižničarskim i informacijskim znanostima, smatraju li da su profesionalna udruženja dovoljno vidljiva i promovirana te slažu li se s tim da profesionalna udruženja doprinose razvoju knjižničarstva i informacijskih znanosti. Za potrebe istraživanja provedena je anonimna anketa među studentima informacijskih znanosti u Zagrebu, Zadru i Osijeku koju je ukupno ispunilo 129 studenata. Rezultati istraživanja pokazuju kako su studenti upoznati s udruženjima koja se češće spominju tokom studija te da smatraju kako su udruženja iznimno korisna za knjižničarstvo i informacijske znanosti. Također, rezultati istraživanja ukazali su na to kako su studenti neodlučni u nakani da se učlane u neko profesionalno udruženje te smatraju da bi se vidljivost profesionalnih udruženja poboljšala kada bi se više promovirali i oglašavali na društvenim mrežama.Professional associations are non-profit, independent and non-governmental organizations whose primary goal is not to make a profit, but to make positive changes in the community. Like-minded people gather within professional associations with the aim of strengthening and improving their field. Professional associations are founded by at least three founders and operate according to the principles of non-profit, independence, charity and autonomy. In this paper, some of the most important foreign and Croatian professional associations are presented. The aim of the research in this paper is to investigate how familiar students are with professional associations in library and information sciences, whether professional associations are sufficiently visible and promoted, and whether they agree that professional associations contribute to the development of librarianship and information sciences. For the purposes of the research, an anonymous survey was conducted among information science students in Zagreb, Zadar and Osijek, which was completed by a total of 129 students. The results of the research show that students are familiar with the associations that are mentioned more often during their studies and that they believe that the associations are extremely useful for librarianship and information sciences. Also, the results of the research indicated that students are hesitant in their intention to join a professional association and believe that the visibility of professional associations would improve if they were more promoted and advertised on social networks

Professional associations from the perception of information science students

Profesionalna udruženja neprofitne su, neovisne i nevladine organizacije čiji primarni cilj nije ostvarivanje profita, već ostvarivanje pozitivnih promjena u zajednici. Unutar profesionalnih udruženja okupljaju se istomišljenici s ciljem da ojačaju i poboljšaju svoju struku. Profesionalna udruženja osnivaju se od strane najmanje tri osnivača i djeluju prema načelima neprofitnosti, neovisnosti, dobrotvornosti i samostalnosti. U ovom diplomskom radu predstavljena su neka od najznačajnijih inozemnih i hrvatskih profesionalnih udruženja. Cilj istraživanja u okviru ovog rada je istražiti koliko su studenti upoznati s profesionalnim udruženjima u knjižničarskim i informacijskim znanostima, smatraju li da su profesionalna udruženja dovoljno vidljiva i promovirana te slažu li se s tim da profesionalna udruženja doprinose razvoju knjižničarstva i informacijskih znanosti. Za potrebe istraživanja provedena je anonimna anketa među studentima informacijskih znanosti u Zagrebu, Zadru i Osijeku koju je ukupno ispunilo 129 studenata. Rezultati istraživanja pokazuju kako su studenti upoznati s udruženjima koja se češće spominju tokom studija te da smatraju kako su udruženja iznimno korisna za knjižničarstvo i informacijske znanosti. Također, rezultati istraživanja ukazali su na to kako su studenti neodlučni u nakani da se učlane u neko profesionalno udruženje te smatraju da bi se vidljivost profesionalnih udruženja poboljšala kada bi se više promovirali i oglašavali na društvenim mrežama.Professional associations are non-profit, independent and non-governmental organizations whose primary goal is not to make a profit, but to make positive changes in the community. Like-minded people gather within professional associations with the aim of strengthening and improving their field. Professional associations are founded by at least three founders and operate according to the principles of non-profit, independence, charity and autonomy. In this paper, some of the most important foreign and Croatian professional associations are presented. The aim of the research in this paper is to investigate how familiar students are with professional associations in library and information sciences, whether professional associations are sufficiently visible and promoted, and whether they agree that professional associations contribute to the development of librarianship and information sciences. For the purposes of the research, an anonymous survey was conducted among information science students in Zagreb, Zadar and Osijek, which was completed by a total of 129 students. The results of the research show that students are familiar with the associations that are mentioned more often during their studies and that they believe that the associations are extremely useful for librarianship and information sciences. Also, the results of the research indicated that students are hesitant in their intention to join a professional association and believe that the visibility of professional associations would improve if they were more promoted and advertised on social networks

