Depersonalization of Nurses in Conditions of a Bio-technologically Based Medicine

Medicinska sociologija je kao posebna disciplina sociologije najviše javnih i akademskih priznanja, te financijske i organizacijske potpore, priskrbila istraživanjem socijalnih i profesionalnih relacija koje se razvijaju u odnosima liječnika i pacijenta. Sredinom ovog stoljeća taj je odnos tumačen kao čisti interpersonalni odnos. Razvojem bazičnih prirodnih znanosti, fizike, bilogije i kemije, te tehnološkom aplikacijom tih spoznaja, odnos liječnika i pacijenta postaje višestruko posredovan. Profesionalna uloga medicinske sestre mijenja se u skladu s tim tendencijama i odlikuje se sve izraženijim procesima alijenacije i depersonalizacije. U članku se analiziraju: 1. procesi alijenacije sestara i depersonalizacije pacijenata u bolnicama koje se još uvijek ne odlikuju visokim stupnjem biotehnologijske zasnovanosti procesa liječenja; 2. Promjene koje nastaju u organizaciji zdravstvene prakse i karakteru medicinskog znanja usvajanjem novih znanja i tehnologija; 3. Potrebe za novim pristupima istraživanju odnosa medicinska sestra - pacijent, liječnik - pacijent, te medicinska sestra - liječnik, a u kontekstu subjektiviziranja tehnologije i objektivizacije zdravstvenog osoblja. Koristeći Seemanovu klasifikaciju različitih stupnjeva alijenacije medicinskih sestara u istraživanju se pokazuje da već u toku sedamdesetih godina medicinske sestre doživljavaju u procesu rada: 1. Rutinizaciju svakodnevnih zadataka; 2. Parcijalizaciju uvida u ukupnost procesa liječenja; 3. Ritualizaciju formaliziranih svakodnevnih radnji; 4. Izolaciju u odnosu na skupinu s kojom rade; Rezultat je tih procesa izražen gubitak socijalnog identiteta i profesionalne odgovornosti. Svi ti doživljaji karakteristični su za početnu fazu uvođenja visokih tehnologija u poslove koji se obavljaju sa ljudima. Zbog toga se može zaključiti da je današnji položaj liječnika u bio-tehnologiziranoj zdravstvenoj zaštiti anticipiran položajem medicinskih sestara. Obje profesionalne skupine doživljavaju promjenu socijalne pozicije od statusa subjekta medicinske prakse u status deperonaliziranih sredstava strojne ili kibernetičke obrade pacijenata. Ti procesi zahtijevaju od medicinske sociologije da promijeni i paradigmu na osnovi koje je analizirala odnos liječnika i pacijenta, i epistemu na osnovi koje je prihvaćala bio-medicinski model medicine.Medical sociology, as a special branch of sociology, has gained most of its public and academic acknowledgements, financial and organizational support, trough studies on social and professional relationships between physicians and their patients. In the middle of this century this relationship was interpreted as a pure interpersonal relationship. With the development of basic natural sciences, physics, biology and chemistry, as well as the technological application, of this notios the relationship physician-patient has become manifoldly interceded. The professional role of the nurse is changing in accordance with these tendencies and is characterized by growing processes of alienation and depersonalization. The article analyzes the following: 1. Processes of alienation and nurses and depersonalization of patients in hospitals which are still not characterized by a high degree of bio-technologically based process of treatment; 2. Changes that occur in the organization of health practice and in the character of medical knowledge by acquiring new knowledge and technologies; 3. needs for new approaches to studies on the relationship nurse-patient, physician-patient and nurse-physician and in the context of subjectivizing technology and objectivizing health personnel. Using Seeman’s classification of different degrees of alienation of nurses, the study has shown that already in the 70\u27s nurses experience in the process of work the following: 1. Everyday tasks become a routine 2. Formalized everyday work become a ritual 3. Isolation in relation to the group who they are working with. The result of these processes is the loss of social identity and professional responsibility. All these experiences are characteristic for the initial phase of introducing sophisticated technology into work which is performed with people. That is why it can be concluded that the present position of physicians in the bio-technologically based health care is anticipated by the position of nurses. Both professional groups experience changes of their social position from the status of the subject of medical practice to the status of depersonalized means of computer or cybernetic processing of patients. These processes require from medical sociology to change the paradigm on the basis of which it has analyzed the relationship physician-patient as well as the epistema on the basis of which it has accepted the bio-medical model of medicine

