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Open access

Irena Klavs, Mojca Serdt, Aleš Korošec, Tatjana Lejko Zupanc, Blaž Pečavar and

Abstract

Introduction

In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them.

Methods

Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors.

Results

Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3).

Conclusions

The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.

Open access

Vojko Strojnik and Branko Gabrovec

Abstract

Introduction

This paper aimed to review the effect of physical activity and exercise in frail older persons. As the process which leads to frailty and disability can be slowed down or even completely reversed, it can be appropriate for early interventions.

Methodology

A literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published from 2002 to 2017. From 620,043 initial hits, 25 publications were selected.

Results

Physical activity and exercise in frail elderly are effective and relatively safe and may reverse frailty.

Conclusion

Different exercise interventions in frail elderly persons can increase strength and power, improve balance and reduce fall incidence resulting in greater quality of life. From this perspective, physical exercise interventions should become daily routine in frail elderly persons.

Open access

Sanela Slavkovic, Spela Golubovic, Matilda Vojnovic and Congor Nadj

Abstract

Introduction

Multiple sclerosis (MS) results in a wide range of disabilities. The effects of cognitive and motor dysfunctions are significant and affect level of functioning in people with MS.

Objective

The aim of the research was to determine the common contribution of neurological, motor and cognitive status to the overall functioning of MS patients.

Method

The sample consisted of 108 subjects with RRMS. The instruments used in the research included: The General Questionnaire, the World Health Organization Disability Assessment Schedule, the Audio Recorded Cognitive Screen, Paced Auditory Serial Addition Test, the Nine Hole Peg Test, the 25 Foot Walk Test, and the Expanded Disability Status Scale.

Results

Subjects with a mild neurological deficit had a higher level of current functioning in all domains (a lower WHODAS 2.0 score) than subjects with a moderate neurological deficit (r=0.43, p<0.001). We found a positive correlation between the level of cognitive impairment and motor deficits of both upper and lower extremities and the level of neurological deficit (p<0.001). Subjects with lower neurological deficits had significantly lower WHODAS 2.0. scores, i.e. better motor abilities of both upper and lower extremities than subjects with moderate neurological deficits (p<0.001). The greatest contribution to explaining the overall level of current functioning of people with MS had subjects’ age, cognitive abilities and motor abilities of the upper extremities.

Conclusion

Inverse relationship of neurological, motor and cognitive status affects the overall daily functioning of people with MS, requiring planning of comprehensive programs in the rehabilitation of people with MS.

Open access

Mirjam Rogl Butina, Igor Švab, Barbara Perić and Igor Bartenjev

Abstract

Introduction

Most data related to cutaneous melanoma survivors’ health behaviour comes from epidemiological studies and is predominantly concerned with safe-sun behaviour and self-examination. Data regarding other changes of health behaviour are scarce and so are qualitative studies in this realm. The aim of our research is to acquire insight into the experiences of patients with cutaneous melanoma in Slovenia. How did they react to the diagnosis, which changes did they introduce in their health behaviour and how do they assess the role of family doctors?

Methods

Using the qualitative approach of collective case reports, a demographically diverse group of patients with different forms and stages of cutaneous melanoma was selected. Semi-structured interviews conducted by a psychologist were recorded and transcribed verbatim. For data processing, the approach of Qualitative Content Analysis was applied.

Results

We integrated interviewees’ experiences after the diagnosis of cutaneous melanoma in several subcategories: either they did not introduce any changes or they mentioned changing their habits when exposed to the sun and performing skin self-examination; they also emphasized their ways of dealing with stress and raising awareness about melanoma among family members and friends. The role of family doctors in the prevention and care appears unclear; even contradictory.

Conclusion

We obtained insight into the experiences of Slovenian patients with cutaneous melanoma. The interviewees prioritised safe behaviour in the sun, strengthening of psychological stability and raising awareness about melanoma. Findings will be used in the creation of a structured questionnaire for national epidemiological survey.

Open access

Eva Dolenc and Danica Rotar-Pavlič

Abstract

Background

The increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today’s problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world.

Methods

Documents published after 2010 were searched for in the PubMed database using keywords and other specific criteria.

Results

A total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly.

Conclusions

None of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.

Open access

Monika Korenč, Katja Štern, Ivan Verdenik and Miha Lučovnik

Abstract

Objective

To determine the usefulness of a novel classification of indications for caesarean section (CS) in labour in recognizing differences in clinical practice in different maternity units.

Methods

Data from the National Perinatal Information System (NPIS) for 2013 and 2014 were used to classify indications for CS in nulliparous women with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses within 14 Slovenian maternity units into foetal distress and different sub-groups of dystocia according to use and dosage of oxytocin. Chi-square test was used for statistical comparison between units (P≤0.05 significant).

Results

There were 13,572 deliveries and 1,567 (12.0%) CS in nulliparous patients with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses in Slovenia during the study period. Rates of CS in this group of women differed significantly among different maternity units (from 4.1% to 20.9%; P<0.001) suggesting significant differences in clinical practice. The most common indication for CS was cephalopelvic disproportion, which was diagnosed with different frequency in different units (from 11.2% to 45.9%; odds ratio 6.72; 95% confidence interval 3.10– 14.71; P<0.001).

Conclusions

It is possible to use NPIS data to retrospectively classify indications for CS. Such classification reveals significant differences among maternity units and could allow for a meaningful analysis of CS rates in different hospitals leading to evidence-based initiatives to decrease the incidence of primary CS.

