Distribution of Changes in Systolic Blood Pressure and Waist Circumference – Indicators for Primary Prevention

Eliminating or diminishing risk behaviors that lead to cardiovascular diseases could be achieved through primary prevention during the general practice visits. However, there is difference in effectiveness of preventive measure while there are no symptoms, and reactive response when burden of diseases start to show. We analyzed trends in gender and age- -pattern changes of systolic blood pressure and waist circumference, as a reflection of primary prevention. Results show increase of values for both indicators in both genders, through youngest and middle age groups. In the oldest group stagnation and even decrease of values is evident. These results signal possible absence of primary prevention in younger age groups and some action when symptoms occur. It is hard to distinguish weather lower values is consequence of medication or lifestyle change. The absence of primary prevention is usually missed opportunity that is charged later both to the patient and health care system

Distribution of Changes in Systolic Blood Pressure and Waist Circumference – Indicators for Primary Prevention

Eliminating or diminishing risk behaviors that lead to cardiovascular diseases could be achieved through primary prevention during the general practice visits. However, there is difference in effectiveness of preventive measure while there are no symptoms, and reactive response when burden of diseases start to show. We analyzed trends in gender and age- -pattern changes of systolic blood pressure and waist circumference, as a reflection of primary prevention. Results show increase of values for both indicators in both genders, through youngest and middle age groups. In the oldest group stagnation and even decrease of values is evident. These results signal possible absence of primary prevention in younger age groups and some action when symptoms occur. It is hard to distinguish weather lower values is consequence of medication or lifestyle change. The absence of primary prevention is usually missed opportunity that is charged later both to the patient and health care system

Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe

The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations

Could Determinants of PCS and MCS Serve for Public Health Intervention regarding Chronic Diseases in Croatia?

The aim of this article was to identify parameters that determinate PCS and MCS values, and analyze 5-year changes in those values according to the age, sex and geographic region. Cohort of 3229 participants was obtained from the CAHS 2003–2008. Results revealed no statistically significant differences between same age group, sex, and different region regarding PCS and MCS. When chronic conditions were in themodel difference was present, PCS beingmore influenced by all conditions but bronchial asthma. The strongest influence comes from musculoskeletal conditions; followed by weak heart. Values for PSC and MSC decreased in 2008 compared with 2003, but only in few cases decrease was statistically significant. Values of PCS and MCS are higher in men in all regions, but they show higher variability than woman. Our results support the findings that data obtained through SF-36 could be the useful for public health interventions regarding chronic diseases

Could Determinants of PCS and MCS Serve for Public Health Intervention regarding Chronic Diseases in Croatia?

The aim of this article was to identify parameters that determinate PCS and MCS values, and analyze 5-year changes in those values according to the age, sex and geographic region. Cohort of 3229 participants was obtained from the CAHS 2003–2008. Results revealed no statistically significant differences between same age group, sex, and different region regarding PCS and MCS. When chronic conditions were in themodel difference was present, PCS beingmore influenced by all conditions but bronchial asthma. The strongest influence comes from musculoskeletal conditions; followed by weak heart. Values for PSC and MSC decreased in 2008 compared with 2003, but only in few cases decrease was statistically significant. Values of PCS and MCS are higher in men in all regions, but they show higher variability than woman. Our results support the findings that data obtained through SF-36 could be the useful for public health interventions regarding chronic diseases

Bisphenol A – an Environmental and Human Threat

Bisphenol A (BPA) is a chemical substance primarily used as a plasticizer in food packaging production. Unfortunately, it has become a ubiquitous environmental pollutant. The main route for human exposure is the consumption of contaminated food and beverages. Contamination can occur during the production and transport, or due to unsuitable storage conditions; but most common, the contamination is a result of leaching from the packaging containing BPA. Excess exposure to BPA is associated with various health conditions, including cardiovascular disorders, diabetes, various types of cancer, hepatotoxicity, and metabolic and immune function. Literature indicates disrupted endocrine activity and reproductive problems as the main health concerns in humans. The aim of this paper is to review and critically discuss the literature that relates occurrence of BPA in food/beverages and adverse effects on human health, and to point out the most relevant discoveries. So far, BPA has not been found in unprocessed food, which means that it originates from food and beverage packaging, especially from plastic packaging and cans. The migration of BPA from packaging increases during exposure to sunlight and higher temperatures. In addition to food and beverages, people are exposed to BPA through equipment used in medical treatments. Therefore, there is a strong need for better and evidence-based recommendations and regulations related to BPA

