The Croatian Health Survey – SF-36: I. General Quality of Life Assessment

The objective of the Croatian Health Survey was the assessment of population health related quality of life in the transitional enviroment of Croatia. Health status measures incorporate dimensions such as physical, psychological, and social functioning, role performance and perception of wellbeing. In order to assess health status, »The medical outcome study 36-item short-form health survey (SF-36) model« was used. A total sample of 5048 inhabitants (1983 males and 3065 females), 18 years and over, represents approximately 1‰ of the general population of Croatia. Mean scores were as follows: physical functioning (PF) 69.94, role-physical (RP)63.01, bodily pain (BP) 64.51, general health (GH) 53.40, vitality (VT) 51.85, social functioning (SF) 72.96, role-emotional (RE) 72.42, mental health (MH) 61.71 and health transition (HT) 44.79. Results of the SF-36 health survey in Croatia are very much like the results in other European countries with indication that general quality of life is lower in Croatia

Attitudes, Behaviour and Knowledge on Sexuality among Female Adolescents in Zagreb, Croatia

The aim of this study was to estimate the level of knowledge about sexuality, attitudes and sexual behaviour of female adolescents. The study included 194 female students, 117 from Medical High School (MHS) and 77 from General High School (GHS) in Zagreb. Data was collected using an anonymous self-administered questionnaire. In addition to items on personal data (age, parental education etc.), the participants were asked to define terms about sexuality (e.g. menstruation, puberty) the definitions of which are found in biology textbooks for the fifth and eighth grade of primary school. The aim of the third part of the survey was to collect information about attitudes and behaviour of female adolescents. The results showed a low level of knowledge in students of both schools. General High School students showed a higher level of knowledge than their Medical High School peers. One fifth of General High School students and 1/3 of Medical High School students were unable to define the term »menstruation«. The majority of adolescents talk about sexuality with their friends, 92.1% of General High School and 81.2% of Medical High School students. Almost 50% of students of both schools would like to talk about sexuality with their school doctor. 6.9% of Medical High School students had at least one sexual intercourse while none of the General High School students had been sexually active at the time of the survey. As the majority of students were not sexually active and results showed a rather low level of knowledge, this seems to be the ideal period for the implementation of educational programs aimed at increasing the level of knowledge, and thus preventing unwanted consequences (STD, pregnancy, abortion, infertility)

School Choice and Vocational Guidance for Schoolchildren with Chronic Diseases and Other Health Problems

Osim praćenja rasta, razvoja i zdravstvenog stanja učenika tijekom školovanja, liječnik školske medicine razmišlja i o njihovu profesionalnom razvoju. Posebnu pozornost zahtijevaju učenici s kroničnim bolestima, kojih je prema istraživanjima 10 % do 15 %. Prije izbora zanimanja potrebno je upoznati roditelje i učenike s ograničenjima koja proizlaze iz prirode bolesti ili stanja. To omogućuje učenicima da razviju interes za zanimanja za koja nemaju kontraindikaciju. Sistematski pregled u osmom razredu osnovne škole procjena je učenikovih psihofi zičkih sposobnosti za nastavak srednjoškolskog obrazovanja. Tijekom pregleda provodi se profesionalno informiranje za sve učenike. Učenici s kroničnim bolestima, teškoćama u razvoju i drugim poremećajima zdravlja upućuju se na profesionalno usmjeravanje. Cilj ovog rada bio je prikaz razloga upućivanja na školsko i profesionalno usmjeravanje učenika osmih razreda, deset osnovnih škola iz Varaždinske županije, u razdoblju od školske godine 1998./99. do 2007./08. Od ukupno 4939 pregledanih učenika, na profesionalno usmjeravanje bilo je upućeno njih 458 (9,3 %). Najčešći razlozi upućivanja bili su bolesti i stanja iz skupine duševnih poremećaja i poremećaja ponašanja, sa zastupljenošću od 41,3 %. Preporuke stručnog tima za profesionalno usmjeravanje za daljnje školovanje nije slijedilo 10,5 % učenika. Za učenike s kroničnim bolestima i drugim poremećajima zdravlja bilo bi potrebno osigurati dovoljan broj upisnih mjesta u srednjim školama te kontinuirano pratiti njihov profesionalni razvoj radi intervencije u slučaju potrebe promjene škole i uvida u ishod obrazovanja. To bi se postiglo koordiniranim radom školskih liječnika, timova za profesionalno usmjeravanje, srednjih škola i županijskih upravnih odjela za prosvjetu, kulturu i šport.By following a child’s growth, development, and health, school medicine specialist can see opportunities for career choice. Special attention is needed for schoolchildren with chronic diseases and developmental difficulties, because of limited occupation choices. Studies report 10 % to 15 % prevalence of chronic diseases among schoolchildren. Parents and children should be informed about child’s limitations before career choice. It would be helpful for the students to develop interests for occupations that are not contraindicated for their condition. Physical examination gives an insight into the psycho-physical abilities of an eighth-grade primary school student for further education. During examination, counselling and vocational guidance is provided for all students with chronic diseases and other health problems. All procedures are oriented to personal abilities and preferences. The aim of this study was to analyse the reasons for vocational guidance in the Varaždin County of Croatia. It included eighth-grade students from ten primary schools from 1998/99 to 2007/08. Of 4939 students, 458 (9.3 %) with chronic diseases and health difficulties were referred to vocational guidance. Of these, 41.3 % were referred due to mental and behavioural disorders. These students were assessed and received a recommendation for at least two occupations. Forty-eight students (10.5 %) did not follow the recommendation. In a coordinated effort, school physicians, vocational guidance experts, and school and local authorities should secure enrollment of students with chronic diseases and health difficulties in secondary schools and follow their development and education to provide them the best available career opportunities

Subjektivna procjena kvalitete života (WHOQOL-BREFF) u odnosu na neuroticizam (Cornell index)

It is generally agreed that personality variables have a relatively consistent influence on the subjective estimation of different situations in everyday life and the way people react to them. The aim of this review was to summarise our previously published findings on the relationship between subjective estimation of one’s quality of life and the personality trait neuroticism-emotional stability. We used the WHO Quality of Life - BREF or SF-36 questionnaires for the assessment of the quality of life, Cornell Index for the assessment of neuroticism, and The Social Readjustment Rating Scale for the evaluation of common stressors. Our results have shown that more emotionally stable participants (lower neuroticism) perceive their life better in quality and are more satisfied with their work environment. In addition, our results support the findings from other studies that women have higher neuroticism and lower quality of life scores than men.Općenito se smatra kako varijable ličnosti imaju važnu ulogu u relativno dosljednom utjecaju na subjektivnu procjenu različitih situacija u svakodnevnom životu, kao i na reakcije na te situacije. Cilj ovoga preglednog članka bio je objediniti naše objavljene rezultate o odnosu između subjektivne procjene kvalitete života i crte ličnosti neuroticizam - emocionalna stabilnost. Upotrijebljeni su WHOQOL-BREF ili SF-36 upitnici za procjenu kvalitete života, Cornell indeks za procjenu neuroticizma i The Social Readjustment Rating Scale za evaluaciju uobičajenih stresora. Dobiveni rezultati pokazali su kako osobe s izraženijom emocionalnom stabilnošću (manjim neuroticizmom) percipiraju svoj život kvalitetnijim te su zadovoljnije svojom radnom okolinom. Također je u skladu s drugim objavljenim studijama nađeno kako žene postižu više rezultate na skalama neuroticizma od muškaraca te niže rezultate na upitnicima kvalitete života

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings