Prikaz projekta European Union Network for Patient Safety and Quality of Care, PaSQ

Međunarodni projekt European Union Network for Patient Safety and Quality of Care, skraćenice PaSQ, projekt je financiran iz Drugog programa zajednice u području zdravstva 2008.-2013., kroz zajedničku aktivnost (joint action) 28 zemljama članica Europske Unije i Norveške. Projekt traje tri godine, od 01. travnja 2012. do 31. ožujka 2015. godine.Cilj projekta PaSQ jest uspostava on-line platforme za razmjenu iskustva i znanja institucija iz zemalja partnera projekta o sigurnosti pacijenata i kvaliteti zdravstvene zaštite, te uz to promicati i implementirati europsko zakonodavstvo iz ovog područja

Dentoalveolar Characteristics in Subjects with Anterior Open Bite

Svrha ovoga rada bila je utvrditi izraženost dentoalveolarnih kompenzatornih mehanizama u ispitanika s otvorenim zagrizom u usporedbi s eugnatim ispitanicima. Ispitivanje je provedeno na 37 latero-lateralnih rentgenkefalograma pacijenata s otvorenim zagrizom i na 35 eugnatih ispitanika u dobi od 15 do 18 godina. Svaki rentgenkefalogram iscrtan je dva puta od dvaju autora. Rentgenkefalometrijska raščlamba sastojala se od mjerenja angularnih i linearnih parametara. Angularne varijable bile su: n-s-gn, sp-pm:mgo, m-go-ar, suma kuteva prema Bjorku, 1:sp-pm i 1:m-go. Linearne varijable oi, om, oi/om, ui, um, i ui/um uzete su iz Korkhausove analize. Statistička raščlamba obuhvatila je deskriptivnu statistiku, metodsku pogrešku, t-test i Pearsonov koeficijent korelacije. Statistički znatne razlike (p<0,001) između ispitivanih skupina pronađene su kod svih ispitivanih varijabli osim 1:sp-pm, oi/om i um. Pronađena je retruzija donjih sjekutića, što upućuje na dentoalveolarnu adaptaciju na postojeću posteriornu rotaciju čeljusti. Inklinacija gornjih inciziva je u odnosu prema bazi maksile u znatnoj negativnoj korelaciji s varijablom n-s-gn, i u laganoj negativnoj korelaciji s varijablom sppm: m.go. Varijable visine gornje i donje čeljusti (oi, om, ui, um) u znatnoj su međusobnoj korelaciji. Znatna negativna korelacija pronađena je između varijabli um i m-go-ar. Korelacija između varijable um i Bjorkova poligona lagana je i negativna. Varijabla ui pokazuje laganu negativnu korelaciju s varijablom m-go-ar. Takav odnos rezultat je kompenzatorne retruzije donjih inciziva na strmu mandibularnu ravninu.The purpose of this study was to determine the frequency and extent of dentoalveolar compensation in subjects with disharmonious vertical jaw base relationships, in relation to subjects with normal occlusion. The study was performed on 37 lateral cephalograms of patients with open bite and 35 of patients with normal occlusion, aged 15 to 18 years. Each cephalogram was traced twice by two authors. The cephalometric analyses were performed by linear and angular measurements. The angular cephalometric variables were: n-s-gn, sp-pm:m-go, m-go-ar, the sum of the posterior angles according to Bjork (1947, 1954,1966,1972),1:sp-pm and 1:m-go. Linear cephalometric variables: oi, om oi/om, ui, um and ui/um were analysed using the methods of Korkhaus (1959). Statistical data analysis included descriptive statistics, method error, t-test and Pearson(s correlation coefficient for association between variables. Significant differences (p < 0.001) between the samples were found in all investigated variables except 1:sp-pm, oi/om and um. Retrusion of the lower incisors was found, indicating dentoalveolar adaptation to the present posterior rotation of the mandible. Inclination of the upper incisors in relation to the base of the maxilla was significantly negative correlated with the variable n-s-gn, and slightly negatively by correlated with the variable sp:pmm-go. The variables of the height of the upper and lower jaws (oi, om, ui, um) were significantly correlated. A significiant negative correlation was found between variables um and m-go-ar. The correlation between variable um and Bjork’s polygon was slightly negative. The variable ui showed slight negative correlation with the variable m-go-ar. Such a relationship is the result of compensatory retrusion of the lower incisors and a steep mandibular plane

