Hospital in Meeting Comprehensive Health Goals

The Ottawa Charter for Health Promotion put forward the idea that health is created and lived by people within the settings of their everyday life. This settings approach to HP led to a number of initiatives, among them HPH. The HPH strategy focuses on four areas: promoting the health of patients, promoting the health of staff, changing the organization to a health promoting setting, and promoting the health of the community in the catchments area of the hospital. The need for and the relevance of setting standards for HP in hospitals was realized in the International Network of HPH, which acts as a network of networks linking all national and/or regional networks. It supports the exchange of ideas and strategies implemented in different cultures and health care systems, developing knowledge on strategic issues and enlarging the vision. Nowadays, the International Network of HPH comprises 30 member states, 33 national and/or regional networks and more than 650 hospitals. There is international consensus that patients should be given recommendations, guidance, and support with regard to HP in hospitals. An important element is the activation of the patient’s individual resources and competences in coping with disease. Example of effective intervention of this type of services is the case of Golnik hospital, where introducing specific type of treatment for specific group of patients has developed from hospital vision to national clinical pathway implementation

Hospital in Meeting Comprehensive Health Goals

The Ottawa Charter for Health Promotion put forward the idea that health is created and lived by people within the settings of their everyday life. This settings approach to HP led to a number of initiatives, among them HPH. The HPH strategy focuses on four areas: promoting the health of patients, promoting the health of staff, changing the organization to a health promoting setting, and promoting the health of the community in the catchments area of the hospital. The need for and the relevance of setting standards for HP in hospitals was realized in the International Network of HPH, which acts as a network of networks linking all national and/or regional networks. It supports the exchange of ideas and strategies implemented in different cultures and health care systems, developing knowledge on strategic issues and enlarging the vision. Nowadays, the International Network of HPH comprises 30 member states, 33 national and/or regional networks and more than 650 hospitals. There is international consensus that patients should be given recommendations, guidance, and support with regard to HP in hospitals. An important element is the activation of the patient’s individual resources and competences in coping with disease. Example of effective intervention of this type of services is the case of Golnik hospital, where introducing specific type of treatment for specific group of patients has developed from hospital vision to national clinical pathway implementation

Health geography in case of Zasavje: Linking of atmospheric air pollution and respiratory diseases data

The aim of the study was to assess the association between atmospheric air pollution and respiratory diseases in children on the level of small spatial units in the Zasavje. The health and environmental data were obtained for the period between January 1 and December 31, 2011. Studied small spatial units were designed on the basis of estimated level of atmospheric air pollution and digital maps and boundaries of local communities and settlements. The impact of atmospheric air pollution on respiratory diseases was analysed by using the Bayesian models. Considering the identified deficiencies, the presented methodolgy can often be used to identify areas with a higher health risks

Terminologija klinične prehrane: Prehranska obravnava – presejanje prehranske ogroženosti in prehranski pregled

Izhodišča: Pomembno vlogo pri prehranski obravnavi imata tako presejanje prehranske ogroženosti kot prehranski pregled, na podlagi katerega lahko postavimo diagnozo motnje prehranjenosti ali s prehranjenostjo povezane motnje. Ocena posameznikovega prehranskega stanja, ki jo pridobimo s prehransko obravnavo, je namreč ključna za načrtovanje učinkovite prehranske oskrbe. Za razvoj področja je pomembno, da so vsi termini, ki se uporabljajo pri kliničnem delu, usklajeni. Taki terminološki dokumenti v mednarodnem prostoru že obstajajo, smiselni pa so tudi za slovenščino in naše okolje. Metode: Prispevek temelji na eksplicitnem terminološkem dogovoru skupine 42 relevantnih slovenskih strokovnjakov iz 19 slovenskih ustanov. Osnova oblikovanja terminoloških smernic je terminološki dokument Evropskega združenja za klinično prehrano in presnovo, pri čemer so bili upoštevani tudi novejši izsledki klinične prehrane. Rezultati: Predstavljeni so slovenski termini in terminološke definicije s področja klinične prehrane. Opredeljeni so osnovni pojmi s področja prehranske obravnave, ki je praviloma del medicinske obravnave. Predstavljena sta pojma prehranska ogroženost in presejanje prehranske ogroženosti, ob čemer so navedeni tudi različni presejalni testi za presejanje prehranskih motenj in s prehranjenostjo povezanih stanj. Podrobno so opredeljeni tudi prehranski pregled in njegovi sestavni deli. Zaključki: Tako presejanje prehranske ogroženosti kot prehranski pregled sta bistvena za diagnostično obravnavo v okviru klinične prehrane, poenoteno razumevanje terminologije pa omogoča primerno prepoznavo patoloških stanj pri bolnikih in pripravo ustreznega načrta prehranskih ukrepov

Terminologija klinične prehrane: Motnje prehranjenosti in s prehranjenostjo povezana stanja

Izhodišča: Prehransko stanje posameznika uvrščamo med ključne dejavnike njegovega zdravja. Za učinkovito individualno in multidisciplinarno obravnavo stanj, povezanih s prehranskim stanjem posameznika, moramo dobro poznati terminologijo klinične prehrane. Ker je klinična prehrana kot medicinska stroka razvita tudi pri nas, v tujini pa so tovrstni terminološki dokumenti že na voljo, želimo tudi v Sloveniji na podlagi konsenza oblikovati enotno terminologijo. Metode: Prispevek je osnovan na podlagi eksplicitnega terminološkega dogovora. K sodelovanju smo povabili obsežno skupino relevantnih slovenskih strokovnjakov s kliničnih, predkliničnih in drugih področij, ki so povezana z dejavnostjo klinične prehrane v medicini, pri oblikovanju pa je sodeloval tudi terminolog s področja medicine. Kot izhodišče smo izbrali terminološke smernice Evropskega združenja za klinično prehrano in presnovo ter ob njih upoštevali najnovejša strokovna priporočila za posamezne pojme. Avtorji so bili v stiku prek osebnih srečanj in elektronske pošte. Pri končnem oblikovanju konsenza je sodelovalo 42 avtorjev iz 19 slovenskih ustanov. Rezultati: Predstavljamo temeljne pojme, terminološke definicije in pripadajoče slovenske termine s področja klinične prehrane. Opredelili smo osnovne motnje prehranjenosti – podhranjenost, prekomerno hranjenost, neravnovesje mikrohranil in sindrom ponovnega hranjenja. Poleg tega smo opredelili tudi s prehranjenostjo povezana stanja – sarkopenijo in krhkost. Osnovne pojme smo podprli s kliničnim kontekstom, v katerem nastopajo. Zaključki: Poenoteno razumevanje osnovnih patoloških stanj, ki jih obravnava klinična prehrana, je izhodišče za nadaljnji razvoj stroke, poleg tega pa je podlaga tudi za prehransko obravnavo in učinkovito prehransko oskrbo

Elektronske cigarete, ogrevani tobačni izdelki, nikotinske vrečke in brezdimni tobačni izdelki: kaj o teh izdelkih s tobakom ali nikotinom povedo raziskave?