Pharmacoeconomics - Concepts, Methods and Controverses

Farmakoekonomika je moderna znanstvena disciplina koja je počela igrati važnu ulogu u razvoju i marketingu lijekova tek početkom 1990-ih godina. Očekuje se da će i u 21. stoljeću nastaviti dobivati na važnosti. Društva za zdravstveno osiguranje, ministarstva zdravlja, medicinski fakulteti i škole javnog zdravlja te farmaceutske tvrtke sve viπe postaju svjesne potrebe stjecanja stručnosti iz toga područja. Sve veći troškovi medicinske skrbi doveli su kupce i proizvođače medicinskih aparata i farmaceutskih proizvoda do prepoznavanja potrebe evaluiranja proizvoda i usporedbe investicija i troškova u odnosu na učinak koji se postiže. Time se nadilaze tradicionalni kriteriji učinkovitosti i sigurnosti koji su prije pojave farmakoekonomike činili standarde istraživanja, registriranja, odobravanja za javno financiranje, propisivanja i praćenja utilizacije lijekova.Pharmacoeconomics is a modern scientific branch of medicine whose importance in drug development and marketing began to be recognized in the 1990-ties. It is expected that its importance will continue to grow in the 21 century as well. Health insurance societies, ministries of health, medical schools, schools for public health and the pharmaceutical industry are being aware of the importance of specialising and gaining knowledge in this particular field. The rising costs of medical care lead the manufacturers and buyers of medical instruments and pharmaceutical products to recognize the need to evaluate and compare the cost of investments and expenditures regarding the effects achieved. This surpasses the traditional criteria of efficacy and safety valid before the advent of pharmacoeconomics in investigation, registration, financing, prescribing and utilization of drugs

Depersonalization of Nurses in Conditions of a Bio-technologically Based Medicine

Medicinska sociologija je kao posebna disciplina sociologije najviše javnih i akademskih priznanja, te financijske i organizacijske potpore, priskrbila istraživanjem socijalnih i profesionalnih relacija koje se razvijaju u odnosima liječnika i pacijenta. Sredinom ovog stoljeća taj je odnos tumačen kao čisti interpersonalni odnos. Razvojem bazičnih prirodnih znanosti, fizike, bilogije i kemije, te tehnološkom aplikacijom tih spoznaja, odnos liječnika i pacijenta postaje višestruko posredovan. Profesionalna uloga medicinske sestre mijenja se u skladu s tim tendencijama i odlikuje se sve izraženijim procesima alijenacije i depersonalizacije. U članku se analiziraju: 1. procesi alijenacije sestara i depersonalizacije pacijenata u bolnicama koje se još uvijek ne odlikuju visokim stupnjem biotehnologijske zasnovanosti procesa liječenja; 2. Promjene koje nastaju u organizaciji zdravstvene prakse i karakteru medicinskog znanja usvajanjem novih znanja i tehnologija; 3. Potrebe za novim pristupima istraživanju odnosa medicinska sestra - pacijent, liječnik - pacijent, te medicinska sestra - liječnik, a u kontekstu subjektiviziranja tehnologije i objektivizacije zdravstvenog osoblja. Koristeći Seemanovu klasifikaciju različitih stupnjeva alijenacije medicinskih sestara u istraživanju se pokazuje da već u toku sedamdesetih godina medicinske sestre doživljavaju u procesu rada: 1. Rutinizaciju svakodnevnih zadataka; 2. Parcijalizaciju uvida u ukupnost procesa liječenja; 3. Ritualizaciju formaliziranih svakodnevnih radnji; 4. Izolaciju u odnosu na skupinu s kojom rade; Rezultat je tih procesa izražen gubitak socijalnog identiteta i profesionalne odgovornosti. Svi ti doživljaji karakteristični su za početnu fazu uvođenja visokih tehnologija u poslove koji se obavljaju sa ljudima. Zbog toga se može zaključiti da je današnji položaj liječnika u bio-tehnologiziranoj zdravstvenoj zaštiti anticipiran položajem medicinskih sestara. Obje profesionalne skupine doživljavaju promjenu socijalne pozicije od statusa subjekta medicinske prakse u status deperonaliziranih sredstava strojne ili kibernetičke obrade pacijenata. Ti procesi zahtijevaju od medicinske sociologije da promijeni i paradigmu na osnovi koje je analizirala odnos liječnika i pacijenta, i epistemu na osnovi koje je prihvaćala bio-medicinski model medicine.Medical sociology, as a special branch of sociology, has gained most of its public and academic acknowledgements, financial and organizational support, trough studies on social and professional relationships between physicians and their patients. In the middle of this century this relationship was interpreted as a pure interpersonal relationship. With the development of basic natural sciences, physics, biology and chemistry, as well as the technological application, of this notios the relationship physician-patient has become manifoldly interceded. The professional role of the nurse is changing in accordance with these tendencies and is characterized by growing processes of alienation and depersonalization. The article analyzes the following: 1. Processes of alienation and nurses and depersonalization of patients in hospitals which are still not characterized by a high degree of bio-technologically based process of treatment; 2. Changes that occur in the organization of health practice and in the character of medical knowledge by acquiring new knowledge and technologies; 3. needs for new approaches to studies on the relationship nurse-patient, physician-patient and nurse-physician and in the context of subjectivizing technology and objectivizing health personnel. Using Seeman’s classification of different degrees of alienation of nurses, the study has shown that already in the 70\u27s nurses experience in the process of work the following: 1. Everyday tasks become a routine 2. Formalized everyday work become a ritual 3. Isolation in relation to the group who they are working with. The result of these processes is the loss of social identity and professional responsibility. All these experiences are characteristic for the initial phase of introducing sophisticated technology into work which is performed with people. That is why it can be concluded that the present position of physicians in the bio-technologically based health care is anticipated by the position of nurses. Both professional groups experience changes of their social position from the status of the subject of medical practice to the status of depersonalized means of computer or cybernetic processing of patients. These processes require from medical sociology to change the paradigm on the basis of which it has analyzed the relationship physician-patient as well as the epistema on the basis of which it has accepted the bio-medical model of medicine