Starenje stanovništva – izazov zdravstvenog sustava današnjice

Prema popisu stanovništva iz 2011. godine Republika Hrvatska predstavlja državu s vrlo starim stanovništvom, s udjelom osoba starijih od 65 godina od 17,7%. Obzirom na tendenciju daljnjeg starenja cjelokupne populacije, od iznimne je važnosti osigurati zdravo starenje osoba uz aktivno sudjelovanje u prevenciji najčešćih bolesti i stanja koja, osim što narušavaju kvalitetu života i funkcijske sposobnosti starijih osoba, u isto vrijeme predstavljaju poseban izazov za sam zdravstveni sustav, koliko u financijskom smislu, toliko i u organizacijskom smislu potrebnih resursa na pojedinim razinama zdravstvene zaštite. Kako su vodeći uzroci smrtnosti u starijoj dobi cirkulacijske bolesti, od posebnog je značaja usmjeravanje preventivnih aktivnosti na bolesti i komplikacije kroničnih bolesti cirkulacijskog sustava, ali i bolesti kao što je šećerna bolest te stanja vezana uz koštano – mišićni sustav. Posebnost ove dobi jest porast incidencije kroničnih bolesti i posljedične pojave multimorbiditeta. Stoga, od presudne je važnosti u planiranju razvoja i organizacije zdravstvenog sustava i potrebnih resursa predvidjeti posebnosti starije populacije koja je u porastu te usmjeriti fokus na njih.S daljnjim očekivanim ubrzanim starenjem populacije, može se očekivati da će se starenje populacije značajno odraziti na sve izraženiji porast korištenja zdravstvene zaštite i potrošnje sredstava u zdravstvenom sustavu. Samim time, starenje stanovništva prepoznato je i kao značajan javnozdravstveni problem u Nacionalnoj strategiji razvoja zdravstva od 2012. do 2020.Ovim radom prikazano je kako promjene u demografskoj strukturi utječu na porast troškova sustava zdravstva, osobito na teret obveznog zdravstvenog osiguranja. Troškovi zdravstvene zaštite prikazani su kroz trogodišnje razdoblje, 2011.- 2013., te detaljnije razrađeni po dobnoj i spolnoj strukturi kako na razini županija, tako i na razini cijele Hrvatske. Također, dan je osvrt na primarnu zdravstvenu zaštitu kao centralno mjesto za poduzimanje javnozdravstvenih preventivnih akcija, kao i mjesto od velikog utjecaja na ekonomično trošenje ograničenih sredstava.Ključne riječi: starenje stanovništva, troškovi liječenja, sustav zdravstv

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

QUALITY OF HEALTH CARE, ACCREDITATION, AND HEALTH TECHNOLOGY ASSESSMENT IN CROATIA: ROLE OF AGENCY FOR QUALITY AND ACCREDITATION IN HEALTH

U 20. stoljeću Avedis Donabedian, utemeljitelj znanosti o kvaliteti medicinske skrbi, definirao je pojam kvalitete medicinske skrbi, uveo čimbenike usporedbe, preporučio određivanje standarda kvalitete i pokazatelja (indikatora) kvalitete na razini ustroja, provedbe i ishoda skrbi. Počeci akreditacije datiraju iz 1913. godine osnivanjem American College of Surgeons sa svrhom promoviranja koncepta bolničkih standarda; 50.-ih godina prošlog stoljeća osnovana je International Commision on Accreditation of Health Care Organization (JCAHO). Zatim je slijedilo razvijanje kanadskog akreditacijskog sustava (Canadian Council on Health Services Accreditation - CCHSA), danas poznatog kao Accreditation Canada, australskog (Australian Council on Healthcare Standards International - ACHSI), da bi 80-tih i 90-tih godina započeo intenzivniji razvoj akreditacijskih sustava u Europi i svijetu. Proces procjene zdravstvenih tehnologija započeo je prije 30-tak godina u Americi, a u Europi 1980. godine osnutkom prve nacionalne HTA agencije u Švedskoj. Agencija za kvalitetu i akreditaciju u zdravstvu, kao javna, neovisna i neprofitna ustanova osnovana je 2007. godine temeljem Zakona o kvaliteti zdravstvene zaštite kojim je i definirana njena uloga u procesu praćenja kvalitete zdravstvene zaštite, akreditacije nositelja zdravstvene djelatnosti, te postupku provođenja procjene zdravstvenih tehnologija u Republici Hrvatskoj. Cilj je ovoga rada dati pregled dosadašnjih aktivnosti Agencije od ljeta 2009. godine, kao i budućih aktivnosti na navedenim područjima, ukazati na potrebu edukacije osnovnih korisnika i dionika u navedenim procesima te prikazati međunarodnu suradnju i aktivno sudjelovanje u europskim projektima.Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance standards, and providing other services in the field of healthcare quality assurance, improvement, promotion and monitoring, according to the Act. Formal activities of the Agency in the field of HTA actually began in summer 2009. In the field of quality and accreditation, the plan and program of healthcare quality assurance, improvement, promotion and monitoring was finished and published in October 2010; preparation of the healthcare quality standards as well as the accreditation standards is still in process, with the aim to start accreditation process at 10 hospitals in 2011. Education in the field of healthcare quality assurance, improvement and promotion has been established as a continuous process from the beginning. The Agency is member of the International Society for Quality in Health Care (ISQua) and participates in the work of the European Accreditation Network (EAN). In the field of HTA, the Agency has established international collaboration and support, which resulted in its appointment and participation in the European network for Health Technology Assessment (EUnetHTA) Joint Action Project as a EUnetHTA Partner, as well as its membership in the international society, HTAi. TAIEX project has been approved as a two-day workshop in December 2010. The Croatian HTA Guidelines have been issued with the aim to start the HTA process and reports that should serve as recommendations, as a support to policy-makers at the national level, in particular the Croatian Ministry of Health and Social Welfare, and Croatian Institute of Health Insurance, in making evidence-informed decisions on the strategic planning, investment, management and implementation of technologies in health care, on funding (reimbursement) and coverage of health technologies, and at hospital level on the request from hospital directors and policy teams. In conclusion, establishment of all these measures in Croatia is by no means an easy and quick process, however, we do believe that it is feasible through continuous and close collaboration of all those involved

