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Osteoporosis (OP) is nowadays considered one of the most important health care problems due to its frequency and due to medical and socio-economic consequences of its major complications, fragility fractures. The Global burden of OP has not been completely described yet, but the most recent data regarding incidence, morbidity, mortality and costs of these fractures resulted in a considerable increase of interest towards its prevention. Establishing proper prophylactic measures requires an organized social intervention, at several levels, focused on health care providers, but including a complex network of institutions and structures. One of the key points for an early effective intervention refers to improving the knowledge of the potentially exposed persons, so that they could actively be involved in prophylaxis. This paper analyses the degree of awareness regarding risk factors for OP in order to establish proper strategies able to decrease the incidence of this condition and, thus, its complications. Since the incidence of OP is maximal in post-menopause women, the target group was represented by women before 45 years old treated for non-osteoporotic fractures in a Level 1 Trauma Centre. This research showed that the risk factors are unequally known, that the primary health care services only partially fulfill their preventive and educational role and the compliance to medical recommendations is not proper. Therefore, future directions for decreasing the impact of OP can be established, targeting enhanced health education by stakeholders, as well as increased material resources from our society for prevention activities.
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Aim: The aim of this paper is to assess the available data sources on the trends of cardiovascular diseases (CVDs) and related risk factors in Bosnia and Herzegovina (BiH), in comparison with data from some of the neighbouring countries and the European Region average of the World Health Organization (WHO). Background: Mortality and morbidity from cardiovascular diseases in BiH are influenced by interaction of different socio-economic factors, metabolic and behavioural risk factors. Methods: Analysis of trends of CVDs mortality in BiH in the 2005-2014 period, with use of available data from the Agency for Statistics of BiH, entity Institutes for Public Health and the results of the population surveys conducted and analysed for BiH. Comparison of CVD mortality trends and risk factor exposure in BiH with the recent data for CVD trends in neighbouring countries and WHO average for the European Region. Results: The analysis showed that more than half of the population in BiH is dying from CVDs, while hypertension, overweight/obesity, lack of physical activity, alcohol and tobacco consumption contribute as main risk factors. CVD mortality and risk factor exposure are above the average of neighbouring countries and the WHO average for the European region. Conclusion: Emerging trends in morbidity and mortality from cardiovascular diseases are one of the major public health challenges in BiH. Preventive oriented health services, mainly at primary health care, should be supported by health promotion interventions directed towards whole population and groups under risk.
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AIDS is an example of the global threat. In my article I would like to present the most important ethical dilemmas related to global outspreading of AIDS/HIV epidemic in the world and also make an attempt of finding a possible solution. I assume that the dilemmas could be described in three basic dimensions: The first discussed ethical problem is related to treating sick people by the healthy people. We observe the discrimination of people suffering from AIDS/HIV and it stands in opposition to Christianity and Church which commands to accept sick people, to respect and help them. The second discussed aspect concerns ethical challenges that modern medicine must face regarding the outspread of AIDS and HIV. On one hand, medical stuff who have contact with blood must incessantly confront their fear of infection with duty of helping people and providing medical care. On the other hand, medical professionals may encounter the moral dilemma how to keep medical records in secret and protect interests of people who are exposed to infection. The last important ethical dimension of global AIDS epidemic and other civilisation illnesses, which has been recently observed, is the polarization of the world in the field of health.
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Independent mobility is significant for everybody’s quality of life; it is especially important for people with disabilities. This article presents ergonomics guidelines for adapting individual cars to meet the needs of drivers with disabilities and their passengers. The solutions have been described for individual cars and for universal cars for transporting any user of a wheelchair. This article ends with a confrontation of the guidelines with the principles of ergonomics.
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Emergency Medicine in Poland has changed a lot in the last ten years. Social awareness and knowledge about first aid have developed due to implementation of Emergency Medical System law and the increasing prevalence of formal and informal first aid education. Elementary knowledge about providing first aid in emergencies and the Emergency Medical System was surveyed among university students after first aid education.
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Intussusception is based on a telescopic movement of the proximal into thedistal part of the intestine, leading to compressions of the proximal mesenteric vessels.The consequence of this process is often necrosis, leading in turn to bowel perforation,peritonitis, and septic shock.
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Introduction: In urogynecology, both in subject literature and in clinical work, different systems for the assessment of pelvic organ prolapse are used. The lack of standardization causes difficulties in treatment planning and in the evaluation of the effectiveness of applied surgical methods. The most commonly used scale is the POP-Q System which describes the severity of the prolapse without taking the type of defect into account. On the other hand, the clinical classification by De Lancey defines the type of defect but does not take its severity into account. The latter classification system also does not include cystocele with apical defect. Material and methods: The authors examined 96 patients presenting for advice of treatment due to symptomatic pelvic floor disease. A new, standardized method of urogycological examination was implemented. The evaluation included the type of defect and its severity at all three pelvic floor levels. Results: This method of examination allowed the identification of both already known cystocele with middle and lateral defects, as well as not yet described cystocele with apical and mixed defects. Conclusions: The authors propose a new, standardized method of urogynecological examination which assumes the simultaneous application of the POP-Q System and the modified classification of lower pelvic organ prolapse by De Lancey which also describes the impact of level I defects (apical defects) on level II prolapse. It seems that this approach allows for more effective planning of urogynecological procedures, while reducing the rate of recurrence.