Predictors of the Desire/Decision to Quit Smoking in a Cohort of Croatian Adult Smokers Followed for Five Years: The CroHort Study

This study provides an overview of the incidence of smoking, the socio-demographic characteristics of Croatian smokers during a five-year period and an assessment of predictors of the desire/decision to quit smoking. Analyses were performed separately for 2003 and 2008. A total of 3,229 subjects were included in the survey. There is a significant trend of a decreasing number of smokers in all age groups in 2008, compared to 2003. Almost half of the smokers included in the study expressed desire to quit smoking. Factors contributing significantly to decision to quit smoking were different in 2003 and 2008, except one. Concern about the harmful effects of tobacco smoking on health was a significant predictor in both models. Very worried respondents were more likely to decide to quit smoking (OR 17.6, 95% CI 9.41 to 33.17 vs. OR 12.54; 95% CI 6.0 to 26.2) than those who were not worried at all

Youth and AIDS – A Study of Attitudes, Knowledge, Behavior and Risks in the Post-War Croatia

According to the latest reports, the Eastern Europe currently exhibits the greatest relative increase in the number of newly registered HIV infections in the world. At the same time, Central Europe remains relatively spared from the epidemic, with reported rates significantly lower than those in both Eastern and Western Europe. Croatia geographically affiliates to Central Europe, but it has two specific potential risk factors in comparison to neighboring countries: recent War events and a summer season when immigration of large number of tourists from Central and Eastern Europe is expected. Therefore, it is critical to examine AIDS attitudes in young people, increase their knowledge, monitor their behavior and warn on risks in order to prevent larger spread of epidemics from Eastern Europe to Croatia. In this study, we report on a large related survey and education program among 17-year-old high school pupils that was conducted in years immediately following the War (1996–1999)

Youth and AIDS – A Study of Attitudes, Knowledge, Behavior and Risks in the Post-War Croatia

According to the latest reports, the Eastern Europe currently exhibits the greatest relative increase in the number of newly registered HIV infections in the world. At the same time, Central Europe remains relatively spared from the epidemic, with reported rates significantly lower than those in both Eastern and Western Europe. Croatia geographically affiliates to Central Europe, but it has two specific potential risk factors in comparison to neighboring countries: recent War events and a summer season when immigration of large number of tourists from Central and Eastern Europe is expected. Therefore, it is critical to examine AIDS attitudes in young people, increase their knowledge, monitor their behavior and warn on risks in order to prevent larger spread of epidemics from Eastern Europe to Croatia. In this study, we report on a large related survey and education program among 17-year-old high school pupils that was conducted in years immediately following the War (1996–1999)