Bisphenol A – an Environmental and Human Threat

Bisphenol A (BPA) is a chemical substance primarily used as a plasticizer in food packaging production. Unfortunately, it has become a ubiquitous environmental pollutant. The main route for human exposure is the consumption of contaminated food and beverages. Contamination can occur during the production and transport, or due to unsuitable storage conditions; but most common, the contamination is a result of leaching from the packaging containing BPA. Excess exposure to BPA is associated with various health conditions, including cardiovascular disorders, diabetes, various types of cancer, hepatotoxicity, and metabolic and immune function. Literature indicates disrupted endocrine activity and reproductive problems as the main health concerns in humans. The aim of this paper is to review and critically discuss the literature that relates occurrence of BPA in food/beverages and adverse effects on human health, and to point out the most relevant discoveries. So far, BPA has not been found in unprocessed food, which means that it originates from food and beverage packaging, especially from plastic packaging and cans. The migration of BPA from packaging increases during exposure to sunlight and higher temperatures. In addition to food and beverages, people are exposed to BPA through equipment used in medical treatments. Therefore, there is a strong need for better and evidence-based recommendations and regulations related to BPA

Approaches to the international standards application in healthcare and public health in different countries

As a result of consequent development, and guided by an increasing demand of different types of the organizations regarding structured management, the system of standardization has been established. The idea behind standardization is adjusting the characteristics of a product, process or a production cycle to make them consistent and in line with the rules regarding what is proper and acceptable. The “standard” is a document that specifies such established set of criteria covering a broad range of topics and applicable to commissioners of health, specialists in primary care, public health staff, and social care providers, as well as the local authorities and service users. Health products, ranging from medical devices and health informatics to traditional medicines and unconventional healing tools are all in the focus of standards’ application. Different countries have their own quality management traditions based on their history, mentality, socio-economic environment and the local regulations. Taking into consideration that community social system organization and the quality of social infrastructure are the main foundations of social relations and future prosperity, here we review the existing standardization environment in the health sector in different countries, both developed and those on a convergence path. We focused on standardization environment in the United States of America, Great Britain, Germany, Ukraine, Russian Federation, Croatia and Albania. In order to simplify comprehension, we also demonstrate the algorithm of standardization, as well as the opportunities for application of the international standards in healthcare and public health

Disposal of radioactive waste after medical diagnostic and therapy

Apsorpcija ionizirajućeg zračenja u organizmu izaziva ionizaciju ili ekscitaciju molekula. Energija oslobođena tom ionizacijom dovodi do kemijskih promjena, prilikom čega se stvaraju slobodni radikali koji mogu uzrokovati ireverzibilna oštećenja molekula koje su esencijalne za biološko funkcioniranje stanice. Na takav način nastaju biokemijske (metaboličke) promjene, posljedica čega mogu biti fiziološka ili morfološka oštećenja i/ili mutacije stanice koje primarno djeluju na jezgru, ali i na druge stanične dijelove. Oštećenja stanice očituju se usporenjem stanične diobe, staničnom smrću ili preobrazbom u zloćudne stanice. Različite dijagnostičke metode koje se primjenjuju u medicini, poput rendgena (RTG), kompjutorizirane tomografije (CT) i scintigrafije pored svojeg pozitivnog, nažalost, imaju i negativan utjecaj na zdravlje čovjeka. Pozitivan utjecaj očituje se u brzoj i točnoj dijagnostici koja je neophodna pri liječenju mnogih bolesti, a negativan u tome što su ljudi izloženi tim dijagnostičkim metodama istovremeno izloženi i određenoj dozi zračenja koja se emitira njihovom primjenom i koja posljedično može dovesti do karcinoma. Osim toga, primjenom radionuklida u dijagnostičke i terapijske svrhe stvara se medicinski otpad koji je radioaktivan te potencijalno opasan. Stoga je potrebno prikladno zbrinjavanje medicinskog radioaktivnog otpada kako bi se na taj način osigurala zaštita zdravlja ljudi i okoliša od radijacije. Pri zbrinjavanju radioaktivnog otpada moraju se jasno definirati ciljevi tog postupka, osigurati zakonodavni okvir, raspodjela odgovornosti između nadležnih institucija, financijska sredstva te odgovarajući broj ljudi zadužen za ispunjavanje navedenog zadatka.Absorption of ionizing radiation in the organism causes ionization or excitation of molecules. Energy released by ionization leads to chemical changes, during which the free radicals are created, which can cause irreversible damage to molecules that are essential for biological functioning of a cell. This is how biochemical (metabolic) changes are made, result of which can be physiological or morphological damage and/or mutation of a cell that primarily influence the core, but also other cell parts. Cell damage manifests itself by slowing of the cell division, cell decay and transformation into malignant cells. Different diagnostic methods that are applied in medicine like X-ray (RTG), computerized tomography (CT) and scintigraphy, along with everything positive, also have negative effects on human health. Positive effects are manifested by accurate diagnostic which is necessary for treating many illnesses, while negative are that people who are exposed to these (and some other) diagnostic methods in the same time exposed to a certain amount of radiation which is emitted by their appliance and which can lead to cancer. The mentioned diagnostic methods generate radioactive medical waste that, as such, is very dangerous and has to be adequately disposed of in special warehouse, to ensure the safety of people environment from the radiation. The goals of disposal of radioactive waste have to be clearly defined, legislative frame ensured, responsibility of institutions in charge and financial funds allocated, as well as an adequate number of people engaged in fulfilling the mentioned task