Circumstances and risk factors for alcohol, drugs and tobacco consumption in children and adolescents with reference to the duration of the COVID-19 pandemic

Uvod: Konzumacija alkohola, droga i duhana među mladima najčešći su oblici rizičnih ponašanja. Poznavanje obrazaca navedenih ponašanja u određenoj sredini dalo bi smjernice za izradu specifičnih preventivnih programa. Cilj: Utvrditi prevalenciju, okolnosti i rizične čimbenike konzumacije alkohola droga i duhana među učenicima završnih razreda srednjih škola u Splitsko-dalmatinskoj županiji (SDŽ), razlike među školama (strukovne vs. gimnazije i privatne škole) te razlike u ovisnosti o mjestu pohađanja škole (Split i okolica, dalmatinsko zaleđe, otoci), kao i promjene u konzumaciji alkohola za vrijeme lockdowna tijekom pandemije COVID-19. Ovim istraživanjem želimo utvrditi i učestalost i promjene učestalosti hospitalizacija zbog akutnih alkoholnih intoksikacija (AAI) među djecom u dobi od 0 do 18 godina u razdoblju od 2008. do 2015. te ih usporediti s rezultatima iz razdoblja od 2016. do 2021. godine, kao i okolnosti koje su dovele do intoksikacije. Metode: Anonimni anketni upitnik putem mrežne (online) poveznice proslijeđen je učenicima završnih razreda srednjih škola u SDŽ-u (N = 1030). Učenici su upitnik mogli popuniti od lipnja do srpnja te od listopada do kraja prosinca 2020. godine. Pretražena je i medicinska dokumentacija djece starosti od 0 do 18 godina liječene na Klinici za dječje bolesti KBC-a Split od 1. siječnja 2008. do 31. prosinca 2021. godine zbog AAI-a (N = 272 od 2008. do 2015. i N = 71 od 2016. do 2021.) Rezultati: Prevalencija je pušenja među učenicima u SDŽ-u 37,28 %, konzumacije droga 24,27 % te pijenja alkohola 84,66 %. Učenici koji pohađaju strukovne škole češće puše od učenika u gimnazijama i privatnim školama (P < 0,001), dok među učenicima navedenih škola nema razlike u konzumaciji alkohola (P = 0,751) i droga (P = 0,192). Dječaci češće konzumiraju droge nego djevojčice (P = 0,013), dok nema razlike u konzumaciji alkohola (P = 0,328) i duhana (P = 0,85) među spolovima. Pušenje je najčešće među učenicima iz dalmatinskoga zaleđa (P = 0,037), konzumacija alkohola najčešća je na otocima (P = 0,007), a droga u Splitu i okolici (P = 0,029). Alkohol se najčešće pije u noćnim klubovima i café barovima (54,36 %), s prijateljima (92,89 %). Učenici ga obično piju kako bi se bolje osjećali (34,86 %). Pritom se najčešće piju žestoka pića u kombinaciji s bezalkoholnim pićem (39,33 %). Najveći broj učenika bez problema samostalno nabavlja alkoholna pića (85,33 %), njih 69,03 % barem se jednom opilo. Visina džeparca, samostalno zarađivanje, učestalost izlazaka, depresivnost, muški spol, razvedenost roditelja i viši stupanj obrazovanja majke povezani su s većim rizikom za upuštanje u rizična ponašanja, dok je za religioznost, veću učestalost prakticiranja vjere, bavljenje sportom i bolji školski uspjeh pokazano suprotno. Tijekom lockdowna zbog pandemije COVID-19 došlo je do značajnoga pada konzumacije alkohola među učenicima završnih razreda srednjih škola u SDŽ-u (P < 0,001), posebno u društvu s prijateljima (P < 0,001), dok je porasla učestalost pijenja s članovima obitelji (P < 0,001), samostalnoga pijenja (P < 0,001) te pijenja u različitim socijalnim kontekstima (P = 0,002). Tijekom lockdowna najčešće se pilo iz dosade (39,05 %). Učestalost pijenja tijekom lockdowna bila je manja među 53,98 % učenika, dok je 15,63 % učenika povećalo učestalost konzumacije (P < 0,001). Među učenicima gimnazija i privatnih škola zabilježen je značajniji pad pijenja u odnosu na učenike strukovnih škola (P = 0,002), kao i među učenicima na otocima (P = 0,050). Mladići su tijekom lockdowna češće pili od djevojaka (P < 0,001). Značajno smanjenje AAI-a među djecom u dobi od 0 do 18 godina zabilježen je i u 2020. (razdoblje pandemije) u odnosu na 2019. godinu, koja je prethodila pandemiji (P = 0,025). U razdoblju od 2008. do 2015. godine 488 djece bilo je liječeno na Klinici za dječje bolesti KBC-a Split zbog akutnih intoksikacija, od čega njih 272 (55,74 %) zbog AAI-a, dok ih je u razdoblju od 2016. do 2021. bilo 218, među kojima je 71 dijete (32,57 %) liječeno zbog AAI-a. U obama ispitivanim razdobljima AAI je bio češći među dječacima (63,60 % od 2008. do 2015. te 70,42 % od 2016. do 2021.), najčešće među skupinom u dobi od 14 do 18 godina (P < 0,001), tijekom vikenda i blagdana (P < 0,001) te izvan kuće (P < 0,001). Prosječna je dob bila 15,95 ± 1,51 godinu u razdoblju 2008. – 2015., odnosno 16,17 ± 1,3 godine u razdoblju 2016. – 2021.; koncentracija alkohola 2,003 ± 0,585 ‰ u razdoblju 2008. – 2015., odnosno 2,15 ± 0,539 ‰ u razdoblju 2016. – 2021.; prisustvo ozljeda u 11,03 % slučajeva u razdoblju 2008. – 2015., odnosno 23,94 % u razdoblju 2016. – 2021.; u razdoblju 2008. – 2015. na droge je bilo pozitivno 6,25 %, a u razdoblju 2016. – 2021. 