Atmospheric VOCs measurement in Nature Reserve Kopački rit,Croatia

To determine the impact of volatile organic compounds (VOCs) on ozone formation, their identification as well as air concentration assessment is necessary. These were one of the first collections on adsorption tube samples of VOCs in air from the Nature Reserve Kopa?ki rit. The samples were analysed by gas chromatography coupled with flame ionisation detector (FID) and mass selective detector (MSD), and results for the hydrocarbons with two to six carbon atoms are reported. The results show that among the measured concentrations, ethane, propane and n-butane were the highest. Biogenic hydrocarbon isoprene, whose concentrations follow daily cycle of ozone formation during the summer, was also identified and quantified. We used the cluster analysis (CA) to indentify the possible common emission sources among the measured data. The measured data are discussed in relation to the EU guidelines (Directive 2008/112/EC; Directive 2004/42/EC).     

Sarcoidosis and tuberculosis in South Croatia: are there epidemiological similarities or not?

Objective

Tuberculosis and sarcoidosis are chronic granulomatous diseases. Clinical, pathologic and immunologic aspects are similar although different. The authors were interested to highlight possible epidemiological similarities of these two granulomatous diseases. The objective of this study was to evaluate incidence rate as well as age, sex and geographic distribution of sarcoidosis in South Croatia and to compare it with these epidemiological characteristics of tuberculosis.

Study design

Retrospective.

Methods

The study was including ten years follow up period (1997–2006), and was performed in Split-Dalmatia County, Croatia. All data were collected retrospectively and analyzed using Statistica 7 programme.

Results

The mean annual incidence of sarcoidosis was 3.3/100,000 inhabitants with a mean of 15,6 cases per year. Woman accounted for 61% of all sarcoidosis cases. The mean sarcoidosis patient age was 44.94 ± 11.85 years. The peak age group was 40–49 years (31%). Significant difference according to incidence rate on the islands comparing to the rates on the coast and the mainland was observed (P = 0.003). The mean sarcoidosis mortality rate was 1.2/100,000. Statistically significant differences between sarcoidosis and tuberculosis were observed according the higher number of tuberculosis patients (P < 0.000), among males (P < 0.000), and females, too (P < 0.000) as well as in mortality rates (P = 0.401). Significantly more patients had tuberculosis on the mainland (P < 0.000) and on the coast (P < 0.000), but not in the islands (P = 0.260).

Conclusions

The results from this study showed dissimilarities in classic epidemiological patterns between sarcoidosis and tuberculosis, incidence rates, as well as sex and geographic distribution. Our findings resulted from this study might be starting point for the future epidemiological, genetic, and immunological studies.     

Heavy Metals and Acidic Components in Total Deposited Matter in Šibenik and National Park Kornati,Croatia

This article presents the results of 6 years (1999–2004) of monitoring acidic components (fluoride, chloride, nitrate, sulfate) and heavy metals (lead, cadmium, thallium) in total deposited matter (TDM) in the town of Šibenik and the National Park Kornati, Croatia, in order to determine their levels, spatial and temporal variations, and possible emission source. Bulk deposition samples were collected using the Bergerhoff samplers. TDM matter was determined gravimetrically. Acidic anions were analyzed using ion chromatography. Metallic components were determined by atomic absorption spectrometry. Results show that the levels of measured pollutants were relatively low compared to those reported in other investigations. Statistical analysis indicates that the measured pollutants originate from several sources such as resuspended soil, industry, road dust, traffic, and secondary aerosols as the most important. The levels of TDM show a slightly increasing trend at all sampling sites. A significant increasing trend in the levels of nitrate and sulfate in TDM could be the consequence of increasing traffic activity and urbanization. The significant increasing trend in the ratio between nitrate and sulfate in TDM indicates that the nitrate and sulfate relative contribution to acidification is increasing. The level of heavy metals in TDM was in order of lead > thallium > cadmium at all sampling sites with slightly decreasing trend.     

The psychosocial impact of dental aesthetics questionnaire—translation and cross-cultural validation in Croatia

Purpose

To perform a translation and validation of the psychosocial impact of dental aesthetics questionnaire (PIDAQ) in the Croatian cultural context.