ADVERSE HEALTH EVENTS AND HEALTH HAZARDS -REFLECTIONS OF EPIDEMIOLOGISTS AND ENVIRONMENTALISTS

slijedom izlaganja na II. Hrvatskom kongresu preventivne medicine i unaprjeđenja zdravlja. Kongres je dao sliku stanja i mogućnosti svih javnozdravstvenih djelatnosti u ovom trenutku i ukazao da svaki sustav, bilo da se radi o cjelokupnom zdravstvenom sustavu, sustavu opskrbe vodom ili epidemiološkog nadzora, ima svoje pozitivne i negativne strane, a ako ih se ne poznaje i kontinuirano ne djeluje na njihovim izmjenama, postaje nefunkcionalan u slučaju zdravstvene, socijalne ili ekonomske krize. Nameće se zaključak da moderan javnozdravstveni sustav, da bi bio učinkovit, mora njegovati holistički pristup svakom problemu te dostupnost podataka. Često važni okolišni ili epidemiološki podaci ostanu na razini akademske rasprave ili statistike i nikada ne dopru do službe primarne zdravstvene zaštite koja bi ih mogla funkcionalno upotrijebiti pri pružanju svojih usluga. Razmjena informacija u vremenu koje bi moglo biti važno za intervenciju mora biti imperativ, kao i povezanost i dijeljenje informacija svih struka koje sudjeluju u procesu pružanja zdravstvene usluge. Primarna zdravstvena zaštita koja je prva fronta u komunikaciji s korisnicima, prepoznavanju bolesti, ali i preventivnom djelovanju, mora imati pristup svim relevantnim podacimaIn this article we present management of water resources in Croatia as a model of integral approach in public health interventions. The links between provision of clean water, sanitation and good health are so strong that today management and water protection are deeply integrated in primary health care. This article is a follow up on topics presented on 2nd Croatian congress on preventive medicine and health promotion which gave us “state of art” in Croatian public health. We strongly believe that every system has its own advantages and downsides, and only by knowing the system well and continuous improvement we can protect ourselves in time of health, social or economic crisis. The model of water protection showed that to prevent and overcome the variety of water-related health risks, implementation of various activities that include general environmental protection, development of water management system, permanent water quality monitoring and control, and improvement of standards and legislative is needed. On the other hand if there is no holistic approach, to the public health problems, all the efforts in just one field will not result in health indicators improvement. Constant monitoring and uniform analysis of data could help to identify possible risks of adverse effects of various environmental factors and possible burden of disease as a consequence. That information could be a point of arguing with local governments and communities for public health interventions. It is important that epidemiological and environmental data do not remain in the domain of academic discussion or statistics, and never reach primary health care which could use them in direct health care providing. Information exchange in real time is important for the real time public health intervention. Primary health care is the front line in communication with patients and diagnostics of disease as well as prevention, and they need to have access to all relevant data