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Utilising a Skin Prick Test for the determination of the presence of allergic rhinitis in divers

Abstract

Allergic rhinitis occurs in various regions of the world and affects from 10 to 40% of the population. The skin prick test is the “gold standard” for the detection of type I allergic diseases according to the Gella and Coombs classification, which is mediated by IgE. For our experiment, skin prick tests were performed on 60 divers aged between 30 and 40 years of age. The following tests for airborne allergens were used: tests for pollen from trees, grasses, cereals, weeds, proteins from house dust mites, animal hair and epidermis, and moulds. On the basis of an interview and a positive skin prick test allergic rhinitis was diagnosed in 17 divers.

Conclusions:

  1. Allergic rhinitis can cause health problems in divers and be the cause of diving accidents.
  2. The application of the skin prick test during the health qualification in the Military Maritime Health Commission, would allow the exclusion of diver candidates suffering from allergies.

Open access
Analysis of 22 years of surveillance for prion diseases in Slovenia, 1996 to 2017

Abstract

Introduction

The objective was to present the results of surveillance of prion diseases in Slovenia that was established in 1996 and then to assess the interdisciplinary approach according to the algorithm of case management and reporting data to the National Register at the National Institute of Public Health.

Methods

A descriptive study of Creutzfeldt-Jakob disease (CJD) recorded in the period from 1996 to 2017 was carried out.

Results

A total of 123 cases of prion disease were notified between 1996 and 2017. Out of these, 68 were recorded and confirmed by autopsy as sporadic CJD with an average incidence rate of 1,5 cases per million population per year. In one case a gene analysis showed mutation E200K in prion protein gene, PRNP. Two cases of the Gerstman-Sträussler Scheinker syndrome and one clinical case of fatal insomnia with new PRNP mutation, N181S, were notified. Diagnostic value of protein 14-3-3 analysis in the liquor reached 82% sensitivity and 71% specificity. 25 cases of notified clinically possible/probable CJD were disproved after autopsy. In eleven notified possible CJD cases the autopsy had not been performed. Variant CJD has not yet been proven in Slovenia.

Conclusion

Incidence rates were comparable with other European countries. Completeness of reporting and proper management of CJD cases according to the algorithm of reporting, management and case confirmation would need some improvement. A well-functioning surveillance system, including timely notifications, would enable an appropriate epidemiological investigation and an effective response to public health risks, thus the awareness of prion diseases should not decline.

Open access
Correlation between the DAI and ICON indices used for assessment of orthodontic treatment need in Croatian schoolchildren

Abstract

Introduction

The aims were: evaluation of the correlation between the Dental Aesthetic Index (DAI) and Index of Complexity, Outcome and Need (ICON); the assessment of orthodontic treatment need for schoolchildren in a population with two indices, separately for schoolchildren with mixed and permanent dentition; the estimation of the population share that could not receive orthodontic treatment because of the presence of caries and/or gingivitis.

Methods

A total of 2652 Zagreb school children (7 - 19 years old, 52.4% of them were females) completed a questionnaire regarding previous orthodontic treatment and the type of appliance used. Their oral cavity was also inspected. The DAI and ICON indices were used for the assessment of malocclusion prevalence.

Results

The subjects with mixed dentition had a greater need for orthodontic treatment, when compared to subjects with permanent dentition, when using the DAI index (p<0.001). When using the ICON index, 11.7% of subjects with mixed dentition had very severe malocclusion, as opposed to 5.8% of subjects with permanent dentition. The DAI and ICON scores correlated positively linearly (r=0.521; p<0.001). A higher prevalence of both gingivitis and caries was recorded more often in boys; caries more often in the group with the mixed dentition, and gingivitis in the group with permanent dentition (p<0.05).

Conclusion

The DAI and ICON indices have moderate agreement in assessment of malocclusion severity scores. One third of all schoolchildren with various degrees of both ICON and DAI indices have gingivitis, and half of them have caries.

Open access
Empirical evaluation of a conceptual model for the perceived value of health services

Abstract

Introduction

Perceived value and its antecedents and consequences have been claimed to be important in industries with higher customer involvement. The aim of this paper is therefore to empirically assess the conceptual model, with perceived service value as its central component. It also investigates how it affects loyalty and satisfaction, how it is influenced by its antecedents, and to compare with other studies investigating partial relationship between variables.

Methods

A total of 800 patients were enrolled in the main study, and the data was analysed using exploratory and confirmatory factor analyses. By modelling linear structural equations, we assessed reliability and established the convergent and discriminant validity of the questionnaire in the same way as in the pilot study.

