ČIMBENICI STRESA MEDICINSKIH SESTARA U COVID ODJELIMA

Objective: To define the stressors that cause the highest level of stress in nurses / technicians in COVID intensive care units (ICU) and regular COVID departments and to compare stressors between these two departments. Methods: For the purposes of the research, a validated questionnaire on stressors at the workplace of hospital health workers was used. The questionnaires were distributed to 194 nurses/technicians, working in the COVID departments. The questionnaire consists of 3 parts; the first part contains demographic data of the respondents, the second part of the questionnaire consists of 34 questions that describe certain stress factors and are answers are offered on a Likert - type scale and the last part of the questionnaire consists of 3 open-ended questions to which respondents can add stressors to which they are exposed, which were not previously mentioned. Results: Differences were found in the level of education regarding the length of work with COVID patients, nurses / technicians with a higher level of education worked longer in the COVID department (p=0.043). No differences were found in the level of stress between nurses/technicians working in the COVID department compared to the COVID ICU (p=0.181). Among the factors that caused the highest level of stress are: work overload, inadequate personal income, insufficient number of employees and everyday unpredictable and unplanned situations. Conclusion: Our results indicate that there is no difference in the level of stress between nurses working in the COVID departments compared to nurses working in the COVID ICU. Due to the high prevalence of stress among nurses who work with COVID patients, it is necessary to monitor the symptoms of burnout and provide support in the workplace. According to the results of our research, there is a need to optimize working conditions and invest efforts in order to reduce the workload.Cilj: Definirati stresore koji na radnom mjestu u COVID jedinicama intenzivne skrbi i COVID odjelima uzrokuju najvišu razinu stresa kod medicinskih sestara/tehničara i usporediti stresore između navedenih odjela. Metode: Za potrebe istraživanja korišten je validiran upitnik o stresorima na radnom mjestu bolničkih zdravstvenih djelatnika. Upitnici su podijeljeni na 194 medicinske sestre / tehničare koji rade na COVID odjelima. Upitnik se sastoji od 3 dijela; u prvom dijelu su demografski podaci ispitanika, drugi dio upitnika sastoji se od 34 pitanja koja opisuju pojedine čimbenike stresa te su ponuđeni odgovori na skali Likertovog tipa i zadnji dio upitnika sastoji se od 3 pitanja otvorenog tipa na koje ispitanici mogu nadopisati stresore kojima su izloženi, a koji nisu prethodno spomenuti. Rezultati: Utvrđene su razlike u razini obrazovanja obzirom na duljinu rada s COVID bolesnicima, u COVID odjelu su duže radile medicinske sestre/tehničari više razine obrazovanja, P=0.043. Nisu utvrđene razlike u jačini stresa između medicinskih sestara/tehničara koje rade u COVID odjelu u odnosu u COVID JIL, P=0.181. Među čimbenicima koji uzrokuju najvišu razinu stresa su: preopterećenost poslom, neadekvatna osobna primanja, nedostatan broj djelatnika i svakodnevne nepredvidive i neplanirane situacije. Zaključak: Naši rezultati pokazuju da nema razlike u razini stresa između sestara koje rade u COVID odjelima u usporedbi s medicinskim sestrama koje rade u COVID JIL-u. Zbog visoke prevalencije stresa među medicinskim sestrama koje rade s COVID bolesnicima potrebno je pratiti simptome sagorijevanja i pružiti podršku na radnom mjestu. Prema rezultatima našeg istraživanja, postoji potreba za optimizacijom radnih uvjeta i ulaganjem napora u cilju smanjenja radnog opterećenja

Vasoactive stress hormone (adrenaline, noradrenaline and cortisol) concentration in plasma after administration of low doses of S-(+)-ketamine epidurally

Background and Purposes: The aim of this study was to investigate the effect of epidurally administered S-(+)-ketamine on vasoactive stress hormones. It was a prospective study conducted after approval of the Ethical Committee and informed consent of patients. Materials and Methods: The study was performed on 80 patients: 40 patients in Group 1 (0.5% bupivacaine) and 40 patients in Group 2 (0.5% bupivacaine + 25 mg S-(+)-ketamine – 0.326 mg/kg-bm). All patients were adults aged between 18 and 45 years, ASA I and II with epidural anaesthesia for a surgical procedure. Vasoactive parameters: concentrations of adrenaline, noradrenaline and cortisol were measured 30 minutes before setting the vein pathway and 17–25 min. after application of anaesthetics. Results: There were no statistically significant changes in vasoactive stress hormones (adrenaline, noradrenaline and cortisol) plasma concentrations after administering 0.5% bupivacaine, 0.5% bupivacaine + S-(+)- -ketamine epidurally. Conclusion: Setting central nervous block before skin incision, using local anaesthetic, and S-(+)-ketamine, leaves concentrations of stress hormones in plasma within referent values. Adding a low dose of S-(+)- -ketamine into the epidural space in combination with 0.5% bupivacaine does not have an effect on the concentration of stress hormones in plasma