Methods

A total of 262 subjects (34 % males) aged 18–30 years (mean age 22.7 ± 2.6) were included. The questionnaire included the PIDAQ, a self-assessment of satisfaction with dental aesthetics, a self-perceived dental treatment need assessment, self-reported malocclusion, an aesthetic component of index of orthodontic treatment need (IOTN AC) and an oral health impact profile (OHIP-14 CRO). The subjects’ orthodontic treatment needs were assessed by a dentist using the dental health and aesthetic component of the IOTN. The internal consistency, test–retest reliability, validity and responsiveness were assessed. Little’s Irregularity index was used to correlate the amount of resolution of dental crowding by orthodontic treatment with the change in PIDAQ domains.

Results

The domains of the Croatian version of the PIDAQ showed satisfactory internal consistency (α ranging from 0.79 to 0.95) and high test–retest reliability (r > 0.85). The significant association between the PIDAQ domains and self-reported satisfaction with teeth appearance, IOTN AC and OHIP-14 CRO (p < 0.001) confirmed the convergent validity. The domains were able to detect differences in the subjects’ psychosocial impact related to orthodontic treatment that improved dental aesthetics in responsiveness testing (p < 0.001).

Conclusion

The Croatian version of the PIDAQ demonstrated good psychometric properties, similar to those of the original.     

How Do Consumers Perceive Cultured Meat in Croatia,Greece, and Spain?

The meat production industry is one of the leading contributors of greenhouse gas emissions. Cultured meat presents itself as a potential eco- and animal-friendly meat substitute which has the potential to eradicate animal cruelty and reduce both the environmental footprint and the risk of zoonotic illnesses, while delivering a nutrient-dense product. The purpose of this study was to investigate how consumers perceive cultured meat and if the frequency of meat consumption is related to their intention of trying or purchasing cultured meat. Data were collected online in 2020 from Croatia, Greece, and Spain. Among the 2007 respondents, three segments were identified according to meat consumption and variety, plus an a priori identified group of “non-meat eaters”. Sixty percent perceived cultured meat as kind to animals, 57% as unnatural, 45% as healthy and environmentally-friendly, 21% as disgusting, and only 16% as tasty. Although 47% of the respondents had not heard of cultured meat before, 47% would taste it and 41% would purchase it for the same price as conventional meat. This indicates that consumers from Croatia, Greece and Spain might be likely to purchase cultured meat if sold at an affordable price.     

Origins and effects of the 2014–2016 national strategy for palliative care in Croatia

Croatia is among the last countries in Europe to develop organized palliative care at the national level. Real changes in this area started after the parliamentary elections in 2011 and culminated in the 2013 adoption of the Strategic Plan for Palliative Care Development 2014–2016. The National Board for Palliative Care (NBPC), appointed by the Ministry of Health, was in charge of creating a scalable palliative care model and national guidelines. The Board drew on experiences from both neighbouring countries with similar societies and/or health care models (Bosnia and Herzegovina, Poland) and an international leader in palliative care (United Kingdom). It recognised that provision of palliative care in Croatia, thus far based on volunteering and isolated enthusiastic activities, needed to be improved through professionalization, regulation, and organized development. A variety of policy measures was used to implement these changes, including the introduction of professional guidelines and new payment models. The development of new palliative care structures and services significantly increased the number of patients who could access palliative care, from around 1–2% of patients needing such care in 2011 to 20–35% in 2014. It also ensured the provision of more appropriate services at each point of the palliative care pathway. The Strategy was extended for the 2017–2020 period.     

Healthcare Providers’ Knowledge, Attitudes and Counselling on Injury Prevention for Preschool Children in Croatia

Injuries are the leading cause of death for children and young adults in Croatia. Research has indicated that health care providers can be effective in reducing the risk for traumatic injury through anticipatory guidance, but successful guidance requires that providers have injury knowledge and informed safety attitudes. This is the first study in Croatia to identify health care provider’s knowledge, attitudes, and practices regarding anticipatory guidance on injury prevention for children. A stratified, random sample of licensed Croatian healthcare providers was mailed a survey, with a response of rate of 39.5 %. Participants included pediatricians, family physicians, gynecologists, each with a focus on primary care, and community nurses. Participants filled out a 15-minute paper-and-pencil survey that tested their knowledge of injury risks and prevention strategies, assessed their safety-prone attitudes, and measured the extent to which they counselled their patients on injury prevention. Pediatricians had the highest knowledge of injury risks and intervention approaches, with an average correct score of six out of ten (significantly higher than all other provider types). Knowledge was highest regarding infant fall risk and lowest for safe sleep positions. Pediatricians and community nurses had the highest safety-prone attitudes. Safety prone attitudes were strongest for transportation safety and weakest for safe sleeping position for all providers. Community nurses reported the highest level of patient counselling, followed by pediatricians. Both factual education and support in translating knowledge into everyday practice are necessary for health care providers. Implementing anticipatory guidance for child safety is a promising approach in Croatia.     