8,45 % djece. Udio hospitalizacija djece u dobi od 0 do 18 godina zbog AAI-a među svim hospitalizacijama u razdoblju od 2008. (1,33 %) do 2021. godine (0,23 %) značajno se smanjio, pri čemu se u svakoj sljedećoj godini očekuje pad za 21,26 %. Zaključak: Iako je učestalost AAI-a među djecom u SDŽ-u u padu, rezultati istraživanja pokazuju visoku prevalenciju konzumacije alkohola, droga i duhana među mladima u ovisnosti o vrsti škole i mjestu pohađanja škole. Stoga rezultati ovoga istraživanja mogu dati smjernice za izradu specifičnijih preventivnih programa među djecom i mladima. Smanjenje konzumacije alkohola među mladima za vrijeme lockdowna posljedica je smanjenoga druženja s prijateljima i ograničene dostupnosti alkohola u tome razdoblju te je pokazatelj da se smanjenjem dostupnosti opojnih tvari, kao i boljom organizacijom i ponudom aktivnosti namijenjenih mladima, može smanjiti incidencija upuštanja u rizična ponašanja.Background: Alcohol, drugs and tobacco consumption is the most common type of risky behaviors among adolescents. Determinating the speciffic patterns of these behaviors in a particular environment would provide guidelines for creating speciffic prevention programs. Aim: To determine the prevalence, circumstances and risky factors for alcohol, drugs and tobacco consumption among high school students in Split-Dalmatia County (SDC), differences between schools (vocational vs. gymnasiums and private schools) and differences depending on the place of school attendance (Split and surroundings, rural parts, islands), as well as changes in alcohol consumption during the COVID-19 pandemic lockdown. We also wanted to determine the frequency and changes in hospitalizations due to acute alcohol intoxications (AAI) among children aged 0-18 in the period from 2008 to 2015 and compare them with the results from 2016 to 2021, as well as changes in circumstances that led to intoxication. Methods: An anonymous questionnaire survey was distributed online to final grade high school students of all schools in SDC (N = 1030). Students were able to complete the questionnaire survey in a period from June to July and from October to the end of December 2020. The data of children aged 0 to 18 years who were hospitalized for AAI at Department of Pediatrics, University Hospital of Split in a period from January 1, 2008 to December 31, 2021 (N = 272 from 2008 to 2015 and N = 71 from 2016 to 2021) were collected retrospectively from hospital medical records. Results: The prevalence of smoking among students in SDC is 37.28 %, drugs consumption 24.27 %, and drinking 84.66 %. Students attending vocational schools smoke more often than students in gymnasiums and private schools (P < 0.001), while there is no difference in alcohol (P = 0.751) and drugs consumption (P = 0.192) between students depending on the school type. Boys consume drugs more often (P = 0.013) than girls, while there is no difference in alcohol (P = 0.328) and tobacco (P = 0.85) consumption depending on the gender. Smoking is most common among students from the rural parts of SDC (P = 0.037), alcohol consumption on islands (P = 0.007), and drugs in Split and the surrounding area (P = 0.029). Students most frequently drink in nightclubs and coffee bars (54.36 %), with friends (92.89 %), “to feel better” (34.86 %), where they often drink mixed drinks (39.33 %). Students most often buy alcoholic beverages without any problem (85.33 %) and 69.03 % had been drunk in lifetime. While the greater amount of pocket money, employment, frequency of going out, depression, male gender, higher level of maternal education and having divorced parents increase the risk of participating in risky behaviors, religiosity, higher frequency of religion practicing, sports participation, and higher school performance reduce it. During the COVID-19 pandemic lockdown, there was a significant decrease in alcohol consumption among high school students in SDC (P < 0.001), especially with friends (P < 0.001), while the frequency of drinking with family members (P < 0.001), drinking alone (P < 0.001) and in different social context (P = 0.002) increased. Students were most often drinking out of boredom (39.05 %) during the lockdown. There was a decrease in frequency of drinking during the lockdown among 53.98 % of students, while 15.63 % of them increased it (P < 0.001). The decrease in alcohol consumption was more signifficant among students in gymnasiums and private schools than among students from vocational schools (P = 0.002), as well as among students on islands (P = 0.050). Boys were drinking more often than girls (P < 0.001) during the lockdown period. A significant decrease in AAI among children aged 0-18 years was also recorded in 2020 (pandemic period) compared to 2019 (pre-pandemic period) (P = 0.025). In the period from 2008 to 2015, 488 children were hospitalized at Department of Pediatrics, University Hospital of Split for acute intoxications, 272 (55.74 %) of them due to AAI, while in the period from 2016 to 2021 there were 218 intoxicated children, 71 (32.57 %) of them hospitalized due to AAI. In both examined periods, AAIs were more frequent among boys (63.60 % from 2008 – 2015, and 70.42 % from 2016 – 2021), most often among children aged 14 to 18 years (P < 0.001), during weekends and holidays (P < 0.001), and in outside places (P < 0.001). The average age was 15.95 ± 1.51 (in a period 2008 – 2015) and 16.17 ± 1.30 (in a period 2016 – 2021); blood alcohol concentration 2.003 ± 0.585 ‰ (in a period 