LMHS

5 generacija, 10 godina studija, 56 profesora iz inozemstva, 236 studenata. 10.000 sati rada?Proslava 10 godina studija “LMHS-a koja se održala 14.06.2012 na Školi narodnog zdravlja"Andrija Štampar" Medicinskog fakulteta Sveucilišta u Zagrebu, nije bila posebna po tome štoje do zadnjeg mjesta ispunila veliku A dvoranu Š NZ A. Štampar. Bila je posebna po cinjeniciuocljivoj na prvi pogled: polaznici studija “LMHS†razlicitih su struka, dobi, profesija i razinaobrazovanja. U proteklih deset godina studij je završilo 236 polaznika u pet generacija: mnogisu se upisali kada su vec bili redoviti profesori, brojni su doktorirali i stekli visoka sveucilišnazvanja postali ministri, gradonacelnici, predsjednici komora i Zbora lijecnika, glavni ravnateljiklinickih bolnickih centara, poduzentici, kreativni pisci, medunarodni savjetnici…. Da su tofinancijske i logisticke mogucnosti dopuštale, da su mogli doputovati iz inozemstva, u dvoranibi bilo i 56 profesora i predavaca iz 12 zemalja…Udruženi timovi pod tim su akronimom odradili i znacajne savjetnicke poslove za medunarodneinstitucije i vlade u drugim državama. Polaznici studija osnovali su i znacajne profesionalneudruge u zdravstvu. Najvažnije pitanje svakog edukativnog procesa je: kakva teoretska iprakticna znanja i vještine nudi studijski program “LMHSâ€.Više u PDF datoteci

Employment income tax of resident in the Republic of Croatia

Novi sustav oporezivanja dohotka u Republici Hrvatskoj je posljedica donošenja Zakona o porezu na dohodak (NN 115/16., 106/18.) i njegovih zadnjih izmjena koje su na snazi od 1. siječnja 2019. godine. Za razumijevanje terminološki zahtjevne i javno prihodovno dominantne kategorije poreza na dohodak, dohodak od nesamostalnog rada rezidenta u Republici Hrvatskoj, bitno je sažetim „ab initio“ pristupom raščlaniti pravni okvir osnovnih odredaba poreza na dohodak uopće. Njega uz navedenu kategoriju čine i kategorije poreza na dohodak od samostalne djelatnosti, imovine i imovinskih prava, kapitala i drugi dohodak. Unatoč široko rasprostranjenoj tematici koja izvire iz poreza na dohodak, što potkrepljuju brojna/raznovrsna mišljenja Središnjeg ureda Porezne uprave Ministarstva financija Republike Hrvatske i vrijedan opus stručnih članaka, ovim se radom fokus usmjerava na njegov najčešći pojavni oblik-porez na dohodak od nesamostalnog rada rezidenta u Republici Hrvatskoj

Employment income tax of resident in the Republic of Croatia

Novi sustav oporezivanja dohotka u Republici Hrvatskoj je posljedica donošenja Zakona o porezu na dohodak (NN 115/16., 106/18.) i njegovih zadnjih izmjena koje su na snazi od 1. siječnja 2019. godine. Za razumijevanje terminološki zahtjevne i javno prihodovno dominantne kategorije poreza na dohodak, dohodak od nesamostalnog rada rezidenta u Republici Hrvatskoj, bitno je sažetim „ab initio“ pristupom raščlaniti pravni okvir osnovnih odredaba poreza na dohodak uopće. Njega uz navedenu kategoriju čine i kategorije poreza na dohodak od samostalne djelatnosti, imovine i imovinskih prava, kapitala i drugi dohodak. Unatoč široko rasprostranjenoj tematici koja izvire iz poreza na dohodak, što potkrepljuju brojna/raznovrsna mišljenja Središnjeg ureda Porezne uprave Ministarstva financija Republike Hrvatske i vrijedan opus stručnih članaka, ovim se radom fokus usmjerava na njegov najčešći pojavni oblik-porez na dohodak od nesamostalnog rada rezidenta u Republici Hrvatskoj