User experience research methods in the process of designing IT services

Ovaj završni rad se bavi temom istraživanja korisničkog iskustva u procesu dizajna infomatičkih usluga. Cilj rada je objasniti što označava korisničko iskustvo te koje se metode istraživanja provode te pokazati kako je za uspješnu uslugu ključno poznavati korisnike usluge i njihove potrebe i želje. U radu nakon teoretskog dijela slijedi praktični dio gdje se provode odabrane metode istraživanja, a odabrano je provođenje metode upitinika, persona i mape vrijednosti kako bi se dobio uvid u korisničke potrebe. Nakon provedbe istraživanja, analiziraju se i pojašnjavaju dobiveni rezultati te njihov utjecaj na oblikovanje prototipa i funkcionalnosti. Na temelju podataka dobivenih u istraživanju se oblikuje digitalniprototip aplikacije koji sa svojim značajkama odgovara potrebama korisnika

User experience research methods in the process of designing IT services

Ovaj završni rad se bavi temom istraživanja korisničkog iskustva u procesu dizajna infomatičkih usluga. Cilj rada je objasniti što označava korisničko iskustvo te koje se metode istraživanja provode te pokazati kako je za uspješnu uslugu ključno poznavati korisnike usluge i njihove potrebe i želje. U radu nakon teoretskog dijela slijedi praktični dio gdje se provode odabrane metode istraživanja, a odabrano je provođenje metode upitinika, persona i mape vrijednosti kako bi se dobio uvid u korisničke potrebe. Nakon provedbe istraživanja, analiziraju se i pojašnjavaju dobiveni rezultati te njihov utjecaj na oblikovanje prototipa i funkcionalnosti. Na temelju podataka dobivenih u istraživanju se oblikuje digitalniprototip aplikacije koji sa svojim značajkama odgovara potrebama korisnika

MARKETING MANAGEMENT ON THE EXAMPLE OF STORIES CROATIAN UNIQUE HOTELA

Cilj ovog rada je prikazati na koji se način upravlja marketingom u hotelijerstvu i to na primjeru hotela Life Palace iz Šibenika koji posluje unutar grupacije Stories Croatian Unique Hotels. Hotel Life Palace je jedan od prepoznatljivih hotela u Šibeniku jer se nalazi u samom centru grada i to u renesansnoj građevini koja tom hotelu daje posebnu draž. Upravo poslovanje pod grupacijom Stories, hotelu Life Palace je omogućena učinkovitija promocija jer se na taj način dokazuje kako je riječ o hotelu koji nudi posebne proizvode/usluge. Korona kriza je potakla probleme poslovanja diljem svijeta, pa tako i hotela Life Palace. Ipak, kvalitetnom promocijom, suradnjom sa lokalnom vlasti, trenutna turistička sezona je izvan svih očekivanja. To je samo rezultat učinkovitog marketinga, kao i suradnje sa lokalnom vlasti, turističkim zajednicama grada Šibenika i Županije. Takva suradnja bi se trebala nastaviti i dalje unaprjeđivati ponudu, ali i stručnost i osposobljenost zaposlenika.The subject of the paper is to show how marketing is managed in the hotel industry on the example of the Life Palace Hotel from Šibenik, which operates within the group Stories Croatian Unique Hotels. Hotel Life Palace is one of the recognizable hotels in Šibenik because it is located in the city centre in a Renaissance building that gives this hotel a special charm. It is the business under the Stories group that enables the more efficient promotion of the Life Palace hotel, as this proves that it is a hotel that offers special products / services. The corona crisis has triggered business problems around the world, including the Life Palace Hotel. However, with quality promotion, cooperation with local authorities, the current tourist season is beyond all expectations. This is just the result of effective marketing, as well as cooperation with local authorities, tourist boards of the city of Šibenik and the County. Such cooperation should continue to further improve the offer, but also the expertise and training of employees