2008 – 2015) and 2.15 ± 0.539 ‰ (in a period 2016 – 2021); the presence of injuries was detected among 11.03 % (in a period 2008 – 2015) and 23.94 % (in a period 2016 – 2021) children; and 6.25 % (in a period 2008 – 2015) and 8.45 % (in a period 2016 – 2021) children were positive for drugs in urine samples. The proportion of hospitalizations of children aged 0-18 due to AAI among all hospitalizations has signifficantly decreased from 2008 (1.33 %) to 2021 (0.23 %), with an expected decrease of 21.26 % in every next year. Conclusion: Although the incidence of AAIs among children in SDC is declining, the results of this study show a high prevalence of alcohol, drug and tobacco consumption among adolescents, depending on the type and place of school attendance. Therefore the results of this study can provide guidelines for more specific prevention programms among children and adolescents. The decrease in alcohol consumption among adolescents during the lockdown is a consequence of reduced socializing with friends and limited availability of alcohol during this period, and an indication that reducing the availability of psychoactive substances and maybe with better organization and offer of activities where young people can socialize, the incidence of risky behaviors among them can be reduced

Circumstances and risk factors for alcohol, drugs and tobacco consumption in children and adolescents with reference to the duration of the COVID-19 pandemic

Uvod: Konzumacija alkohola, droga i duhana među mladima najčešći su oblici rizičnih ponašanja. Poznavanje obrazaca navedenih ponašanja u određenoj sredini dalo bi smjernice za izradu specifičnih preventivnih programa. Cilj: Utvrditi prevalenciju, okolnosti i rizične čimbenike konzumacije alkohola droga i duhana među učenicima završnih razreda srednjih škola u Splitsko-dalmatinskoj županiji (SDŽ), razlike među školama (strukovne vs. gimnazije i privatne škole) te razlike u ovisnosti o mjestu pohađanja škole (Split i okolica, dalmatinsko zaleđe, otoci), kao i promjene u konzumaciji alkohola za vrijeme lockdowna tijekom pandemije COVID-19. Ovim istraživanjem želimo utvrditi i učestalost i promjene učestalosti hospitalizacija zbog akutnih alkoholnih intoksikacija (AAI) među djecom u dobi od 0 do 18 godina u razdoblju od 2008. do 2015. te ih usporediti s rezultatima iz razdoblja od 2016. do 2021. godine, kao i okolnosti koje su dovele do intoksikacije. Metode: Anonimni anketni upitnik putem mrežne (online) poveznice proslijeđen je učenicima završnih razreda srednjih škola u SDŽ-u (N = 1030). Učenici su upitnik mogli popuniti od lipnja do srpnja te od listopada do kraja prosinca 2020. godine. Pretražena je i medicinska dokumentacija djece starosti od 0 do 18 godina liječene na Klinici za dječje bolesti KBC-a Split od 1. siječnja 2008. do 31. prosinca 2021. godine zbog AAI-a (N = 272 od 2008. do 2015. i N = 71 od 2016. do 2021.) Rezultati: Prevalencija je pušenja među učenicima u SDŽ-u 37,28 %, konzumacije droga 24,27 % te pijenja alkohola 84,66 %. Učenici koji pohađaju strukovne škole češće puše od učenika u gimnazijama i privatnim školama (P < 0,001), dok među učenicima navedenih škola nema razlike u konzumaciji alkohola (P = 0,751) i droga (P = 0,192). Dječaci češće konzumiraju droge nego djevojčice (P = 0,013), dok nema razlike u konzumaciji alkohola (P = 0,328) i duhana (P = 0,85) među spolovima. Pušenje je najčešće među učenicima iz dalmatinskoga zaleđa (P = 0,037), konzumacija alkohola najčešća je na otocima (P = 0,007), a droga u Splitu i okolici (P = 0,029). Alkohol se najčešće pije u noćnim klubovima i café barovima (54,36 %), s prijateljima (92,89 %). Učenici ga obično piju kako bi se bolje osjećali (34,86 %). Pritom se najčešće piju žestoka pića u kombinaciji s bezalkoholnim pićem (39,33 %). Najveći broj učenika bez problema samostalno nabavlja alkoholna pića (85,33 %), njih 69,03 % barem se jednom opilo. Visina džeparca, samostalno zarađivanje, učestalost izlazaka, depresivnost, muški spol, razvedenost roditelja i viši stupanj obrazovanja majke povezani su s većim rizikom za upuštanje u rizična ponašanja, dok je za religioznost, veću učestalost prakticiranja vjere, bavljenje sportom i bolji školski uspjeh pokazano suprotno. Tijekom lockdowna zbog pandemije COVID-19 došlo je do značajnoga pada konzumacije alkohola među učenicima završnih razreda srednjih škola u SDŽ-u (P < 0,001), posebno u društvu s prijateljima (P < 0,001), dok je porasla učestalost pijenja s članovima obitelji (P < 0,001), samostalnoga pijenja (P < 0,001) te pijenja u različitim socijalnim kontekstima (P = 0,002). Tijekom lockdowna najčešće se pilo iz dosade (39,05 %). Učestalost pijenja tijekom lockdowna bila je manja među 53,98 % učenika, dok je 15,63 % učenika povećalo učestalost konzumacije (P < 0,001). Među učenicima gimnazija i privatnih škola zabilježen je značajniji pad pijenja u odnosu na učenike strukovnih škola (P = 0,002), kao i među učenicima na otocima (P = 0,050). Mladići su tijekom lockdowna češće pili od djevojaka (P < 0,001). Značajno smanjenje AAI-a među djecom u dobi od 0 do 18 godina zabilježen je i u 2020. (razdoblje pandemije) u odnosu na 2019. godinu, koja je prethodila pandemiji (P = 0,025). U razdoblju od 2008. do 2015. godine 488 djece bilo je liječeno na Klinici za dječje bolesti KBC-a Split