Mortality patterns in Southern Adriatic islands of Croatia: a registry-based study

Aim To investigate the mortality patterns on the Southern Adriatic islands of Croatia and compare them with those in two, mainly coastal, mainland counties. Methods In this registry-based study we used the official mortality register data to analyze the mortality patterns on seven Croatian islands (Brač, Hvar, Korčula, Lastovo, Mljet, Šolta, and Vis) and Pelješac peninsula in the 1998-2013 period and calculated the average lifespan, life expectancy, and standardized mortality ratios (SMR). We compared the leading causes of death with those in the mainland population of two southernmost Croatian counties. Results The average lifespan of the island population was 3-10 years longer for men and 2-7 years longer for women than that on the mainland. All-cause SMRs were significantly lower for both men and women on Korčula, Brač, Mljet, and Pelješac but significantly higher for women on Šolta (1.22; 95% confidence intervals 1.07-1.38). The leading causes of death on the islands were cardiovascular diseases, with higher percentages in men and lower in women in comparison with those on the mainland. There were no substantial differences in the life expectancy at birth. Conclusions Despite longer lifespan, lack of differences in life expectancy at birth suggests that the recent generations of islanders no longer show beneficial mortality patterns, possibly due to diminishing adherence to the Mediterranean diet and lifestyle. Restoring the traditional lifestyles is a public health priority, with the ultimate aim of reducing inequalities and improving the health of island inhabitants

Effects of social skills training among freshman undergraduate nursing students: a randomized controlled trial

Ciljevi istraživanja: U ovom radu željeli smo provjeriti učinak treninga socijalnih vještina na usvajanje socijalnih vještina studenata zdravstvenih studija. Sljedeći cilj je bio utvrditi povezanost između različitih socijalnih vještina u četiri različite situacije: između eksperimentalne i kontrolne skupine, te prije i nakon treninga socijalnih vještina. Materijali i metode: Koristili smo eksperimentalni nacrt 2x2 s eksperimentalnom i kontrolnom skupinom. U treningu socijalnih vještina sudjelovali su studenti iz četiri hrvatska sveučilišta. Uzorak se sastojao od 193 studenta, od kojih je 132 bilo u kontrolnoj, a 61 u eksperimentalnoj skupini. Trening socijalnih vještina (nezavisna varijabla) proveli smo samo na studentima iz eksperimentalne skupine. Bodove na Skali socijalnih vještina (zavisna varijabla) uspoređivali smo prije i nakon treninga kod obje skupine studenata. Rezultati: Rezultati su potvrdili postojanje značajnih efekata treninga samo kod eksperimentalne skupine. Više stupnjeve povezanosti između različitih socijalnih vještina pronašli smo u eksperimentalnoj skupini, usituaciji nakon završenoga treninga. Međutim, razlike u neočekivanom smjeru pronašli smo u socijalnim vještinama između eksperimentalne i kontrolne skupine u početnom mjerenju (prije treninga). Zaključak: Trening socijalnih vještina je učinkovit u učenju socijalnih vještina studenata zdravstvenih studija. Međutim, pretpostavili smo da rezultati na skali socijalnih vještina dijelom mogu odražavati stavove prema učenju socijalnih vještina, što je moglo interferirati s rezultatima na skali.Objectives. The goal of the study was to evaluate the effects of workshops focused on the training of communication skills. The next goal was to determine the inter-correlations between different social skills, in four situations: in experimental/ control group of participants and before/ after social skills training intervention. Materials and Methods. Experimental design type 2x2, with experimental and control group was used. Students from four Croatian universities were involved in the Social Skills Training (SST). The sample consisted of 193 students, from which N =132 in the control group and N = 61 in the experimental group. Training of Social Skills (used as an independent variable) was conducted only in the experimental group, while the Social Skills Checklist (SSC) scores were the dependent variable. Results. Some expected significant differences in certain SSC in the experimental group suggested positive effects of Social Skills Training. Similar insights provide the trend of intercorrelations, which are generally higher in the experimental group in the situation after SST. However, unexpected differences in certain social skills between experimental and control groups were found in the initial measurement. Conclusion. SST was found to be effective for students’ social skills learning. Reasonable explanations of the results obtained are given in terms of the assumption that SST could also partially reflect the attitudes towards SST, while the SSC need not be identical to real acquired social skills

The importance of socioeconomic indicators in determining health and health-related risks in Southern Croatia