In Slovenia, tobacco smoking remains one of the most important preventable risk factors for death and healthy years of life lost. Slovenia and numerous developed countries are experiencing a decline in smoking prevalence. In order to maintain or increase sales and profits, the industry is launched various types of tobacco or nicotine products, such as electronic cigarettes, heated tobacco products and nicotine pouches, which are also present in Slovenia. Smokeless tobacco products are also becoming increasingly popular in Slovenia. Heated tobacco products, electronic cigarettes and nicotine pouches expose the user to significant levels of harmful substances. The long-term effects of their use on health have not yet been adequately studied, as they are in use for too short a time. However, the available data indicate that they have adverse effects on health, some already in the short term, and that they are likely to lead to significant health consequences in the long term. It cannot be claimed that these products are less harmful than smoking, as there is a lack of good quality studies. The harmful effects of long-term use of smokeless tobacco products are known. All of these products are also often promoted as effective smoking cessation aids, but again there is not enough good quality research to draw conclusions about their role in smoking cessation, so they are not recommended for this purpose. All of these products contain nicotine (the exception being nicotine-free electronic cigarettes) and are addictive to the user. The use of nicotine products by youth is associated with additional important risks, such as addiction, which develops more rapidly and more strongly than in adults, and adverse effects on brain development. The use of electronic cigarettes and smokeless tobacco products among youth is also associated with increased risk of cigarette smoking in the future. Data for Slovenia show that the use of these products among youth increases with age and that the percentages of users among youth mostly exceed that of the population aged 25 and over. In recent years, the percentages of users of electronic cigarettes and smokeless tobacco products have been increasing more markedly among adolescents than adults. It is crucial to regulate these products more strictly as soon as possible to prevent and reduce their use, especially among youth.V Sloveniji je kajenje tobaka še vedno med najpomembnejšimi preprečljivimi dejavniki tveganja za smrt in na prvem mestu za izgubljena zdrava leta življenja. V Sloveniji in številnih razvitih državah beležimo zniževanje prevalence kajenja. Industrija je za ohranitev oziroma večanje prodaje in dobička dala na trg različne vrste izdelkov s tobakom ali nikotinom, kot so elektronske cigarete, ogrevani tobačni izdelki in nikotinske vrečke, ki so prisotni tudi v Sloveniji. Vse bolj priljubljeni v Sloveniji postajajo tudi brezdimni tobačni izdelki. V bibliografski podatkovni zbirki PubMed smo poiskali sistematične preglede in metaanalize o vplivih na zdravje pri uporabi teh izdelkov, poiskali poročila mednarodnih organizacij o njihovem vplivu na zdravje in okolje ter uporabili najnovejše dostopne podatke iz slovenskih nacionalnih raziskav za prikaz razširjenosti njihove uporabe v Sloveniji. Ogrevani tobačni izdelki, elektronske cigarete in nikotinske vrečke izpostavijo uporabnika znatnim ravnem zdravju škodljivih snovi. Dolgoročni učinki njihove uporabe na zdravje še niso ustrezno raziskani, saj so v uporabi še prekratek čas, dostopni podatki pa kažejo, da imajo škodljive učinke na zdravje, nekateri že kratkoročno, in da bodo verjetno privedli do pomembnih posledic za zdravje pri dolgoročni uporabi. O manjši škodljivosti teh izdelkov v primerjavi s kajenjem cigaret ni možno govoriti, saj je na voljo premalo kakovostnih raziskav, poznani pa so škodljivi učinki dolgoročne uporabe brezdimnih tobačnih izdelkov. Vsi omenjeni izdelki se pogosto promovirajo tudi kot učinkoviti pripomočki za opuščanje kajenja, a tudi na tem področju ni na voljo zadosti kakovostnih raziskav, da bi lahko sklepali zaključke o njihovi vlogi v opuščanju kajenja, zato se jih v te namene ne priporoča. Vsi omenjeni izdelki vsebujejo nikotin (izjema so elektronske cigarete brez nikotina) in uporabnika zasvojijo. Uporaba izdelkov z nikotinom med mladimi pa je povezana še z dodatnimi pomembnimi tveganji; poleg zasvojenosti, ki se razvije hitreje in močneje kot pri odraslih, so tu še škodljivi učinki na razvoj možganov, pri elektronskih cigaretah in brezdimnih tobačnih izdelkih pa tudi zvišano tveganje za kajenje cigaret v prihodnosti. Podatki za Slovenijo kažejo, da uporaba teh izdelkov med mladimi narašča s starostjo ter da med mladimi odstotki uporabnikov večinoma presegajo odstotek med populacijo, starejšo od 25 let. V zadnjih letih odstotki uporabnikov elektronskih cigaret in brezdimnih tobačnih izdelkov med mladostniki naraščajo izraziteje kot med odraslimi. Ključna je čimprejšnja strožja zakonodajna ureditev teh izdelkov, da preprečimo in zmanjšamo njihovo uporabo, predvsem med mladimi

Economic Analysis as a Tool for Planning and Evaluation of Public Health Interventions

The central problem addressed by the discipline of economics is that of resource scarcity, and so the purpose of economic evaluation is, in a very broad sense, to help decision-makers when addressing problems arising due to the scarcity issue. Therefore, such evidence is generated with the direct intention of influencing policy. Over recent years, there have been repeated expressions of concern about the usefulness of health economic analyses, and responses have tended to centre on questions of how research by health economists can be made more useful and accessible to policy makers. How an economic evaluation can be used in practice, is presented in the case of folic acid food fortification. After the introduction of folate deficiency problem and discussion of strengths and weaknesses of folic acid food fortification, it is demonstrated how an economic evaluation can add value to decision-making process. However, it is important to understand that, even if the best possible economic evaluations were available, they would be only one element in a complex process of decision-making that is also shaped by scientific evidence and political feasibility

Economic Analysis as a Tool for Planning and Evaluation of Public Health Interventions

The central problem addressed by the discipline of economics is that of resource scarcity, and so the purpose of economic evaluation is, in a very broad sense, to help decision-makers when addressing problems arising due to the scarcity issue. Therefore, such evidence is generated with the direct intention of influencing policy. Over recent years, there have been repeated expressions of concern about the usefulness of health economic analyses, and responses have tended to centre on questions of how research by health economists can be made more useful and accessible to policy makers. How an economic evaluation can be used in practice, is presented in the case of folic acid food fortification. After the introduction of folate deficiency problem and discussion of strengths and weaknesses of folic acid food fortification, it is demonstrated how an economic evaluation can add value to decision-making process. However, it is important to understand that, even if the best possible economic evaluations were available, they would be only one element in a complex process of decision-making that is also shaped by scientific evidence and political feasibility