zbog akutnih intoksikacija, od čega njih 272 (55,74 %) zbog AAI-a, dok ih je u razdoblju od 2016. do 2021. bilo 218, među kojima je 71 dijete (32,57 %) liječeno zbog AAI-a. U obama ispitivanim razdobljima AAI je bio češći među dječacima (63,60 % od 2008. do 2015. te 70,42 % od 2016. do 2021.), najčešće među skupinom u dobi od 14 do 18 godina (P < 0,001), tijekom vikenda i blagdana (P < 0,001) te izvan kuće (P < 0,001). Prosječna je dob bila 15,95 ± 1,51 godinu u razdoblju 2008. – 2015., odnosno 16,17 ± 1,3 godine u razdoblju 2016. – 2021.; koncentracija alkohola 2,003 ± 0,585 ‰ u razdoblju 2008. – 2015., odnosno 2,15 ± 0,539 ‰ u razdoblju 2016. – 2021.; prisustvo ozljeda u 11,03 % slučajeva u razdoblju 2008. – 2015., odnosno 23,94 % u razdoblju 2016. – 2021.; u razdoblju 2008. – 2015. na droge je bilo pozitivno 6,25 %, a u razdoblju 2016. – 2021. 8,45 % djece. Udio hospitalizacija djece u dobi od 0 do 18 godina zbog AAI-a među svim hospitalizacijama u razdoblju od 2008. (1,33 %) do 2021. godine (0,23 %) značajno se smanjio, pri čemu se u svakoj sljedećoj godini očekuje pad za 21,26 %. Zaključak: Iako je učestalost AAI-a među djecom u SDŽ-u u padu, rezultati istraživanja pokazuju visoku prevalenciju konzumacije alkohola, droga i duhana među mladima u ovisnosti o vrsti škole i mjestu pohađanja škole. Stoga rezultati ovoga istraživanja mogu dati smjernice za izradu specifičnijih preventivnih programa među djecom i mladima. Smanjenje konzumacije alkohola među mladima za vrijeme lockdowna posljedica je smanjenoga druženja s prijateljima i ograničene dostupnosti alkohola u tome razdoblju te je pokazatelj da se smanjenjem dostupnosti opojnih tvari, kao i boljom organizacijom i ponudom aktivnosti namijenjenih mladima, može smanjiti incidencija upuštanja u rizična ponašanja.Background: Alcohol, drugs and tobacco consumption is the most common type of risky behaviors among adolescents. Determinating the speciffic patterns of these behaviors in a particular environment would provide guidelines for creating speciffic prevention programs. Aim: To determine the prevalence, circumstances and risky factors for alcohol, drugs and tobacco consumption among high school students in Split-Dalmatia County (SDC), differences between schools (vocational vs. gymnasiums and private schools) and differences depending on the place of school attendance (Split and surroundings, rural parts, islands), as well as changes in alcohol consumption during the COVID-19 pandemic lockdown. We also wanted to determine the frequency and changes in hospitalizations due to acute alcohol intoxications (AAI) among children aged 0-18 in the period from 2008 to 2015 and compare them with the results from 2016 to 2021, as well as changes in circumstances that led to intoxication. Methods: An anonymous questionnaire survey was distributed online to final grade high school students of all schools in SDC (N = 1030). Students were able to complete the questionnaire survey in a period from June to July and from October to the end of December 2020. The data of children aged 0 to 18 years who were hospitalized for AAI at Department of Pediatrics, University Hospital of Split in a period from January 1, 2008 to December 31, 2021 (N = 272 from 2008 to 2015 and N = 71 from 2016 to 2021) were collected retrospectively from hospital medical records. Results: The prevalence of smoking among students in SDC is 37.28 %, drugs consumption 24.27 %, and drinking 84.66 %. Students attending vocational schools smoke more often than students in gymnasiums and private schools (P < 0.001), while there is no difference in alcohol (P = 0.751) and drugs consumption (P = 0.192) between students depending on the school type. Boys consume drugs more often (P = 0.013) than girls, while there is no difference in alcohol (P = 0.328) and tobacco (P = 0.85) consumption depending on the gender. Smoking is most common among students from the rural parts of SDC (P = 0.037), alcohol consumption on islands (P = 0.007), and drugs in Split and the surrounding area (P = 0.029). Students most frequently drink in nightclubs and coffee bars (54.36 %), with friends (92.89 %), “to feel better” (34.86 %), where they often drink mixed drinks (39.33 %). Students most often buy alcoholic beverages without any problem (85.33 %) and 69.03 % had been drunk in lifetime. While the greater amount of pocket money, employment, frequency of going out, depression, male gender, higher level of maternal education and having divorced parents increase the risk of participating in risky behaviors, religiosity, higher frequency of religion practicing, sports participation, and higher school performance reduce it. During the COVID-19 pandemic lockdown, there was a significant decrease in alcohol consumption among high school students in SDC (P < 0.001), especially with friends (P < 0.001), while the frequency of drinking with family members (P < 0.001), drinking alone (P < 0.001) and in different social context (P = 0.002) increased. Students were most often drinking out of boredom (39.05 %) during the lockdown. There was a decrease in frequency of drinking during the lockdown among 53.98 % of students, while 15.63 % of them increased it (P < 0.001). The decrease in alcohol consumption was more signifficant among students in gymnasiums and private schools