Uvod: Socioekonomske nejednakosti jedan su od najvažnijih javnozdravstvenih problema u praksi i istraživanju. Njihov utjecaj na zdravlje prepoznat je u cijelom svijetu. Socioekonomski status utječe i na zdravlje i zdravstvene odrednice kao što su životni stil i obrasci ponašanja što uključuje pušenje, izloženost stresu, društvenu osamljenost, tjelesnu aktivnost, obrasce prehrane i preventivna zdravstvena ponašanja. Cilj: Istražiti povezanost socioekonomskog statusa i zdravstvenih pokazatelja u populacijama osamljenog otoka Visa (N=1,025), manje osamljenog otoka Korčule (N=969) i obalnog grada Splita kao drugog najvećeg grada u Hrvatskoj (N=1,012). Materijali i metode: Pomoću povijesti bolesti i anketnih upitnika izvedene su 33 izlazne varijable koje su analizirane koristeći logističku regresiju kroz 6 analitičkih modela (za tri lokacije istraživanja i oba spola zasebno). U populacija otoka Visa je praćena i smrtnost te su ovi podatci analizirani pomoću Cox-ove regresije. Rezultati: Socioekonomske nejednakosti pokazale su se slabo povezanima s zdravljem i zdravstvenim pokazateljima. U matrici od 33 izlazne varijable i 13 pokazatelja socioekonomskog statusa samo je 10 povezanosti bilo značajno na razini značajnosti P<0,001. Nijedna od povezanosti nije se ponovila kroz različite populacije ni kroz oba spola. Nije zabilježena ni povezanost socioekonomskog statusa i smrtnosti na otoku Visu. Zaključak: Očekivano je da homogene otočne populacije imaju veće razine homogenosti i sukladno tomu slabije izražene socioekonomske nejednakosti u zdravlju. Manjak jače povezanosti u gradskoj populaciji Splita vjerojatno je rezultat mehanizama koji su se održali iz bivšeg komunističkog režima i visoke razine zadržane formalne i neformalne društvene potpore.Background: Socioeconomic inequalities have been identified as one of the most interesting targets in public health research and practice. Their impact on health seems to be strongly expressed across the entire human population. The effect of socioeconomic inequalities also extends to more determinants of morbidity, such as lifestyle and behavioural patterns, including smoking, stress, social isolation, physical activity, diet and preventive health behaviours. Objectives: The aim was to investigate the association of socioeconomic status and health outcomes in populations of the remote island of Vis (N=1,025), less remote island of Korcula (N=969) and the coastal city of Split (N=1,012), the second largest city in Croatia. Materials and methods: Medical history and survey information were used to create 33 variables that were analysed using logistic regression in 6 analytic models (for every research location and both genders). The population from the island of Vis was followed up and mortality data was used to calculate hazard ratios using Cox regression. Results: Socioeconomic inequalities were poorly associated with health and disease indices. In the matrix of 33 outcome variables and 13 socioeconomic predictor classes, only 10 associations were significant at the level of P<0.001. None of the associations was replicated across samples or gender. We did not detect the association of any socioeconomic estimate with mortality data for the island of Vis. Conclusions: Homogenous island populations were expected to have greater levels of social homogeneity and consequently less expressed inequalities in health. The lack of stronger association in the urban population of Split is likely the result of the mechanisms that persisted from the former communist regime and high level of retained formal and informal social support

The importance of socioeconomic indicators in determining health and health-related risks in Southern Croatia