The Content of Cobalt,Silver and Vanadium in Raw Cow’s Milk in Croatia and Risk Assessment for Consumers

Concentrations of selected trace elements Ag, Co and V in raw milk sampled from four geographical regions in Croatia were measured. Silver, Co and V were detected above the limit of detection within the range of 9.52%–30.8%, 1.6%–12.1% and 12.4%–30.8%. Silver concentrations were not detected in milk samples from the Croatian Littoral and Mountainous Croatia (CL-MC) region. Similar Ag content was found in Southern, Eastern and Central Croatia. The lowest mean of Co and V of 33.2 and 83.8 µg kg^?1 were found in the CL-MC region while the highest of 49.8 and 136.9 µg kg^?1 was found in Central Croatia. There were no statistically significant differences in Ag, Co and V contents between the four regions. The estimated daily dietary intakes (EDI) of total mean and total 95th percentile values of Ag, Co and V showed lower values in comparison with available EFSA health-based limits.

     

Haematological malignancies in childhood in Croatia: Investigating the theories of depleted uranium, chemical plant damage and ‘population mixing’

Some of potential causes proposed to explain the reported increase of haematological malignancies in childhood during or after the war period in several countries include depleted uranium, chemical pollution and population mixing theory. The aim of this study was to define the population of Croatian children aged 0-14 years who were potentially exposed to each of those risks during the war and to investigate any possible association between the exposure and the incidence of haematological malignancies. The authors analyzed the data reported by the Cancer Registry of Croatia during the pre-war period (1986-1990), war period (1991-1995) and post-war period (1996-1999). In the group of 10 counties potentially exposed to depleted uranium and two counties where chemical war damage occurred, no significant difference in incidence of the studied haematological malignancies was noted in comparison to pre-war period. The incidence of lymphatic leukaemia significantly increased in four counties where population mixing had occurred during the war period, supporting the 'mixing theory'. In those counties, the incidence of Hodgkin's lymphoma decreased during and after the war. In Croatia as a whole, decreases in incidence of myeloid leukaemias during war and non-Hodgkin lymphoma after the war were noted.     

Attitudes and beliefs related to childhood vaccinations among parents of 6 years old children in Zagreb,Croatia

The Croatian Immunization Programme is a mandatory prevention programme in which vaccines are offered free of charge and little is known about parental vaccine-related beliefs and attitudes. We aimed to describe beliefs and attitudes towards childhood vaccination of parents in Zagreb, estimate the proportion of parents with positive attitudes towards vaccination, and to identify the possible predictors of positive attitudes. Using a self-administered questionnaire, we performed a cluster sampling survey among parents of 6-years-old children in Zagreb. In total 542 questionnaires were collected, 80% (n = 430/542) of respondents were mothers. Even though 72.6% (n = 385/531; 95%CI: 69–76) respondents feel that childhood vaccination should remain mandatory, 36.3% (n = 192/528; 95%CI: 58.3–65.3) considered that simultaneous administration of vaccines can have negative effect to their child’s health. In addition, 38% (n = 202/532; 95%CI: 33.2–43.1%) feared that vaccines may harm their child. Of total, parents mostly reported positive attitude towards vaccination (61.8%; 95% CI: 34.7–42). Parents with positive attitudes were more likely to state their child experienced mild or no adverse reaction after vaccination, report not delaying vaccination and provide additional non-mandatory vaccines to their child (p < 0.05). Gender, age, education and marital status of parent were not significantly associated with the positive attitude towards vaccination. Our results suggest the need for educational interventions and communication strategies that could foster better knowledge on immunization with a focus on parental misconceptions, perceived constraints and safety issues about vaccine.     

Atmospheric particulate matter and ozone under heat-wave conditions: do they cause an increase of mortality in Croatia?

In August 2003 Croatia experienced a heat-wave period during which elevated concentrations of particulate matter (PM10) and ozone in ambient air were measured. By applying the model of Stedman and Rooney et al., it was shown that a significant part of excess mortality during this period can be attributed to PM10 and ozone in ambient air.     

Have Lifestyle Habits and Psychological Well-Being Changed among Adolescents and Medical Students Due to COVID-19 Lockdown in Croatia?