than among students from vocational schools (P = 0.002), as well as among students on islands (P = 0.050). Boys were drinking more often than girls (P < 0.001) during the lockdown period. A significant decrease in AAI among children aged 0-18 years was also recorded in 2020 (pandemic period) compared to 2019 (pre-pandemic period) (P = 0.025). In the period from 2008 to 2015, 488 children were hospitalized at Department of Pediatrics, University Hospital of Split for acute intoxications, 272 (55.74 %) of them due to AAI, while in the period from 2016 to 2021 there were 218 intoxicated children, 71 (32.57 %) of them hospitalized due to AAI. In both examined periods, AAIs were more frequent among boys (63.60 % from 2008 – 2015, and 70.42 % from 2016 – 2021), most often among children aged 14 to 18 years (P < 0.001), during weekends and holidays (P < 0.001), and in outside places (P < 0.001). The average age was 15.95 ± 1.51 (in a period 2008 – 2015) and 16.17 ± 1.30 (in a period 2016 – 2021); blood alcohol concentration 2.003 ± 0.585 ‰ (in a period 2008 – 2015) and 2.15 ± 0.539 ‰ (in a period 2016 – 2021); the presence of injuries was detected among 11.03 % (in a period 2008 – 2015) and 23.94 % (in a period 2016 – 2021) children; and 6.25 % (in a period 2008 – 2015) and 8.45 % (in a period 2016 – 2021) children were positive for drugs in urine samples. The proportion of hospitalizations of children aged 0-18 due to AAI among all hospitalizations has signifficantly decreased from 2008 (1.33 %) to 2021 (0.23 %), with an expected decrease of 21.26 % in every next year. Conclusion: Although the incidence of AAIs among children in SDC is declining, the results of this study show a high prevalence of alcohol, drug and tobacco consumption among adolescents, depending on the type and place of school attendance. Therefore the results of this study can provide guidelines for more specific prevention programms among children and adolescents. The decrease in alcohol consumption among adolescents during the lockdown is a consequence of reduced socializing with friends and limited availability of alcohol during this period, and an indication that reducing the availability of psychoactive substances and maybe with better organization and offer of activities where young people can socialize, the incidence of risky behaviors among them can be reduced

Circumstances and risk factors for alcohol, drugs and tobacco consumption in children and adolescents with reference to the duration of the COVID-19 pandemic

Uvod: Konzumacija alkohola, droga i duhana među mladima najčešći su oblici rizičnih ponašanja. Poznavanje obrazaca navedenih ponašanja u određenoj sredini dalo bi smjernice za izradu specifičnih preventivnih programa. Cilj: Utvrditi prevalenciju, okolnosti i rizične čimbenike konzumacije alkohola droga i duhana među učenicima završnih razreda srednjih škola u Splitsko-dalmatinskoj županiji (SDŽ), razlike među školama (strukovne vs. gimnazije i privatne škole) te razlike u ovisnosti o mjestu pohađanja škole (Split i okolica, dalmatinsko zaleđe, otoci), kao i promjene u konzumaciji alkohola za vrijeme lockdowna tijekom pandemije COVID-19. Ovim istraživanjem želimo utvrditi i učestalost i promjene učestalosti hospitalizacija zbog akutnih alkoholnih intoksikacija (AAI) među djecom u dobi od 0 do 18 godina u razdoblju od 2008. do 2015. te ih usporediti s rezultatima iz razdoblja od 2016. do 2021. godine, kao i okolnosti koje su dovele do intoksikacije. Metode: Anonimni anketni upitnik putem mrežne (online) poveznice proslijeđen je učenicima završnih razreda srednjih škola u SDŽ-u (N = 1030). Učenici su upitnik mogli popuniti od lipnja do srpnja te od listopada do kraja prosinca 2020. godine. Pretražena je i medicinska dokumentacija djece starosti od 0 do 18 godina liječene na Klinici za dječje bolesti KBC-a Split od 1. siječnja 2008. do 31. prosinca 2021. godine zbog AAI-a (N = 272 od 2008. do 2015. i N = 71 od 2016. do 2021.) Rezultati: Prevalencija je pušenja među učenicima u SDŽ-u 37,28 %, konzumacije droga 24,27 % te pijenja alkohola 84,66 %. Učenici koji pohađaju strukovne škole češće puše od učenika u gimnazijama i privatnim školama (P < 0,001), dok među učenicima navedenih škola nema razlike u konzumaciji alkohola (P = 0,751) i droga (P = 0,192). Dječaci češće konzumiraju droge nego djevojčice (P = 0,013), dok nema razlike u konzumaciji alkohola (P = 0,328) i duhana (P = 0,85) među spolovima. Pušenje je najčešće među učenicima iz dalmatinskoga zaleđa (P = 0,037), konzumacija alkohola najčešća je na otocima (P = 0,007), a droga u Splitu i okolici (P = 0,029). Alkohol se najčešće pije u noćnim klubovima i café barovima (54,36 %), s prijateljima (92,89 %). Učenici ga obično piju kako bi se bolje osjećali (34,86 %). Pritom se najčešće piju žestoka pića u kombinaciji s bezalkoholnim pićem (39,33 %). Najveći broj učenika bez problema samostalno nabavlja alkoholna pića (85,33 %), njih 69,03 % barem se jednom opilo. Visina džeparca, samostalno zarađivanje, učestalost izlazaka, depresivnost, muški spol, razvedenost roditelja i viši stupanj obrazovanja majke povezani su s većim rizikom za upuštanje u rizična ponašanja, dok je za religioznost, veću učestalost prakticiranja vjere, bavljenje sportom i bolji školski uspjeh pokazano suprotno. Tijekom lockdowna zbog pandemije