Uvod: Socioekonomske nejednakosti jedan su od najvažnijih javnozdravstvenih problema u praksi i istraživanju. Njihov utjecaj na zdravlje prepoznat je u cijelom svijetu. Socioekonomski status utječe i na zdravlje i zdravstvene odrednice kao što su životni stil i obrasci ponašanja što uključuje pušenje, izloženost stresu, društvenu osamljenost, tjelesnu aktivnost, obrasce prehrane i preventivna zdravstvena ponašanja. Cilj: Istražiti povezanost socioekonomskog statusa i zdravstvenih pokazatelja u populacijama osamljenog otoka Visa (N=1,025), manje osamljenog otoka Korčule (N=969) i obalnog grada Splita kao drugog najvećeg grada u Hrvatskoj (N=1,012). Materijali i metode: Pomoću povijesti bolesti i anketnih upitnika izvedene su 33 izlazne varijable koje su analizirane koristeći logističku regresiju kroz 6 analitičkih modela (za tri lokacije istraživanja i oba spola zasebno). U populacija otoka Visa je praćena i smrtnost te su ovi podatci analizirani pomoću Cox-ove regresije. Rezultati: Socioekonomske nejednakosti pokazale su se slabo povezanima s zdravljem i zdravstvenim pokazateljima. U matrici od 33 izlazne varijable i 13 pokazatelja socioekonomskog statusa samo je 10 povezanosti bilo značajno na razini značajnosti P<0,001. Nijedna od povezanosti nije se ponovila kroz različite populacije ni kroz oba spola. Nije zabilježena ni povezanost socioekonomskog statusa i smrtnosti na otoku Visu. Zaključak: Očekivano je da homogene otočne populacije imaju veće razine homogenosti i sukladno tomu slabije izražene socioekonomske nejednakosti u zdravlju. Manjak jače povezanosti u gradskoj populaciji Splita vjerojatno je rezultat mehanizama koji su se održali iz bivšeg komunističkog režima i visoke razine zadržane formalne i neformalne društvene potpore.Background: Socioeconomic inequalities have been identified as one of the most interesting targets in public health research and practice. Their impact on health seems to be strongly expressed across the entire human population. The effect of socioeconomic inequalities also extends to more determinants of morbidity, such as lifestyle and behavioural patterns, including smoking, stress, social isolation, physical activity, diet and preventive health behaviours. Objectives: The aim was to investigate the association of socioeconomic status and health outcomes in populations of the remote island of Vis (N=1,025), less remote island of Korcula (N=969) and the coastal city of Split (N=1,012), the second largest city in Croatia. Materials and methods: Medical history and survey information were used to create 33 variables that were analysed using logistic regression in 6 analytic models (for every research location and both genders). The population from the island of Vis was followed up and mortality data was used to calculate hazard ratios using Cox regression. Results: Socioeconomic inequalities were poorly associated with health and disease indices. In the matrix of 33 outcome variables and 13 socioeconomic predictor classes, only 10 associations were significant at the level of P<0.001. None of the associations was replicated across samples or gender. We did not detect the association of any socioeconomic estimate with mortality data for the island of Vis. Conclusions: Homogenous island populations were expected to have greater levels of social homogeneity and consequently less expressed inequalities in health. The lack of stronger association in the urban population of Split is likely the result of the mechanisms that persisted from the former communist regime and high level of retained formal and informal social support

The importance of socioeconomic indicators in determining health and health-related risks in Southern Croatia

Uvod: Socioekonomske nejednakosti jedan su od najvažnijih javnozdravstvenih problema u praksi i istraživanju. Njihov utjecaj na zdravlje prepoznat je u cijelom svijetu. Socioekonomski status utječe i na zdravlje i zdravstvene odrednice kao što su životni stil i obrasci ponašanja što uključuje pušenje, izloženost stresu, društvenu osamljenost, tjelesnu aktivnost, obrasce prehrane i preventivna zdravstvena ponašanja. Cilj: Istražiti povezanost socioekonomskog statusa i zdravstvenih pokazatelja u populacijama osamljenog otoka Visa (N=1,025), manje osamljenog otoka Korčule (N=969) i obalnog grada Splita kao drugog najvećeg grada u Hrvatskoj (N=1,012). Materijali i metode: Pomoću povijesti bolesti i anketnih upitnika izvedene su 33 izlazne varijable koje su analizirane koristeći logističku regresiju kroz 6 analitičkih modela (za tri lokacije istraživanja i oba spola zasebno). U populacija otoka Visa je praćena i smrtnost te su ovi podatci analizirani pomoću Cox-ove regresije. Rezultati: Socioekonomske nejednakosti pokazale su se slabo povezanima s zdravljem i zdravstvenim pokazateljima. U matrici od 33 izlazne varijable i 13 pokazatelja socioekonomskog statusa samo je 10 povezanosti bilo značajno na razini značajnosti P<0,001. Nijedna od povezanosti nije se ponovila kroz različite populacije ni kroz oba spola. Nije zabilježena ni povezanost socioekonomskog statusa i smrtnosti na otoku Visu. Zaključak: Očekivano je da homogene otočne populacije imaju veće razine homogenosti i sukladno tomu slabije izražene socioekonomske nejednakosti u zdravlju. Manjak jače povezanosti u gradskoj populaciji Splita vjerojatno je rezultat mehanizama koji su se održali iz bivšeg komunističkog režima i visoke razine zadržane formalne i neformalne društvene potpore.Background: Socioeconomic inequalities have been identified as one of the most interesting targets in public health research and practice. Their impact on health seems to be strongly expressed across the entire human population. The effect of socioeconomic inequalities also extends to more determinants of morbidity, such as lifestyle and behavioural patterns, including smoking, stress, social isolation, physical activity, diet and preventive health behaviours. Objectives: The aim was to investigate the association of socioeconomic status and health outcomes in populations of the remote island of Vis (N=1,025), less remote island of Korcula (N=969) and the coastal city of Split (N=1,012), the second largest city in Croatia. Materials and methods: Medical history and survey information were used to create 33 variables that were analysed using logistic regression in 6 analytic models (for every research location and both genders). The population from the island of Vis was followed up and mortality data was used to calculate hazard ratios using Cox regression. Results: Socioeconomic inequalities were poorly associated with health and disease indices. In the matrix of 33 outcome variables and 13 socioeconomic predictor classes, only 10 associations were significant at the level of P<0.001. None of the associations was replicated across samples or gender. We did not detect the association of any socioeconomic estimate with mortality data for the island of Vis. Conclusions: Homogenous island populations were expected to have greater levels of social homogeneity and consequently less expressed inequalities in health. The lack of stronger association in the urban population of Split is likely the result of the mechanisms that persisted from the former communist regime and high level of retained formal and informal social support