Objective: To investigate dietary habits, sleep and psychological well-being of adolescents and medical students during COVID-19 lockdown in Split, Croatia. Methods: We surveyed 1326 students during 2018 and 2019, and compared their responses with 531 students enrolled in May 2020. Perceived stress, quality of life (QoL), happiness, anxiety, and optimism were assessed as proxies of psychological well-being, using general linear modelling. Results: We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall Mediterranean diet (MD) adherence. However, the MD pattern changed, showing increased adherence to the MD pyramid for fruit, legumes, fish, and sweets, while cereals, nuts, and dairy intake decreased during COVID-19 lockdown. A third of students reported weight loss during lockdown, 19% reported weight gain, while physical activity remained rather stable. The most prominent change was feeling refreshed after a night’s sleep, reported by 31.5% of students during lockdown vs. 8.5% before; median length of sleep duration increased by 1.5 h. Lockdown significantly affected QoL, happiness, optimism (all p < 0.001), and perceived stress in students (p = 0.005). MD adherence was positively correlated with QoL and study time, and negatively with TV and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less perceived hardship and greater happiness and QoL during lockdown. Conclusion: These insights provide valuable information for tailored interventions aimed at maintaining healthy lifestyle in young population. Given the numerous beneficial effects associated with MD adherence, modification of lifestyle through application of lifestyle medicine deserves a priority approach.     

The Prevalence of Live Birth Down Syndrome in the Region of Primorsko-goranska County in Croatia, 1996–2005: The Impact of Screening and Amniocentesis

Objectives To investigate the prevalence of live birth Down syndrome (DS) in the region of Primorsko-goranska County (PGC) in Croatia from 1996 to 2005 and to evaluate the impact of second-trimester maternal serum screening (MSS) and amniocentesis on live birth DS prevalence. Methods Study was based on databases from the Department of Gynecology and Obstetrics, University Hospital Centre Rijeka, the Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, and the Croatian National Institute of Public Health. The regional policy of prenatal diagnosis for DS includes amniocentesis for pregnant women aged 35 or over and MSS for younger women. We estimated live birth and total prevalence of DS and measured the proportion of pregnant women using MSS and amniocentesis. Trends of live birth and total prevalence of DS were tested by linear regression analysis. Results The live birth prevalence of DS was 1.4/1000 in the period 1996–2005. A decreasing, but nonsignificant, trend of prevalence was observed over time (P = 0.577). Women aged 35 or over represented 11.6% of all pregnant women included in the study. The proportion of women who had MSS was 33.9%. The proportion who underwent amniocentesis was 6.1%. Conclusions No marked decrease in prevalence of live birth DS was observed in the region of PGC during the last 10 years. The usage of MSS and amniocentesis was too low to have any significant impact on live birth DS prevalence. Women’s, as well as physician’s, knowledge and attitudes towards prenatal diagnosis of DS should be evaluated.     

Levels of β-HCH,HCB, p,p′-DDE,p,p′-DDT and PCBs in human milk from a continental town in Croatia,Yugoslavia

Summary Concentrations of -HCH, HCB, p,p-DDE, p,p-DDT and PCBs were determined by gas chromatography in 50 human milk samples collected from the general population during 1981/1982 in a continental town in Croatia (Yugoslavia). The samples were collected between one and 22 weeks after delivery from mothers breast-feeding one child only. The mothers' age was 18 to 31 years, and they were nursing their first or second child. All 50 samples contained -HCH, HCB, p,p-DDE and PCBs, whereas p,p-DDT was present in 37 samples. The concentrations of -HCH, HCB, p,p-DDE, p,p-DDT and PCBs expressed on a whole milk basis were (median in g/kg): 11, 7.1, 67, 7.3 and 22 respectively, and expressed on a fat basis (median in mg/kg): 0.28, 0.21, 1.9, 0.18 and 0.62 respectively. The fat content was 3.7% (median). PCBs were present in a mixture containing penta-, hexa- and heptachlorobiphenyls.     