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Introduction: HBV and HCV are among the most common causes of viral hepatitis. Chronic forms of infection may lead to liver cirrhosis and hepatocellular carcinoma, and therefore death. From the literature it shows that the young generation does not have the right amount of knowledge on the subject, and lack of awareness of infection with HBV and HCV creates conditions for uncontrolled transmission of these viruses. The purpose of this study was to assess hepatitis B and C knowledge among secondary school students’. Material and methods: The study was conducted among the students enrolled in a upper secondary schools (N=250). In order to gather information a personal questionnaire was used. Statistical analysis was performed with Mann-Whitney U test, the Kruskal-Wallistest, Pearson correlation coefficient. P-values less than 0.05 were considered statistically significant. Results: The largest percentage of respondents (54%) was characterized by a low level of knowledge about hepatitis B and C. Students are not aware that hepatitis is an infectious disease and viruses, HBV and HCV can survive outside the human organism. They do not know whether they were vaccinated against hepatitis B and mistakenly believe that there is a vaccine against HCV. Only 4% of the students showed a high level of knowledge on the subject. Indeed, more knowledgeable students are female (p=0.006) and rural residents (p=0.024). The main source of information is the Internet (55% of responses). Conclusions: General knowledge of secondary school students about hepatitis B and Cis low. Students’ knowledge is determined by the gender and place of residence, and its main source is the Internet.
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Participants of the failed Reform of the Judiciary from the Government and Non-Government sectors indicate the existence of fear among judges and prosecutors, but does not offer a clear answer to the causes of the condition. This paper investigates the role of the academic community and intelligence agencies in the Security System Reform (SSR), i.e. their intervention in the Criminal Justice System. The subsequent problems in the reform of the Serbian Justice System could be explained by “politicization and ideologization of human rights that usually comes from methalegal sources of power – political, economic or military (which) (…) arbitrarily usurp right to control (…) human Rights and apply the so-called double standards (…) Intention of the author of this paper is to initiate awareness of mental pollution and its attachment to Human Rights to Life and a Healthy Life” [1]
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This paper deals with the results of findings on the fundus at 226 patients with hypertension in relation to the height of diastolic pressure and the age of a patient and the changes on the fundus during therapy. The finding on the fundus is one of the most important findings in the evaluation of difficulty of Arterial hypertension. With the increase of diastolic pressure, the severity of changes on the fundus also grows. Beside diastolic pressure, duration of hypertension and age of patient play an important role.
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One of the most important interests of each society is to establish the highest level of occupational safety and health, with the aim of minimizing all adverse effects: injuries at work, occupational diseases, work-related illnesses. The ultimate imperative is the creation of such workplace conditions where the employee would have a sense of satisfaction in performing the assigned professional tasks. One way to achieve this ambitious goal is to have a legal regulation that creates a platform for effective occupational safety. This paper analyzes the legislation on occupational safety and health in the Republic of Serbia and the Republic of Montenegro. By comparing these two legal systems in the field of occupational safety and health, we will discuss the advantages and deficiencies of each, and provide some ideas for their improvement.
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This article provides an overview of the problems and challenges that arise in the field of public health in Poland. In the first part it discusses general issues, i.e. the definition of public health, its essential operations according to WHO and core services, as well as public spending on preventive services. Next, it examines some aspects of the public health practice, with special attention given to planning, evaluation and good practices, as well as recommendations for public health capacity improvements. The author claims that it is necessary to standardize the terminology and develop tools, standards and work protocols regarding public health.
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Medical documentation of 4680 patients of an individual nursing practice in Jarosław, Poland, was analyzed statistically. The inclusion criteria of the conducted research were patients age ≥60 years with type 2 diabetes diagnosed by a physician. The study patients were selected with the use of a diagnostic survey method, the authors’ own questionnaire, and medical documentation analysis. As a result, the study involved 170 patients. The chi-square test of independence and the Mann-Whitney test were applied to verify the differences between the variables. The majority of the studied patients were women (61.1%), in the 71–80 age group (57.6%). Irrespective of gender, diabetes was most often diagnosed in people in early senility, aged 60–70 years (62.9%). Most of the respondents received oral medications (59.4%); had a large waist circumference (92.9%), as well as high body mass index (95.3%). In the majority of the elderly, no hypoglycaemia (83.0%) or hyperglycaemia (77.6%) were recognized. However, numerous complications were diagnosed, namely dyslipidaemia (85.9%), hypertension (81.8%), macroangiopathy (90.0%), microangiopathy (71.2%), and ophthalmological diseases (25.9%). Most diabetics suffer from overweight or obesity, and long-term diabetes complications. Analyzing the incidence of diabetes and its complications should help to outline further actions that need to be taken to diagnose and prevent the disease in order to detect its complications early and prolong the patients’ survival as well as raise their quality of life.