Kratke upute za akademsko pisanje

Kratke upute za akademsko pisanje namijenjene studentima predddiplomskog i diplomskog studija Fakulteta elektrotehnike i računarstva Sveučilišta u Zagrebu

Transparency and public accessibility of clinical trial information in Croatia: how it affects patient participation in clinical trials

IntroductionDespite increased visibility of clinical trials through international trial registries, patients often remain uninformed of their existence, especially if they do not have access to adequate information about clinical research, including the language of the information. The aim of this study was to describe the context for transparency of clinical trials in Croatia in relation to countries in Central and Eastern Europe, and to assess how informed Croatian patients are about clinical trials and their accessibility. Materials and methodsWe assessed the transparency of clinical trials from the data available in the public domain. We also conducted an anonymous survey on a convenience sample of 257 patients visiting two family medicine offices or an oncology department in south Croatia, and members of national patients’ associations. ResultsDespite legal provisions for transparency of clinical trials in Croatia, they are still not sufficiently visible in the public domain. Among countries from Central and Eastern Europe, Croatia has the fewest number of registered trials in the EU Clinical Trials Registry. 66% of the patients in the survey were aware of the existence of clinical trials but only 15% were informed about possibilities of participating in a trial. Although 58% of the respondents were willing to try new treatments, only 6% actually participated in a clinical trial. Only 2% of the respondents were aware of publicly available trial registries. ConclusionsOur study demonstrates that there is low transparency of clinical trials in Croatia, and that Croatian patients are not fully aware of clinical trials and the possibilities of participating in them, despite reported availability of Internet resources and good communication with their physicians. There is a need for active policy measures to increase the awareness of and access to clinical trials to patients in Croatia, particularly in their own language

Kratke upute za akademsko pisanje

Kratke upute za akademsko pisanje namijenjene studentima predddiplomskog i diplomskog studija Fakulteta elektrotehnike i računarstva Sveučilišta u Zagrebu

Is experimentally induced pain associated with socioeconomic status? Do poor people hurt more?

BACKGROUND: The association of pain and socioeconomic status is widely reported, yet much less clearly understood. The aim of this study was to investigate the association of experimentally induced pain threshold and tolerance with socioeconomic status. ----- MATERIAL/METHODS: The study sample consisted of 319 adult subjects from the population of the island of Vis, Croatia, which was previously shown to have a high level of social homogeneity. A manual dolorimeter was used to measure mechanical pressure pain threshold (least stimulus intensity) and pain tolerance (maximum tolerance stimulus intensity) on both hands. Pain tolerance interval was defined as the difference between pain tolerance and threshold. Years of schooling and material status were used as socioeconomic estimates. ----- RESULTS: Both of the socioeconomic estimates were significantly correlated with pain threshold, tolerance, and tolerance interval (P<0.001). The mixed modeling analysis, controlled for the effects of age, gender, and 4 psychological variables, indicated that education was not a significant predictor in any of the 3 models. However, lower material status was significantly associated with lower pain tolerance (P=0.038) and narrower pain tolerance interval (P=0.032), but not with pain threshold (P=0.506). The overall percentages of explained variance were lower in the tolerance interval model (20.2%) than in pain tolerance (23.1%) and threshold (33.1%), suggesting the increasing share of other confounding variables in pain tolerance and even more so in tolerance interval model. ----- CONCLUSIONS: These results suggest a significant association between experimentally induced pain tolerance and tolerance interval with material status, suggesting that poor people indeed do hurt more