Results

In the conceptual model for testing our hypotheses, we also included the relationship between patient satisfaction and loyalty. In this manner, the fitting of data to the model was significantly improved. After including the additional relationship, global fit indices had the following values: Chi-square=349.6 (sig.=0.00), df=143, RMSEA=0.05, NFI=0.96, CFI=0.97. All relationships between the constructs were statistically significant, thus confirming all our hypotheses.

Conclusions

The major conclusion of this paper is that an especially higher reputation and higher perceived service quality can contribute to perceived service value and therefore to more satisfied patients. The research approach has a few limitations. In the future, the model of perceived service value can be extended with variables such as emotions, patient trust, and commitment as well.

Open access
Outpatient antibiotic consumption for urinary infections in Croatia 2005 - 2014: What can be learned from utilization trends

Abstract

Aim

The aim of this study was to determine quantities of antibiotics used mainly or exclusively for urinary tract infections in Croatia between 2005 and 2014, to describe utilisation trends, and general consequences of antibiotic consumption on antimicrobial resistance.

Methods

Antibiotic utilisation data were obtained from annual reports of both the Croatian Drug Agency and Croatian Academy of Medical Sciences. Antibiotic consumption was expressed in DDD/1000 inhabitants/day (DDD TID). Antimicrobial resistance was analysed for E. coli, E. faecalis, E. faecium, P. aeruginosa, Klebsiella spp., P. mirabilis. Descriptive statistics were used to process data and calculate trends.

Results

Overall, utilisation of antibacterials decreased by 4.8% (from 3,35 to 3,19 DDD TID), while trends of individual agents varied substantially – from 87% decline for ceftibuten to 160% rise for levofloxacin. The consumption of quinolones increased by 32.3%. This was mostly due to increased ciprofloxacin consumption (144% raise). Sulfamethoxazole-trimethoprim declined by 57%, while nitrofurantoin increased by 86%. The use of fosfomycin was marginal. Antimicrobial resistance of E. coli increased against quinolones by 54.5%, and against nitrofurantoin by 2–3%. Quinolone resistance of other pathogens (Klebiella spp, Proteus mirabilis), increased variably – between 17.2% (Klebsiella) and 90% (Proteus), while for P. aeruginosa remained the same at 22%.

Conclusion

High rates of antimicrobial utilisation require prescribing restrictions and educational interventions. The increased use of fluoroquinolones is a potentially serious public health threat due to the rapid development of resistance among uropathogens. This threat can be avoided by greater use of nitrofurantoin and fosfomycin.

Open access
Surgical site infections in Slovenian acute care hospitals: Surveillance results, 2013–2016

Abstract

Introduction

The objective was to present the results of the Slovenian National surgical site infections (SSIs) surveillance system from 2013 to 2016 and to compare them to the reference data for the European Union (EU) and European Economic Area (EEA) countries.

Methods

Surveillance was conducted according to the Slovenian protocol consistent with the European Centre for Disease Prevention and Control protocol. Descriptive analyses were performed.

Results

Data were collected for 1080 patients of whom 57.4% were patients with cholecystectomy (from three hospitals), 29.0% with caesarean sections (from four hospitals) and 4.7%, 4.5% and 4.4% patients with hip prosthesis, knee prosthesis and colon surgery (each surgical category from one hospital). The pooled in-hospital SSI incidence density for caesarean section was 3.7 (95% CI: 1.4-8.1; inter-hospital range: 0.0–11.5) and for cholecystectomy 6.8 (95% CI: 3.5-11.9; inter-hospital range: 4.1–11.9) per 1000 post-operative patient-days. The in-hospital SSI incidence density for colon surgery was 24.8 (95% CI: 12.5-44.0) and for hip prosthesis 2.6 (95% CI: 0.1-14.2) per 1000 post-operative patient-days. No SSIs were reported among the 49 patients with knee prostheses.

Conclusions

The estimated SSIs incidence rates varied between different surgical categories and the different participating hospitals. In some of the participating hospitals and for some of the surgical procedures under surveillance they were rather high in comparison to the reference data for hospitals from EU/EEA countries. It is urgent to expand standardised SSIs surveillance to all Slovenian acute care hospitals with surgical wards to contribute to evidence-based SSIs prevention and control in Slovenia.