Razvijanje vještina pisanja na naprednom stupnju: šest studija slučaja

The paper focuses on the writing skills of advanced learners of English as a foreign language. The attitudes towards different aspects of compositions, the writing strategies that learners use in composition writing and the compositions witten by three good and three poor writers are looked into. The analyses carried out in the study point to the easily discernible differences in the quality of good and poor compositions and the difficulties of determining the causes of these differences

Komparativno istraživanje stavova i motivacije hrvatskih učenika engleskoga i njemačkog jezika

In this comparative longitudinal trend study the authors compare attitudes and motivation of Croatian learners of English and German. Comparisons are made not only with respect to the FL but also to two age points of the learners’ language and affective development: end of primary education (age 14) and end of secondary education (age 18). In the study both the quantitative and qualitative research paradigms were employed. Data was gathered by means of a questionnaire consisting of three parts, including both structured and open-ended items. Conclusions are made on the basis of combined quantitative and qualitative results. Implications for further research are offered as well.U svojoj longitudinalnoj komparativnoj studiji autorice uspoređuju stavove i motivaciju hrvatskih učenika engleskoga i njemačkog jezika. Usporedbe provode s obzirom na jezik ali i stupanj jezičnoga i afektivnog razvoja učenika uključujući učenike osmoga razreda osnovne škole i završnoga razreda srednje škole. U istraživanju se služe i kvantitativnim i kvalitativnim pristupom. Podatke su prikupile upitnikom kojeg je dio bio strukturiran a dio nestrukturiran. Zaključke formiraju na temelju kvantitativnih i kvalitativnih rezultata, a donose i implikacije svojih nalaza za buduća istraživanja

ENGLISH IN CROATIA – FROM NEEDS TO ACHIEVEMENTS

U prilogu se opisuju ciljevi i metodologija istraživanja znanstvenoistraživačkoga projekta Engleski jezik u Hrvatskoj. Ističe se da su razlozi za pokretanje i provođenje projekta vezani uz potrebu da se politika učenja stranih jezika počne koncipirati na temelju znanstveno verifi ciranih pretpostavki, a ne – kao do sada – na temelju proizvoljne i neprovjerene intuicije i stavova pojedinaca. Autorice, od kojih je jedna i voditeljica projekta, također detaljno opisuju razloge za izbor instrumenata koji su korišteni u projektu. Korištenje baterije mađarskih testova i upitnika objašnjavaju sličnošću društveno-obrazovnih konteksta u dvjema zemljama, mogućnošću komparativnih studija i činjenicom da preuzeti testovi ispituju komunikacijsku kompetenciju učenika na europskim referentnim stupnjevima A2 i B1, razinama koje su propisane i hrvatskim nacionalnim kurikulumom. U radu se opisuje predtestiranje preuzetih instrumenata i iznose rezultati toga postupka. Osim novih spoznaja o statusu engleskoga jezika u Hrvatskoj, autorice navode i niz dodatnih rezultata vezanih uz razvijanje istraživačkih kompetencija u ovome području znanstvenih propitivanja.The paper focuses on the aims and research methodology of the Croatian national project English in Croatia. The authors, one of whom headed the research team, point out that reasons for such a project are connected with the need to conceptualise FL education policies on the basis of research-based insights instead of what has been common practice up to now – on unverifi ed individual intuitions. The authors also explain at length the choice of measuring instruments used in the project. They stress that the Hungarian battery of tests used represent measures validated in a similar socio-educational context, that they make possible comparative studies of the same phenomena and that the communicative tests in the battery, aiming at the CEFR A2 and B1 levels, coincide with the language communicative competence set out by the Creational national curriculum. The paper offers a detailed description of the piloting of all the instruments used. Besides the new insights about the status of English in Croatia, the authors also draw attention to some additional project results concerning development of new research competences in the fi eld of FL education investigations