COVID-19 došlo je do značajnoga pada konzumacije alkohola među učenicima završnih razreda srednjih škola u SDŽ-u (P < 0,001), posebno u društvu s prijateljima (P < 0,001), dok je porasla učestalost pijenja s članovima obitelji (P < 0,001), samostalnoga pijenja (P < 0,001) te pijenja u različitim socijalnim kontekstima (P = 0,002). Tijekom lockdowna najčešće se pilo iz dosade (39,05 %). Učestalost pijenja tijekom lockdowna bila je manja među 53,98 % učenika, dok je 15,63 % učenika povećalo učestalost konzumacije (P < 0,001). Među učenicima gimnazija i privatnih škola zabilježen je značajniji pad pijenja u odnosu na učenike strukovnih škola (P = 0,002), kao i među učenicima na otocima (P = 0,050). Mladići su tijekom lockdowna češće pili od djevojaka (P < 0,001). Značajno smanjenje AAI-a među djecom u dobi od 0 do 18 godina zabilježen je i u 2020. (razdoblje pandemije) u odnosu na 2019. godinu, koja je prethodila pandemiji (P = 0,025). U razdoblju od 2008. do 2015. godine 488 djece bilo je liječeno na Klinici za dječje bolesti KBC-a Split zbog akutnih intoksikacija, od čega njih 272 (55,74 %) zbog AAI-a, dok ih je u razdoblju od 2016. do 2021. bilo 218, među kojima je 71 dijete (32,57 %) liječeno zbog AAI-a. U obama ispitivanim razdobljima AAI je bio češći među dječacima (63,60 % od 2008. do 2015. te 70,42 % od 2016. do 2021.), najčešće među skupinom u dobi od 14 do 18 godina (P < 0,001), tijekom vikenda i blagdana (P < 0,001) te izvan kuće (P < 0,001). Prosječna je dob bila 15,95 ± 1,51 godinu u razdoblju 2008. – 2015., odnosno 16,17 ± 1,3 godine u razdoblju 2016. – 2021.; koncentracija alkohola 2,003 ± 0,585 ‰ u razdoblju 2008. – 2015., odnosno 2,15 ± 0,539 ‰ u razdoblju 2016. – 2021.; prisustvo ozljeda u 11,03 % slučajeva u razdoblju 2008. – 2015., odnosno 23,94 % u razdoblju 2016. – 2021.; u razdoblju 2008. – 2015. na droge je bilo pozitivno 6,25 %, a u razdoblju 2016. – 2021. 8,45 % djece. Udio hospitalizacija djece u dobi od 0 do 18 godina zbog AAI-a među svim hospitalizacijama u razdoblju od 2008. (1,33 %) do 2021. godine (0,23 %) značajno se smanjio, pri čemu se u svakoj sljedećoj godini očekuje pad za 21,26 %. Zaključak: Iako je učestalost AAI-a među djecom u SDŽ-u u padu, rezultati istraživanja pokazuju visoku prevalenciju konzumacije alkohola, droga i duhana među mladima u ovisnosti o vrsti škole i mjestu pohađanja škole. Stoga rezultati ovoga istraživanja mogu dati smjernice za izradu specifičnijih preventivnih programa među djecom i mladima. Smanjenje konzumacije alkohola među mladima za vrijeme lockdowna posljedica je smanjenoga druženja s prijateljima i ograničene dostupnosti alkohola u tome razdoblju te je pokazatelj da se smanjenjem dostupnosti opojnih tvari, kao i boljom organizacijom i ponudom aktivnosti namijenjenih mladima, može smanjiti incidencija upuštanja u rizična ponašanja.Background: Alcohol, drugs and tobacco consumption is the most common type of risky behaviors among adolescents. Determinating the speciffic patterns of these behaviors in a particular environment would provide guidelines for creating speciffic prevention programs. Aim: To determine the prevalence, circumstances and risky factors for alcohol, drugs and tobacco consumption among high school students in Split-Dalmatia County (SDC), differences between schools (vocational vs. gymnasiums and private schools) and differences depending on the place of school attendance (Split and surroundings, rural parts, islands), as well as changes in alcohol consumption during the COVID-19 pandemic lockdown. We also wanted to determine the frequency and changes in hospitalizations due to acute alcohol intoxications (AAI) among children aged 0-18 in the period from 2008 to 2015 and compare them with the results from 2016 to 2021, as well as changes in circumstances that led to intoxication. Methods: An anonymous questionnaire survey was distributed online to final grade high school students of all schools in SDC (N = 1030). Students were able to complete the questionnaire survey in a period from June to July and from October to the end of December 2020. The data of children aged 0 to 18 years who were hospitalized for AAI at Department of Pediatrics, University Hospital of Split in a period from January 1, 2008 to December 31, 2021 (N = 272 from 2008 to 2015 and N = 71 from 2016 to 2021) were collected retrospectively from hospital medical records. Results: The prevalence of smoking among students in SDC is 37.28 %, drugs consumption 24.27 %, and drinking 84.66 %. Students attending vocational schools smoke more often than students in gymnasiums and private schools (P < 0.001), while there is no difference in alcohol (P = 0.751) and drugs consumption (P = 0.192) between students depending on the school type. Boys consume drugs more often (P = 0.013) than girls, while there is no difference in alcohol (P = 0.328) and tobacco (P = 0.85) consumption depending on the gender. Smoking is most common among students from the rural parts of SDC (P = 0.037), alcohol consumption on islands (P = 0.007), and drugs in Split and the surrounding area (P = 0.029). Students most frequently drink in nightclubs and coffee bars (54.36 %), with friends (92.89 %), “to feel better” (34.86 %), where they often drink mixed drinks (39.33 %). Students most often buy alcoholic beverages without