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Proposal for Improved Translation and Meaning of "Public Health" in the Republic of Macedonia

The translation and use of the term "public health" in the Republic of Macedonia creates confusions among students, professionals and the public. Its use and meaning in Macedonian language is associated more to the ownership over the healthcare system by the state, rather than to explain the primary goal and mission of public health to protect, promote and restore the health of the public. There is a need to clarify, change and standardize the use of this terminology in the Republic of Macedonia. Medical Faculty in Skopje should take leadership by introducing this change in the public health curriculum of the postgraduate studies.


Aim: Throughout 2004-2010, the series of 6 books entitled “Handbooks for Teachers, Researchers and Health Professionals” were published within the frame of the public health network established in South Eastern Europe (SEE), covering the total of 249 teaching modules. The aim of the study was to assess the use and exchange of these modules between the authors.

Methods: Out of 148 identified authors, 106 took part in the cross-sectional study carried out from July to November 2011 (response rate: 71.6%). The primary endpoints were the utilization (use and/or exchange) of the modules in general, the percentage of utilized modules from all volumes, the percentages of utilized modules of each volume separately, and the percentage of utilized modules from all the volumes at different levels of the educational process. Non-parametric statistical methods were used for analysis (e.g. Mann-Whitney and Friedman tests).

Results: Module utilization was reported by 80/106 participants (75.5%). The median value of the percentage of utilized modules from all the volumes was 4.8, being much higher among full-time university staff (9.2; p=0.008) and authors/editors (14.7; p=0.010). The respondents most frequently utilized Volume 1 (median value: 7.7) and Volume 6 (median value: 4.2) modules (p=0.002) as part of undergraduate (median value: 1.4) and postgraduate vocational (median value: 1.4) study programmes (p<0.001).

Conclusion: The level of module utilization within the group of their authors is good. However, this is only partial information and not representative of the entire target population of SEE public health teachers.



The aim of the study was to analyse the deviations of the body posture and to assess the occurrence of spine deformities. Additionally, Body Mass Index in school children was related to the trend in postural deformities for different age groups (5-8 years old, n=112; 9-11 years old, n=205; 12-14 years old, n=212) as part of the project “Spine Lab”, granted from the European Commission IPA founds, investigating the importance of public health issues.


Body posture was measured using Contemplas 3D software analyser, based on video image trajectory and BIA weight scale (Tanita BC 420). Overall, 17 variables were assessed, and differences were confirmed using MANOVA analysis.


The results showed that there is a significant difference between age groups for the measured variables (F=9.27; p<0.01; η2=0.26), suggesting a moderate difference across the age span.


The study results showed that there is a negative trend of increasing Body Mass Index within the first and youngest age group. The fact is that the trend of increasing deformity of the shoulder belt has been noted, often inclining towards the formation of milder forms of kyphotic posture. Other forms of deformity that are accentuated in the survey results are the negative trend of increasing pelvic rotation and pelvis rotation which inclines towards the formation of lordotic posture for all three age groups.


Background: The prevalence of overweight and obesity among children has increased dramatically in recent decades. The survey examined overweight and obesity in the population of boys and girls from Ljubljana, the capital of Slovenia, aged seven through fourteen from 1991 to 2011.

Methods: An annually repeated cross-sectional study of data from the national SLOFIT monitoring system was used. The body mass index cut-off points of the International Obesity Task Force were used to identify the prevalence of overweight and obesity. Multinomial logistic regression was used for modelling the probability of overweight and obesity as a function of time (year of measurement), sex and age of subjects.

Results: In 1991-2011 period, the odds for overweight and obesity among primary school children (n = 376,719) increased every year by 1.7% (95% CI: 1.6-1.9) and 3.7% (3.4-4%) respectively. Boys have 1.17 (95% CI: 1.15-1.20) times higher odds of becoming overweight and 1.39 (95% CI: 1.35-1.44) times higher odds of becoming obese than girls. In comparison to the reference group (age of 14), the highest odds for overweight were found at the ages of nine and ten (1.39; 95% CI: 1.34-1.44), while for the obesity the highest odds were at the age of eight (2.01; 95% CI: 1.86-2.16).

Conclusion: From 1991 to 2011, overweight and obesity clearly became more prevalent in children from Ljubljana. This trend has been more obvious among boys than girls. In comparison to 14-year-old boys and girls, the highest odds for excessive weight were found below the age of 10.


Introduction: Diabetes prevalence and costs are rising on aglobal scale. Therefore, it is necessary to periodically conduct cost studies for assessing the healthcare burden impact. In Slovenia, the last type 2 diabetes cost assessment was conducted in 2006, not including all diabetes complication costs. The aim of this study was to revise, update and compare to previously published datadirect healthcare costs of type 2 diabetes in Slovenia with additional complications costs consideration.

Methods: The study was performed from the healthcare payer perspective using the bottom-up approach, was prevalence based and estimated direct medical costs.