DEFINING COMMUNICATIVE COMPETENCE

Iako danas postoji visok stupanj suglasja među teoretičarima oko osnovnoga sadržaja defi nicije komunikacijske kompetencije, u literaturi se često navodi kako je pri koncipiranju istraživanja komunikacijske kompetencije potrebno razmotriti i jasno odrediti pojam komunikacijske kompetencije, tj. oblikovati takvu defi niciju koja će omogućiti jednostavnu operacionalizaciju toga konstrukta. U ovom se radu ukratko prikazuje proces defi niranja komunikacijske kompetencije koji je započeo još u 60-im godinama prošloga stoljeća. U okviru dva zasebna poglavlja predstavlja se nekoliko važnijih defi nicija i modela komunikacijske kompetencije, na temelju kojih se u završnom poglavlju izvode zaključci o načinu defi niranja komunikacijske kompetencije relevantnom za projekt «Engleski jezik u Hrvatskoj».There is a high level of agreement among theoreticians today on the basic content of the defi nition of communicative competence. However, it has been often pointed out in the literature on language testing that before undertaking research on communicative competence it is essential to examine and clearly determine the construct of communicative competence, namely, to formulate a defi nition which will enable a simple operationalization of that construct. This paper presents in brief the process of defi ning communicative competence which started in the late 1960s. Several important defi nitions and models of communicative competence are presented in two separate sections. On the basis of these defi nitions and models, there is a discussion in the fi nal section on the manner of defi ning communicative competence which is relevant for the scientifi c research project «English in Croatia»

Double-hit primary unilateral adrenal lymphoma with good outcome

Introduction. Primary adrenal non-Hodgkin’s lymphoma (NHL) is a rare neoplasm with poor prognosis. On the other side, double-hit lymphomas with BCL2 and MYC translocation are characterized by advanced disease stage, extranodal and central nervous system involvements at presentation or disease progression. Case report. We reported a 73-year-old male patient with double-hit primary adrenal lymphoma and preserved adrenal function, showing a favorable clinical course. Computed tomography of abdomen showed a 9 7 cm mass of the left adrenal gland. Laparatomy with left adrenalectomy was done and histological examination revealed diagnosis of a diffuse large B-cell NHL (DLBCL), non-GCB subtype. The patient was treated with 6 cycles of R-CHOP chemotherapy with reduced doses of doxorubicin because of the decreased left verticle ejection fraction. The patient was followed up regularly for 20 months with no evidence of tumor recurrence despite the inherently poor prognostic profile and double-hit phenotype of the disease. Conclusion. R-CHOP chemotherapy in combination with adrenalectomy can be an effective first-line regimen for primary adrenal DLBCL, despite the inherently poor prognostic profile (non-GCB subtype, bulky disease, elevated lactate dehydrogenase and double-hit phenotype of the disease)

Malignant Neoplasms of Respiratory and Intrathoracic Organs (C30-C39) in the Osijek-Baranja County, Croatia

The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of respiratory and intrathoracic organs (C30-C39). The aim of this article was to show the size of cancer problem with the C30-C39 cancer group in the Osijek-Baranja County (OBC). This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in hospital collected in period 2001-2009. Out of all patients diagnosed with C30-C39 cancers, there were 18.2% of females and 81.8% of males. The total incidence rate in males (119.5/100,000) decreases while the total mortality rate (110.9/100,000) does not change in 9-year period. In the same period, the total mortality rate in females (15.7/100,000) increase moderately. The age-standardized incidence rate was six times higher in males than in females. The overall median age at diagnosis of C30-C39 cancers of both genders was 64.5 years, which exceeds the average age at diagnosis of cancer in general in the OBC by 4.8 years. Five-year relative survival rate was 14.8%, 19.7% for females and 13.7% for males. Male lung and bronchus cancer patients (C34) were 1 year younger at diagnosis of cancer than the respective female patients. An average C30-C39 cancer patient was hospitalized 2.0 times during the course of their illness while the median length of stay in hospital amounted to 16.1 days. The number of hospital admissions in both genders decreased over the 2001-2009 period. In both genders, the total length of stay in hospitals was slightly reduced. Females spent 0.4 days more in hospital than males. The overall incidence and mortality rate in the OBC were among the highest in Europe. However, these rates in females reached neither the Croatian nor the EU average. Other data are similar to those in Europe