Open access

Biljana Stern, Gregor Socan, Ksenija Rener-Sitar, Andreja Kukec and Lijana Zaletel-Kragelj

Abstract

Aim

To validate the Slovenian version (SOC-13-SVN) of Sense of Coherence 13-item instrument (SOC-13) in Slovenian multiple sclerosis (MS) patients.

Methods

A consecutive 134 Slovenian MS patients were enrolled in a cross-sectional study in 2013. The reliability of the SOC-13-SVN was assessed for internal consistency by Cronbach’s alpha coefficient (α), dimensionality by the confirmatory factor analysis (CFA), and criterion validity by Pearson correlation coefficient (r) between SOC-13-SVN global score and MSQOL-54 composite scores – Mental Health Composite score (MHC) and Physical Health Composite score (PHC).

Results

For the SOC-13-SVN instrument as a whole, internal consistency was high (αtotal=0.88) while it was low for three subscales (αcomprehensibility=0.79; αmanageability=0.66; αmeaningfulness=0.69). The results of the CFA confirmed a three-factor structure with good fit (RMSEA=0.059, CFI=0.953, SRMR=0.065), however, the correlations between the factors were very high (rcomprehensibility/manageability=0.938; rcomprehensibility/meaningfulness=0.811; rmanageability/meaningfulness=0.930). The criterion validity analysis showed a moderate positive strength of relationship between SOC-13-SVN global score and both MSQOL-54 composite scores (MHC: r=0.597, p<0.001; PHC: r=0.437, p<0.001).

Conclusion

Analysis of some psychometric properties confirmed that this instrument is a reliable and valid tool for use in Slovenian MS patients. Despite the three-dimensional structure of the instrument, the use of the global summary score is encouraged due to the low reliability of the subscale scores and high correlations between them.

Open access

Andrijana Milošević Georgiev, Jelena Kotur-Stevuljević and Dušanka Krajnović

Abstract

Background

Smoking rates in Serbian adults are among the highest in Europe. The objective of this study is to assess the prevalence of smoking and smoking-related behaviours of Belgrade University students depending on their sociodemographic characteristics and faculty group.

Methods

A cross-sectional study was carried out among 2,608 Belgrade University students (59.6% female) in 2015. A self-administered questionnaire was applied to the opportunity sample to collect the data describing students’ smoking habits and attitudes across all 30 faculties of the university.

Results

30.5% of students reported smoking: 26.4% of medical, and 31.1% of non-medical ones. Smoking rate among female students was 31.2% vs. 29.5% among males. Age (p=0.001), relationship (<0.001) and employment status (p=0.002) had statistically significant influence on smoking status, while the differences in smoking status between genders (p=0.141) and medical and non-medical group of students (p=0.066) were not statistically significant. The highest percentage of students started smoking during high school (66.2%). As the most common reason to start smoking, respondents cited peer influence (36.5%). 44.3% of students who smoked unsuccessfully tried to quit smoking.

Conclusion

To combat high smoking prevalence among a younger population, the formal education of students about the adverse impacts of smoking should be integrated in all active anti-smoking programs. Medical students, as future healthcare professionals, can play an important role in smoking rates reduction among both younger and general populations, if properly trained and educated about smoking prevention and cessation techniques.

Open access

Davorina Petek, Ambrož Pušnik, Polona Selič, Eva Cedilnik-Gorup, Žan Trontelj, Marine Riou and Jean Yves Le Reste

Abstract

Introduction

Therapeutic alliance is a term most commonly associated with psychotherapeutic treatment, but recently its use has become increasingly significant in the other fields of medicine. An increasing amount of evidence implies that the quality of the therapeutic alliance between the doctor and patient substantially affects treatment outcomes. A European consensus chose the Working Alliance Inventory – Short Revised (WAI-SR) scale as the most efficient for European primary care. This paper presents the process of establishing the semantic and cultural equivalence of the two WAI-SR scales in Slovene.

Method

As a part of a larger international project, a group of four experts translated the two WAI SR scales (physician and patient versions) from English into Slovene. Twenty-six Slovenian family medicine doctors participated in the process of obtaining semantic, idiomatic, experiential and conceptual equivalence in translation using a Delphi consensus procedure. Afterward, a cultural equivalence was made to adapt the translations within the national context.

Results

Agreement on translation was achieved after two Delphi rounds. The back-translation and cultural equivalence were accomplished without major problems, with some minor additional linguistic corrections.

Conclusion

A Slovene version of the WAI-SR scale was successfully adapted and is available for further scale validation and research on therapeutic alliance.

Open access

Ana Cristina Ferrão, Paula Correia, Manuela Ferreira and Raquel P. F. Guiné

Abstract

Introduction

A healthy diet is crucial for the maintenance of health. Therefore, the aim of this work is to evaluate the perceptions towards a healthy diet among the participants with work or studies in areas related to diet and nutrition and those who did not.

Methods

Anonymous questionnaire data was collected in a cross-sectional study on a non-probabilistic sample of 902 participants living in Portugal.

Results

The results showed that the participants’ perceptions were, in general, compliant with a healthy diet. However, significant differences were found between gender (p=0.004), between the different civil state groups (p=0.016), between the participants who were responsible for buying their own food and those who were not and also regarding the living environment. The variable area of work or studies also showed significant differences (p=0.001), so that people who had work or studies related to agriculture obtained a higher score. Regarding this variable, the mean values of nutrition and agriculture areas were not statistically different between them, but were statistically different from the mean values of psychology and health areas. The participants who had work or studies in areas showing diet and nutrition-related issues achieved a higher mean score (0.72±0.35) when compared to the participants who did not (0.58±0.30).

Conclusion

However, despite the results, it is important to continue developing campaigns that better communicate nutritional aspects, so that people can increase their knowledge on this subject.