Trends in food availability in Portugal in 1966–2003

BACKGROUND: Dietary intake has changed considerably in South European countries, but whether those changes were similar between countries is currently unknown. AIM OF THE STUDY: To assess the trends in food availability in Portugal and four other Mediterranean countries from 1966 to 2003. METHODS: Food and Agricultural Organization food balance sheets from Portugal, France, Italy, Greece and Spain. Trends were assessed by linear regression. RESULTS: The per capita availability of calories has increased in Portugal, France, Greece, Italy and Spain in the past 40 years. Portugal presented the most rapid growth with an annual increase of 28.5 +/- 2.2 kcal (slope +/- standard error), or +1000 kcal overall. In animal products, Portugal had an annual increase of 20.7 +/- 0.9 kcal, much higher than the other four countries. Conversely, the availabilities of vegetable and fruit only showed a slight growth of 1.0 +/- 0.1 kcal/year and 2.5 +/- 0.4 kcal/year, respectively, thus increasing the ration of animal to vegetable products. Olive oil availability increased in all countries with the notable exception of Portugal, where a significant decrease was noted. Wine supply decreased in all five countries; in contrast, beer supply started to take up more alcohol share. Percentage of total calories from fat increased from nearly 25% to almost 35% in Portugal during the study period, mainly at the expenses of calories from carbohydrates, whereas the share of protein showed just a slight increase. Furthermore, fat and protein were increasingly provided by animal products. CONCLUSIONS: Portugal is gradually moving away from the traditional Mediterranean diet to a more Westernized diet as well as France, Greece, Italy and Spain. Noticeably, the trends of diet transition were observed relatively faster in Portugal than in the other four Mediterranean countries.     

Reproduction in the year 2012: in vivo or in vitro?

The Dutch Minister of Health has proposed reducing the number of reimbursed in vitro fertilisation (IVF) cycles per couple from 3 to 1, in order to save 30 million euros per year. In the Netherlands, the number of IVF cycles has increased by 50% in the past 13 years, resulting in, on average, one child conceived through IVF in every classroom today. The increase in the number of IVF treatments is also caused by expansion of the indications for IVF, despite the lack of evidence proving the effectiveness of IVF for some of these indications. In a time of financial constraint, the restriction of reimbursed indications would be fairer than reducing the number of reimbursed treatments with IVF or intracytoplasmic sperm injection (ICSI) for all couples.     

Ethnic differences in self reported health in Malmö in southern Sweden

STUDY OBJECTIVE—The aim of this study was to investigate ethnic differences in self reported health in the city of Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions.
DESIGN/SETTING/PARTICIPANTS—The public health survey in Malmö 1994 was a cross sectional study. A total of 5600 people aged 20-80 years completed a postal questionnaire. The participation rate was 71%. The population was categorised according to country of origin: born in Sweden, other Western countries, Yugoslavia, Poland, Arabic speaking countries and all other countries. The multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the differences by country of origin in self reported health. Finally, variables measuring psychosocial and economic conditions were introduced into the model.
MAIN RESULTS—The odds ratios of having poor self reported health were significantly higher among men born in other Western countries, Yugoslavia, Arabic speaking countries and in the category all other countries, as well as among women born in Yugoslavia, Poland and all other countries, compared with men and women born in Sweden. The multivariate analysis including age and education did not change these results. A huge reduction of the odds ratios was observed for men and women born in Yugoslavia, Arabic speaking countries and all other countries, and for women born in Poland after the introduction of the social network, social support and economic factors into the multivariate model.
CONCLUSIONS—There were significant ethnic group differences in self reported health. These differences were greatly reduced by psychosocial and economic factors, which suggest that these factors may be important determinants of self rated health in certain minority groups.


     

Does the Heartbeat Award scheme in England result in change in dietary behaviour in the workplace?

The Heartbeat Award (HBA) scheme is a national nutrition labelling scheme that operates throughout England. The aim of this study was to assess whether the implementation of the HBA scheme in the workplace results in an improvement in eating habits at work. A longitudinal survey of employees using a structured questionnaire pre- and post-HBA intervention in six workplaces in Leicestershire, England, was conducted. A qualitative food frequency questionnaire was used to assess dietary behaviour 6 months before the scheme was implemented and 6 months afterwards. Four HBA workplaces (n = 453 employees) were compared with two comparison workplaces (n = 124 employees). The outcome measures for dietary change were consumption of 20 food items, i.e. 16 food-frequency and four food-type items. Changes in pre-intervention data compared with post-intervention data evaluated the impact of the HBA on eating habits. Differences were considered statistically different at the p < 0.05 level. Crude and adjusted odds ratios were used to assess differences in change in dietary behaviour between the intervention and comparison workplaces. The results showed that there was significantly more positive change in intervention workplaces only (i.e. the changes were not detected in the comparison workplaces) for four of the 20 food items tested: increase in consumption of fruit (p = 0.029); reduction in consumption of fried foods (p = 0.044) and sweet puddings (p = 0.042); and change to lower fat milks (p = 0.034). In conclusion, the HBA had a modest impact on dietary intake, resulting in a significant positive change in four out of 20 foods consumed by employees in HBA-holding premises.