Results: We estimated total yearly direct medical costs of type 2 diabetes in Slovenia to 99,120,419 euro with annual per capita costs of 834.70 euro. The highest cost shares were attributed to cardiovascular complication costs (21,683,919 euro), diabetes co-medication (20,977,269 euro) and diabetes treatment medication (18,505,015 euro). Highest yearly costs per complication (all cases, all occurrences) were estimated for dialysis I and III (9,162,635 euro), stroke first year costs (4,951,306 euro) and congestive heart failure first year costs (4,879,533 euro). Yearly per one patient, the complication costs were highest for kidney transplantation, followed by dialysis I and III (78,621.25 euro and 36,797.73 euro)

Conclusions: In comparison to the costs published in the literature before, our estimated total yearly direct medical costs were comparable, although annual per capita costs were assessed lower than elsewhere. Further, regarding the complication costs estimations, our assessed expenses were comparable to those published in other countries.

Dostopnost in Izvajalci Primarnega Reproduktivnega Zdravstvenega Varstva Žensk v Sloveniji v Letu 2010

Izhodišča: V zadnjih letih je civilna družba že večkrat opozorila na slabo dostopnost primarnega reproduktivnega zdravstvenega varstva v Sloveniji. Ker je primarno reproduktivno zdravstveno varstvo izjemnega pomena za reproduktivno zdravje žensk, smo analizirali razpoložljivost zdravstvenega osebja in dostopnost reproduktivnega zdravstvenega varstva žensk.

Metode: Uporabili smo podatke Zavoda za zdravstveno zavarovanje Slovenije o številu in zasedenosti izvajalcev primarnega reproduktivnega zdravstvenega varstva ter podatke o starostni strukturi izvajalcev, ki izhajajo iz Baze podatkov izvajalcev zdravstvene dejavnosti Inštituta za varovanje zdravja. Podatke o sprejemanju novih pacientk smo pridobili s pomočjo telefonske ankete med izvajalci primarnega reproduktivnega zdravstvenega varstva.

Rezultati: V Sloveniji je v letu 2010 izvajalo primarno reproduktivno zdravstveno varstvo 137 ginekoloških timov. En tim je pokrival povprečno 4.941 opredeljenih žensk ob povprečni 74,5-odstotni opredeljenosti. Anketiranje je pokazalo, da so nove pacientke sprejemali v 46 izmed 53 zdravstvenih domov, pri 29 izmed 43 anketiranih zasebnikov s koncesijo ter v 12 izmed 14 bolnišnic. Povprečna starost slovenskih ginekologov, ki izvajajo dejavnosti primarnega reproduktivnega zdravstvenega varstva, je bila 52 let.

Zaključek: V vsaki statistični regiji v Sloveniji je na voljo vsaj nekaj izvajalcev primarnega reproduktivnega zdravstvenega varstva, ki še sprejemajo nove pacientke, pri čemer pa podatki naše ankete kažejo slabšo dostopnost kot podatki Zavoda za zdravstveno zavarovanje. V zadnjem desetletju lahko zasledimo večji obseg dejavnosti primarnega reproduktivnega zdravstvenega varstva v bolnišnicah na račun dejavnosti v zdravstvenih domovih in pri zasebnikih s koncesijo, kar s stališča dostopnosti za uporabnice ni najbolj ugodno. V Sloveniji moramo zato skrbno načrtovati mrežo primarnega reproduktivnega zdravstvenega varstva in zagotoviti čim večjo razpršenost ginekoloških timov po državi, tako da bo vsem ženskam omogočena dobra dostopnost dejavnosti primarnega reproduktivnega zdravstvenega varstva.



To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population.


A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients’ data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile–version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL.


Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52–0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51–0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47–0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit.


OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients’ general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients’ OHRQoL as well as HRQoL.

: Nacionalni inštitut za javno zdravje, 2014: 53-62. 15. Korošec A. Metodologija analize rezultatov. In: Tomšič S, Kofol Bric T, Korošec A, Maučec Zakotnik J, editors. Izzivi v izboljševanju vedenjskega sloga in zdravja: desetletje CINDI raziskav v Sloveniji. Ljubljana: Nacionalni inštitut za javno zdravje, 2014: 63-72. 16. Tomšič S, Kofol Bric T, Korošec A, Maučec Zakotnik J, editors. Izzivi v izboljševanju vedenjskega sloga in zdravja: desetletje CINDI raziskav v Sloveniji. Ljubljana: Nacionalni inštitut za javno zdravje, 2014. 17. Nacionalni inštitut za javno zdravje

Health Organization, 2008. Premik M. et al. Slovenska šola za javno zdravje. Ljubljana: Univerza v Ljubljani, Medicinska fakulteta, 2004. Rohregger B. et al. Neenakosti v zdravju v Sloveniji: izsledki misije Svetovne zdravstvene organizacije za hitro oceno socialnih determinant zdravja in neenakosti v zdravju. Ljubljana: Svetovna zdravstvena organizacija, 2010.

275 JOINT ACTION CANCER CONTROL Marjetka JELENC1,*, Tit ALBREHT1 1 Nacionalni inštitut za javno zdravje, Trubarjeva 2, 1000 Ljubljana, Slovenija Prispelo/Received: 11. 6. 2014 Sprejeto/Accepted: 16. 6. 2014 Pismo uredništvu/Letter to the Editor *Corresponding author: Tel: +386 1 2441 557; E-mail: Rakave bolezni predstavljajo veliko breme za družbo in so pomemben vzrok obolevnosti v Evropski uniji (EU). Do nedavnega je bil rak v državah EU drugi najpomembnejši vzrok smrti, takoj za srčno-žilnimi obolenji. Epidemiološka predvidevanja, da