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Background: Healthcare professionals have new challenges to deal with. Aim of the study: To reveal whether emotional intelligence could help healthcare professionals meet these new challenges. Material and methods: Literature review. Results: Emotional intelligence is seen as a valid strategy that can produce visible results. Conclusions: It has been shown that emotional competencies can be effectively developed. Healthcare professionals must take advantage of this to become more effective and successful in their professional growth.
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Background: Medical assistants/care coordinators play a crucial role in the coordinated care system. The tasks of nurses and some qualified supporting staff have been extended to include this role along with the implementation of the pilot program POZ Plus in Polish primary healthcare. A personalized approach to the patient is especially important during the implementation of large-scale prevention programs. Aim of the study: To assess who has the greatest influence on the patient’s decision to undergo screening colonoscopy and outline the current and potential roles of nurses in this process. Material and methods: This questionnaire-based study was conducted at the coordinated care facility Medical and Diagnostic Center (CMD) in Siedlce, Poland between March 1st and June 15th, 2017. Results: 138 patients participated in the study. The majority (75; 54.4%) reported they were directly convinced to undergo colonoscopy by a primary care physician. 18 (13.0%) were convinced by a nurse, and 22 (15.9%) by another specialist. The remaining (23; 16.7%) patients indicated other factors. The majority of patients (74; 53.6%) responded saying that all necessary information about the entire test course was provided by the nurse, while 35 (25.4%) shared that this information had come from the primary care physician, 8 (5.80%) from the specialist doctor, 3 (2.17%) from the receptionist and 18 (13.0%) from other sources of information, such as the Internet, leaflets and notice boards. Conclusions: We found that primary care physicians at this institution have an important role in convincing patients to undergo preventive colonoscopy, while nurses provide key information to patients on the preparation and the course of this procedure. Although the current model seems to be effective in a coordinated care setting, there may be still a place for nurse care coordinators to take on some tasks previously performed by doctors.
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Intestinal microflora is found at approximately 104 bacteria per ml of intestinal fluid. Although this ecosystem is very diverse with dynamic changes taking place within it, there is a certain stability in the type and number of species, referred to as the core microbiome, found in 95% of the human population. Genetic variation of microorganisms is relatively small, and their functions are strictly defined and highly conservative. The microbiome exists symbiotically with the host, protecting it against colonization by pathogenic microorganisms, providing essential metabolites, and stimulating the immune system. Colonization begins prenatally and its development is greatly influenced by the course of pregnancy, method of delivery, food supplied to the child during the first moments of life, and post-birth environment. The appropriate intestinal microflora composition is a key determinant of health and homeostasis, and any intestinal dysbiosis can be associated later in life with the development of obesity, diabetes, allergies or cancer. Due to the increasing number of hospitalised pregnancies and deliveries, affecting the intestinal microflora of a newborn, efforts are being made to minimize this process and restore the newborn’s microbiome. The use of the Vaginal seeding procedure raises up great hopes, but also some fears concerning its safety. Some very simple and most natural factors have been recently also appreciated and promoted, such as breastfeeding or direct contact of the baby’s skin with the mother’s skin, which are allies to probiotic bacteria. The purpose of this paper is to emphasize the importance of microbial colonization of the human body and to present the latest and most effective procedures that are designed to correct the existing dysbiosis or to reduce the risk of its occurrence. The literature for the compilation of this study has been obtained from databases such as PubMed, Google Scholar, Web of Science.
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Children s tumours are one of numerous problem fields within the population ofpersons with motor disorders and/ or chronic diseases. In this study, a sample of 11 patients (8 boys and 3 girls) of chronological age between 6 and 15 years, who were hospitalised at the Oncology and Haematology Department of the Children s Hospital in Zagreb, was defined. According to the clinical study protocol, therapeutic breathing, relaxation exercises and music stimuli were applied for the purpose of arousing attention and psycho-emotional responsiveness ofpatients. The TEMAS (Tell-Me-A-Story) multicultural test of thematic apperception and a form of therapeutic approach was also applied. The programme PROM (Nikolié, 1997) was used in the analysis of qualitative and quantitative changes for controlled variables during the treatment, and the method by Joreskog, Karl G. (1966) was used for testing the differences among matrices of correlation in two assessment points for the fields of cognitive functions, personality functions and affective functions. The presented results arise from the scientific research project "Complementary Supportive Therapies and Development of Life Potentials ", supported by the Ministry of Science, Education and Sports of the Republic of Croatia. Based on the research results, it was established that the TEMAS model as a complementary diagnostic and supportive- therapeutic approach; in particular, changes were established in verbal fluency, as well as in encouraging and releasing the child s spontaneity and creativity. The need for further research in this field has been noted as well.
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