any problem (85.33 %) and 69.03 % had been drunk in lifetime. While the greater amount of pocket money, employment, frequency of going out, depression, male gender, higher level of maternal education and having divorced parents increase the risk of participating in risky behaviors, religiosity, higher frequency of religion practicing, sports participation, and higher school performance reduce it. During the COVID-19 pandemic lockdown, there was a significant decrease in alcohol consumption among high school students in SDC (P < 0.001), especially with friends (P < 0.001), while the frequency of drinking with family members (P < 0.001), drinking alone (P < 0.001) and in different social context (P = 0.002) increased. Students were most often drinking out of boredom (39.05 %) during the lockdown. There was a decrease in frequency of drinking during the lockdown among 53.98 % of students, while 15.63 % of them increased it (P < 0.001). The decrease in alcohol consumption was more signifficant among students in gymnasiums and private schools than among students from vocational schools (P = 0.002), as well as among students on islands (P = 0.050). Boys were drinking more often than girls (P < 0.001) during the lockdown period. A significant decrease in AAI among children aged 0-18 years was also recorded in 2020 (pandemic period) compared to 2019 (pre-pandemic period) (P = 0.025). In the period from 2008 to 2015, 488 children were hospitalized at Department of Pediatrics, University Hospital of Split for acute intoxications, 272 (55.74 %) of them due to AAI, while in the period from 2016 to 2021 there were 218 intoxicated children, 71 (32.57 %) of them hospitalized due to AAI. In both examined periods, AAIs were more frequent among boys (63.60 % from 2008 – 2015, and 70.42 % from 2016 – 2021), most often among children aged 14 to 18 years (P < 0.001), during weekends and holidays (P < 0.001), and in outside places (P < 0.001). The average age was 15.95 ± 1.51 (in a period 2008 – 2015) and 16.17 ± 1.30 (in a period 2016 – 2021); blood alcohol concentration 2.003 ± 0.585 ‰ (in a period 2008 – 2015) and 2.15 ± 0.539 ‰ (in a period 2016 – 2021); the presence of injuries was detected among 11.03 % (in a period 2008 – 2015) and 23.94 % (in a period 2016 – 2021) children; and 6.25 % (in a period 2008 – 2015) and 8.45 % (in a period 2016 – 2021) children were positive for drugs in urine samples. The proportion of hospitalizations of children aged 0-18 due to AAI among all hospitalizations has signifficantly decreased from 2008 (1.33 %) to 2021 (0.23 %), with an expected decrease of 21.26 % in every next year. Conclusion: Although the incidence of AAIs among children in SDC is declining, the results of this study show a high prevalence of alcohol, drug and tobacco consumption among adolescents, depending on the type and place of school attendance. Therefore the results of this study can provide guidelines for more specific prevention programms among children and adolescents. The decrease in alcohol consumption among adolescents during the lockdown is a consequence of reduced socializing with friends and limited availability of alcohol during this period, and an indication that reducing the availability of psychoactive substances and maybe with better organization and offer of activities where young people can socialize, the incidence of risky behaviors among them can be reduced

Changing Pattern of Acute Alcohol Intoxications in Children

In many countries, the number of children hospitalized for alcohol intoxication is increasing. This study analyzed changes in the number of hospitalizations for alcohol intoxication in children aged 0–18 years at the Department of Pediatrics, University Hospital of Split, from 2008 to 2015. Material/Methods Data were collected retrospectively from hospital medical records. Risk groups were classified according to sex, age, drinking habits, and possible benefits of early psychological or psychiatric interventions. Children were divided into 4 age groups: 0–5 years, 6–9 years, 10–13 years, and 14–18 years. Statistics 12.00 was used for statistical analyses, with P-value <0.05 considered as statistically significant. Results Out of 24 651 hospitalized children, 488 were treated for acute intoxication: 36.40% were girls and 63.60% were boys. Among them, 272 children (55.74%) were acutely intoxicated with alcohol, with the average age of 15.95 years and the average blood alcohol concentration of 2.00%. The proportion of children hospitalized for alcohol intoxication decreased from 1.33% in 2008 to 0.75% in 2015. Alcohol intoxications occurred in most cases outside children’s homes (92.42%, P=0.001), and on weekends and holidays (81.62%). Among all intoxicated children, 17 children (6.25%) were positive for drugs. A total of 51.29% of children received psychological support (58.59% of girls and 47.09% of boys). Conclusions In this study, the number of children hospitalized for alcohol intoxication decreased, possibly as a result of preventive, educational, and psychotherapeutic measures or changing drinking habits. Acute alcohol intoxication was most common in the group of children aged 14 to 18 years, and a significant number of these children were positive for drugs, thus, further preventive interventions should be provide