PERSONAL CONSUMPTION MOVEMENT – CASE OF SELECTED EU MEMBERS

Osobna potrošnja najveći je makroekonomski agregat s velikim utjecajem na ekonomska kretanja i udjelom u BDP-u od oko 60 %. Cilj rada bio je utvrditi postoje li značajne razlike u kretanju i strukturi osobne potrošnje u Hrvatskoj i dvjema novim članicama EU-a, Češkoj i Rumunjskoj, te utvrditi obrasce promjena osobne potrošnje u promatranim državama. Analiza je potvrdila snažnu povezanost osobne potrošnje i BDP-a, a ta je veza donekle snažnija kod Rumunjske, gdje se smjer stopa promjena gotovo podudara. Navedeno potvrđuje osobnu potrošnju kao važnu kategoriju o kojoj treba voditi računa kod donošenja makroekonomskih politika. Analiza je također pokazala da je udio osobne potrošnje u BDP-u najmanji u Češkoj, što ukazuje na zaključak da postoje neki drugi pokretači češkog gospodarstva, prvenstveno investicije i neto izvoz. S obzirom na to da su Češka i Hrvatska male otvorene ekonomije koje su usporedive i po dostignutom stupnju razvoja, a imajući u vidu češki gospodarski rast koji je znatno viši nego u Hrvatskoj, može se zaključiti da je model gospodarskog rasta u Češkoj bolji i dugoročno održiviji. Oslanjanje gospodarskog rasta na osobnu potrošnju kao generator agregatne potražnje nije model koji može osigurati održiv rast BDP-a u Hrvatskoj, pogotovo u uvjetima smanjenja broja stanovnika. Stoga je nužno osigurati poticajan institucijski okvir za rast domaćih i inozemnih investicija te veću izvoznu orijentaciju.Personal consumption is the largest macroeconomic aggregate with a large impact on economic trends and a share of GDP of about 60%. The aim of this paper was to determine whether there are significant differences in the movement and structure of personal consumption in Croatia and the two new EU members - the Czech Republic and Romania and to establish patterns of changes in personal consumption in the named countries. The analysis confirmed a strong correlation between personal consumption and GDP, and this correlation is stronger in Romania, where the direction of these two rates of change almost coincides. The previous confirms personal consumption as an important category to be taken into account when adopting macroeconomic policies. The analysis, also, showed that the share of personal consumption in GDP is the smallest in the Czech Republic, suggesting that there are some other Czech economy drivers, primarily investment and net exports. Given that the Czech Republic and Croatia are small and open economies comparable to the level of development, and considering that the Czech economy growth is considerably higher than in Croatia, it can be concluded that the model of economic growth in the Czech Republic is better and more sustainable in the long run. The model of economic growth relying on personal consumption as a generator of aggregate demand is not a model that can ensure sustainable GDP growth in Croatia, especially in terms of population decrease. It is, therefore, necessary to provide a stimulating institutional framework for the growth of domestic and foreign investments and greater export orientation

SERUM BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF): THE SEVERITY AND SYMPTOMATIC DIMENSIONS OF DEPRESSION

Introduction: The aim of this study was to compare the concentration of serum Brain-derived neurotrophic factor (BDNF) in patients suffering from major depressive disorder (MDD) considering the severity of MDD episode defined by the Hamilton rating scale for depression (HAMD-17). The other aim was to research the connection between serum BDNF and the symptomatic dimensions of MDD. Subjects and methods: The study includes 139 participants with major depressive disorder (MDD). Diagnosis of MDD was set by DSM-IV-TR criteria. The severity of MDD was estimated with HAM-D-17 in the manner that mild episode was diagnosed if the score on HAMD-17 was up to 18, moderately severe 18-25 and severe over 25. Concentration of BDNF was determined by the ELISA method. Results: This research could not find a difference in BDNF concentration considering the severity of the depressive disorder in groups suffering from mild, moderately severe and severe episodes of MDD (F=1.816; p=0.169). Factor analysis of HAMD-17 extracted four dimensions of depressive symptoms. None of the symptomatic dimensions was significantly related to BDNF concentration. Conclusion: Results of this study indicate that serum BDNF levels are not related to the severity of depression and its specific symptomatic dimensions. These findings support the idea of a complex relationship between BDNF concentration at the periphery and in the CNS