Open access
Validation of the Slovenian version of motor imagery questionnaire 3 (MIQ-3): Promising tool in modern comprehensive rehabilitation practice

Abstract

Purpose

The high rate of injury incidence and its severity is estimated to cause approximately 9% of global mortality, while a large proportion of people surviving their injuries experience temporary or permanent disabilities. To reduce the occurrence of disability and improve general health of survivors, a more comprehensive rehabilitation approach is needed. Motor imagery is recognized as the promising cognitive strategy to counteract impaired functional capacity of the neuromuscular system. Thus, we aimed to provide to the Slovenian-speaking community a valid and reliable version of Motor Imagery Questionnaire – 3 [MIQ-3], that consists of kinaesthetic imagery [KI] and visual [i.e., Internal Imagery [IMI] and external imagery [EVI]] items.

Methods

We investigated both absolute and relative test-retest repeatability; construct validity and internal consistency of the KI, IMI and EMI items of the Slovenian version of MIQ-3 in 86 healthy adult subjects.

Results

Results showed high to very high average intra-class correlation coefficient [ICC] for the visual items [ICC=0.89] and KI items [ICC=0.92], whilst the measure of absolute variability presented as coefficient of variation [CV%] ranged from 4.9% [EVI] to 6.7% [KI]. The internal consistency was satisfactory [Cronbach α=0.91 [KI] and 0.89]) for both visual items. Confirmatory analysis confirmed a two-factorial structure of MIQ-3.

Conclusion

Understanding the content of the questionnaire is of utmost importance to ensure its effectiveness in rehabilitation practice. The Slovenian translation of the MIQ-3 is culturally and linguistically equivalent to the original English version.

Open access
Work-Related stress factors in nurses at Slovenian hospitals – A cross-sectional study

Abstract

Background

Surveys conducted among healthcare workers revealed that nursing staff often face various stressors associated with occupational activities, which reduce their work efficiency. The aim of the study was to establish the level of stress in nurses working at hospitals in Slovenia and to identify stress-related factors.

Methods

A cross-sectional epidemiological design and a standardized instrument called the “Nursing stress scale” were used. The sample included 983 nurses from 21 Slovenian hospitals. The research was conducted in 2016.

Results

Prevalence of high level of stress was 56.5% of respondents (M (median)=75). Prevalence of high level of stress and stress factors may be statistically significant attributable to dissatisfaction at work (p<0.001), disturbing factors at work (p<0.001), inability to take time off in lieu after working on weekend (p=0.003), shorter serving (p=0.009), fixed-term work (p=0.007), and an increased number of workdays on Sunday (p=0.030).

Conclusion

The stress rate and stress factors are substantially influenced by variables reflecting work organization, competences and skills of healthcare management to work with people. Results reflect the need for nursing management and policy makers to design strategies to ensure adequate staffing, efficient organization and an encouraging work environment.

Open access
Accidents Caused by the Difference in Air Pressure Inside the Diving Apparatus and the Water Surrounding the Diver

Abstract

This paper describes 4 unfortunate accidents caused by the difference in pressure inside and outside the diver’s suit. The issues relate to diver crushing, caisson disease, too fast an ascent to the surface and hypoxia as a result of exhaustion of oxygen in the diving apparatus are explained. The mechanism of the diving injuries was analysed and methods of prevention of such incidents were suggested.

Open access
Description of the Adsorption Equilibrium with Consideration to the Decreasing Availability of Space in the Course of Mobile Adsorption of a Single Gas on a Homogenous Surface of Solid

Abstract

The subsequent stages of the process of formulation of the equation for gas adsorption on a homogenous surface of a solid adsorbent were presented based on the general expression for the canonical ensemble of the mobile single-component adsorption monolayer. The method of formulating the configuration integral of the proposed model was discussed in detail where the role both of the attraction and repulsion between adsorbed molecules was emphasised. The expression for the probability of finding a molecule in a specified point on a surface of an adsorbent was modified by determining its magnitude by the adsorbent concentration. The expression for the so-called effective surface of the adsorbent was obtained by adapting a two-dimensional analogue equation of state hard spheres – Van der Waals equation (2D-vdW) and Reis-Frisch-Lebowitz equation accordingly (2D-RFL). As a result, two new adsorption equations were formulated which differ in detail concerning the adsorbate-adsorbate repulsion. On each of these equations theoretical analysis was performed in terms of two-dimensional phase transformation. In both cases it was proved that the proposed solution allows for the presence of two-phase transformations of the first type which is the gas-liquid condensation and solidification liquid-solid. The verification of the given approach was supplemented by the description of the experimental data given in reference literature and by obtaining a very good correlation between the theory and experiment.

Open access