Medizinische Psychologie in Kroatien – zwanzig Jahre später

Zdravstvena psihologija – nova grana primjene psihologije u zdravstvu – u posljednjih se dvadesetak godina vrlo brzo razvija. Opisan je razvoj zdravstvene psihologije u Hrvatskoj u obrazovanju zdravstvenih djelatnika i psihologa, u svakodnevnoj zdravstvenoj praksi i u istra`ivanjima slo`enih odnosa izme|u psiholoških pojava, zdravlja i bolesti. Kao osnovne zapreke razvoju zdravstvene psihologije u Hrvatskoj spomenute su nedovoljno široke mogu}nosti obrazovanja psihologa s podru~ja zdravstvene psihologije i preusko definirana uloga psihologa kao stru~njaka u zdravstvenom sustavu. Autori predvi|aju buran razvoj zdravstvene psihologije u idu}im godinama, potaknut sve ve}im potrebama za psihološkim uslugama u zdravstvu, posebice u prevenciji, ali i u lije~enju bolesti te u procesu rehabilitacije. Zna~ajni pozitivni pomaci u statusu psihologa u zdravstvu o~ekuju se nakon donošenja Zakona o psihološkoj djelatnosti i osnivanja Hrvatske psihološke komore, što }e omogu}iti psiholozima u zdravstvu ravnopravan status zdravstvenih djelatnika. Dinamika ostvarenja razvoja zdravstvene psihologije u Hrvatskoj ovisi o brojnim ~imbenicima, me|u kojima je vrlo va`no proširenje mogu}nosti dodiplomskog i poslijediplomskog obrazovanja psihologa na podru~ju zdravstvene psihologije.Health psychology – a relatively new branch of psychology applied in health care – has undergone rapid development during the past twenty years. The paper gives a review of the development of health psychology in Croatia in the field of education of health professionals and psychologists, in the field of everyday health care practice, and in the field of studying complex relations between psychological phenomena, health and disease. Insufficiently extensive education of psychologists in the field of health psychology and limited role of psychologists as professionals and experts in the system of health care have been identified as major obstacles to adequate development of health psychology in Croatia. The authors assume the development of health psychology will take a turbulent course in the years to come, mostly due to increased needs for psychological services in the health care system, especially in prevention and rehabilitation processes but also in the treatment procedures. Significant positive changes in the status of psychologists in the health care system are expected after the Law on Psychological Activity is passed and Croatian Psychological Chamber is established. These should enable the psychologists in the health care system to have a status in all respects equal to that of other health professionals. The dynamics of development of health psychology in Croatia depends on numerous factors, among which the possibility to extend undergraduate study curricula in health psychology and the need to organize post-graduate and continuing education of psychologists in health psychology are considered as the most important ones.Die medizinische Psychologie – ein neuer Zweig der angewandten Psychologie, der im Gesundheitswesen zum 485 Einsatz kommt – entwickelt sich in den letzten zwanzig Jahren sehr rasch. Die Verfasser beschreiben die Entwicklung der medizinischen Psychologie in Kroatien – ihre Präsenz in Ausbildungsprogrammen für medizinisches Fachpersonal und Psychologen, in der alltäglichen medizinischen Praxis sowie im Bereich der Forschung, mit der die komplexen Zusammenhänge zwischen psychologischen Phänomenen, Gesundheit und Krankheit beleuchtet werden sollen. Als wichtigste Hindernisse, die sich der vollen Entfaltung der medizinischen Psychologie in Kroatien in den Weg legen, werden erwähnt: eingeschränkte Ausbildungsmöglichkeiten für medizinische Psychologen sowie eine zu eng definierte Rolle des Psychologen als Experten innerhalb des Gesundheitswesens. Die Autoren prognosieren eine intensive Entwicklung der medizinischen Psychologie im Laufe der nächsten Jahre, was auf das gesteigerte Bedürfnis nach psychologischen Dienstleistungen im Gesundheitswesen, besonders im Bereich der Vorbeugung, aber auch als therapeutische Maßnahme sowie im Prozess der Rehabilitation, zurückzuführen sein wird. Bedeutende Fortschritte in der Stellung von Medizinpsychologen sind nach der Verabschiedung eines Gesetzes zur psychologischen Tätigkeit und nach der Gründung eines Verbandes kroatischer Psychologen zu erwarten. Diese Schritte sollen Medizinpsychologen und übrigem medizinischem Fachpersonal einen gleichberechtigten Status ermöglichen. Die Dynamik in der Entfaltung der medizinischen Psychologie in Kroatien hängt von mehreren Faktoren ab, so u.a. auch von einem breiteren Angebot in der Vor- und Nachdiplomausbildung der Medizinpsychologen

Man, environment and ozone

U radu se razglaba o ozonu kao prirodnom sastojku atmosfere, nepovoljnu učinku smanjenja ozonskog omotača te porastu koncentracije ozona u troposferi. Dan je prikaz pojedinih industrijskih grana gdje je ozon prisutan uz osvrt na ambijentalnu izloženost. Također se razglaba o akutnoj i kroničnoj toksičnosti ozona te patofiziološkim mehanizmima djelovanja ozona na tkiva, napose na respiratorni sustav. Spominju se mjerenja ozona u Hrvatskoj s kraja 19. stoljeća te ona započeta nakon 1975. koja i danas traju.Ozone is a naturally occurring gas, formed in the trimolecular reaction of oxygen atoms with molecular oxygen. Its strong absorption in the UV region provides protection from excessive irradiation of the Earth\u27s surface. Occupational exposure to ozone involves electric are welding, mercury vapour lamps, office photocopy machines. X-ray generators and other high voltage electrical equipment, water purification and bleaching. Ozone is the most abundant oxidant in the photochemical smog. The lung cell injury induced by ozone involves a complex biochemical mechanism which is due to free radical generation. Moderate exposure produces upper respiratory tract symptoms and eye irritation, severe acute exposure results in pulmonary oedema. Measurements of atmospheric ozone concentrations in Croatia began at the end of the 19th century; continuous monitoring has been earned out since 1975

Quantification of coronary atherosclerotic burden with coronary computed tomography angiography: adapted Leaman score in Croatian patients

The aim of the study was to quantify the total coronary atherosclerotic burden in patients with suspected coronary artery disease (CAD) defined by coronary computed tomography adapted Leaman score (CT-LeSc) and to estimate its cut-off level for high coronary atherosclerotic burden. We enrolled 434 consecutive patients referred to coronary computed tomography angiography, of which 261 patients fulfilled the study inclusion criteria. Demographic and clinical characteristics, as well as CAD risk factors were obtained. CAD pre-test probabilities were estimated by the Diamond-Forrester model and Morise score. The coronary atherosclerotic burden was estimated using CT-LeSc. As a cut-off for a high coronary atherosclerotic burden, we used 3rd tercile (Tc3) (CT-LeSc ≥ 5.52). We evaluated the association of clinical characteristics and risk factors with Tc3 in univariate and multivariate analysis. There were 60.9% males and 39.1% females, 81% of patients had above-normal weight, 68.2% hypertension, 54.0% dyslipidemia, 15.3% diabetes mellitus, 12.3% positive smoking history and 11.9% had a family history of CAD. According to the Diamond-Forrester model and Morise score the majority of patients had intermediate risk, 59.7 and 52.8%, followed by the high-risk group, 36.0 and 34.4%, respectively. Age, dyslipidemia, hypertension and pre-test risk scores in the univariate analysis significantly predicted Tc3. In the multivariate analysis, male sex (p = 0.004), dyslipidemia (p = 0.002) and coronary calcium score (< 0.001) were identified as predictors of Tc3. CT-LeSc quantified the total coronary atherosclerotic burden and showed an association of risk factors and pre-test probabilities with Tc3

Status of faecal pollution in ports: A basin-wide investigation in the Adriatic Sea

Ports are subject to a variety of anthropogenic impacts, and there is mounting evidence of faecal contamination through several routes. Yet, little is known about pollution in ports by faecal indicator bacteria (FIB). FIB spatio-temporal dynamics were assessed in 12 ports of the Adriatic Sea, a semi-enclosed basin under strong anthropogenic pressure, and their relationships with environmental variables were explored to gain insight into pollution sources. FIB were abundant in ports, often more so than in adjacent areas ; their abundance patterns were related to salinity, oxygen, and nutrient levels. In addition, a molecular method, quantitative (q)PCR, was used to quantify FIB. qPCR enabled faster FIB determination and water quality monitoring that culture-based methods. These data provide robust baseline evidence of faecal contamination in ports and can be used to improve the management of routine port activities (dredging and ballast water exchange), having potential to spread pathogens in the sea

CROATIAN GUIDELINES FOR THE PHARMACOTHERAPY OF TYPE 2 DIABETES

Uvod: Hrvatsko društvo za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora izradilo je 2011. godine prve nacionalne smjernice o prehrani, edukaciji i samokontroli te farmakološkom liječenju šećerne bolesti tipa 2. Sukladno povećanom broju dostupnih lijekova te novim spoznajama o učinkovitosti i sigurnosti primjene već uključenih lijekova, pokazala se potreba za obnovom postojećih smjernica za farmakološko liječenje šećerne bolesti tipa 2 u Republici ­Hrvatskoj. Sudionici: Kao koautori Smjernica navedeni su svi članovi Hrvatskog društva za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora, kao i ostalih uključenih stručnih društava, koji su svojim komentarima i prijedlozima pridonijeli izradi Smjernica. Dokazi: Ove su Smjernice utemeljene na dokazima, prema sustavu GRADE (engl. Grading of Recommendations, Assessment, Development and Evaluation) koji uz razinu dokaza opisuje i snagu preporuke. Zaključci: Individualan pristup temeljen na fiziološkim principima regulacije glikemije nuždan je u liječenju osoba sa šećernom bolesti. Ciljeve liječenja i odabir medikamentne terapije treba prilagoditi oboljeloj osobi, uzimajući u obzir životnu dob, trajanje bolesti, očekivano trajanje života, rizik od hipoglikemije, komorbiditete, razvijene vaskularne i ostale komplikacije, kao i ostale čimbenike. Zbog svega navedenoga od nacionalnog je interesa imati praktične, racionalne i provedive smjernice za farmakološko liječenje šećerne bolesti tipa 2.Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of ­diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the ­pharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes’ patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglycemia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes

Hrvatske smjernice za farmakološko liječenje šećerne bolesti tipa 2 [Croatian guidelines for the pharmacotherapy of type 2 diabetes]

Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the pharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes' patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglyce- mia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes

Water for all : Proceedings of the 7th international scientific and professional conference Water for all

The 7th International Scientific and Professional Conference Water for all is organized to honour the World Water Day by the Josip Juraj Strossmayer University of Osijek, European Hygienic Engineering & Design Group (EHEDG), Danube Parks, Croatian Food Agency, Croatian Water, Faculty of Food Technology Osijek, Faculty of Agriculture in Osijek, Faculty of Civil Engineering Osijek, Josip Juraj Strossmayer University of Osijek Department of Biology, Josip Juraj Strossmayer University of Osijek Department of Chemistry, Nature Park “Kopački rit”, Osijek- Baranja County, Public Health Institute of the Osijek- Baranja County and „Vodovod-Osijek“ -water supply company in Osijek. The topic of World Water Day 2017 was "Wastewater" emphasizing the importance and influence of wastewater treatments on global environment. The international scientific and professional conference Water for all is a gathering of scientists and experts in the field of water management, including chemists, biologists, civil and agriculture engineers, with a goal to remind people about the significance of fresh water and to promote an interdisciplinary approach and sustainability for fresh water resource management. The Conference has been held since 2011. About 300 scientists and engineers submitted 95 abstracts to the 7th International Scientific and Professional Conference Water for all, out of which 33 was presented orally and 62 as posters. 47 full papers were accepted by the Scientific Committee. 38 full papers became the part of the this Proceedings while 9 papers were accepted for publication in Croatian Journal of Food Science and Technology and Electronic Journal of the Faculty of Civil Engineering Osijek - e-GFOS

CROATIAN GUIDELINES FOR THE PHARMACOTHERAPY OF TYPE 2 DIABETES

Uvod: Hrvatsko društvo za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora izradilo je 2011. godine prve nacionalne smjernice o prehrani, edukaciji i samokontroli te farmakološkom liječenju šećerne bolesti tipa 2. Sukladno povećanom broju dostupnih lijekova te novim spoznajama o učinkovitosti i sigurnosti primjene već uključenih lijekova, pokazala se potreba za obnovom postojećih smjernica za farmakološko liječenje šećerne bolesti tipa 2 u Republici ­Hrvatskoj. Sudionici: Kao koautori Smjernica navedeni su svi članovi Hrvatskog društva za dijabetes i bolesti metabolizma Hrvatskoga liječničkog zbora, kao i ostalih uključenih stručnih društava, koji su svojim komentarima i prijedlozima pridonijeli izradi Smjernica. Dokazi: Ove su Smjernice utemeljene na dokazima, prema sustavu GRADE (engl. Grading of Recommendations, Assessment, Development and Evaluation) koji uz razinu dokaza opisuje i snagu preporuke. Zaključci: Individualan pristup temeljen na fiziološkim principima regulacije glikemije nuždan je u liječenju osoba sa šećernom bolesti. Ciljeve liječenja i odabir medikamentne terapije treba prilagoditi oboljeloj osobi, uzimajući u obzir životnu dob, trajanje bolesti, očekivano trajanje života, rizik od hipoglikemije, komorbiditete, razvijene vaskularne i ostale komplikacije, kao i ostale čimbenike. Zbog svega navedenoga od nacionalnog je interesa imati praktične, racionalne i provedive smjernice za farmakološko liječenje šećerne bolesti tipa 2.Introduction: The Croatian Association for Diabetes and Metabolic Disorders of the Croatian Medical Association has issued in 2011 the first national guidelines for the nutrition, education, self-control, and pharmacotherapy of ­diabetes type 2. According to the increased number of available medicines and new evidence related to the effectiveness and safety of medicines already involved in the therapy there was a need for update of the existing guidelines for the ­pharmacotherapy of type 2 diabetes in the Republic of Croatia. Participants: as co-authors of the Guidelines there are listed all members of the Croatian Association for Diabetes and Metabolic Diseases, as well as other representatives of professional societies within the Croatian Medical Association, who have contributed with comments and suggestions to the development of the Guidelines. Evidence: These guidelines are evidence-based, according to the GRADE system (eng. Grading of Recommendations, Assessment, Development and Evaluation), which describes the level of evidence and strength of recommendations. Conclusions: An individual patient approach based on physiological principles in blood glucose control is essential for diabetes’ patients management. Glycemic targets and selection of the pharmacological agents should be tailored to the patient, taking into account the age, duration of disease, life expectancy, risk of hypoglycemia, comorbidities, developed vascular and other complications as well as other factors. Because of all this, is of national interest to have a practical, rational and applicable guidelines for the pharmacotherapy of type 2 diabetes