Zdravstveno Varstvo最新文献

Introduction: To evaluate data on users, the characteristics of admission, placement and discharge of individuals in secure units. These are locked units in special residential institutions in the social care sector.

Methods: A total population descriptive study was performed. In April 2024, a questionnaire comprising 72 items was sent to all six institutions with secure units in the field of mental health and intellectual disabilities. Data from 2023 were gathered. Descriptive and univariate analysis were applied.

Results: A total of 64% of users were male, and the mean age was 54.3 years. The vast majority of users (98%) were admitted involuntarily and deprived of their legal capacity (67%). The largest proportion of users were admitted following admission into a psychiatric hospital (44%), admission to open units of the same institution (34%) and living in the community (10%). The mean length of stay in the secure unit was 64.01 months. During the placement in secure units, 14% of users were admitted to a psychiatric hospital. Only 17% users were discharged from secure units, with 81% taking place later, while 19% discharges took place before the expiry of a court order. The most common location of discharge was the open unit of the same institution (79%).

Conclusions: The results highlight high rates of involuntary admissions, prolonged stays and limited transitions to community care, raising public health and human rights concerns. The findings call for a shift in focus from expanding institutional capacity towards improving discharge practices and strengthening community-based support.

Introduction: Our objective was to identify clusters of lifestyle risk factors among Serbian adults and assess associations with socio-demographic characteristics and self-rated health.

Methods: The sample included 7,885 adults aged 18 and over from the 2019 Serbian National Health Survey, who provided information on all four lifestyle risk factors (smoking, physical inactivity, low fruit and vegetable intake and risky drinking). The Two-Step Cluster Analysis was used to identify different health-related lifestyle clusters. Logistic regression models were used to assess the association of obtained clusters with socio-demographic characteristics and self-rated health.

Results: Five distinct clusters of lifestyle risk factors were identified: Healthy lifestyle (cluster 1), Low fruit and vegetable intake (cluster 2), Physical inactivity (cluster 3), Smoking and other risk factors (cluster 4), Risky drinking and other risk factors (cluster 5). Multi-risk groups (cluster 4, cluster 5) exhibit specific socio-demographic characteristics (men, younger adults, living alone, less educated). Adults in unhealthy lifestyle clusters were more likely to report poor self-rated health than adults in the healthy lifestyle cluster.

Conclusions: Individuals who were men, younger, living alone, less educated and those with poor self-reported health were more likely to engage in clusters of lifestyle risk factors and represent high-priority population groups for multiple health behaviour change interventions.

The forthcoming United Nations General Assembly High-Level Meeting on noncommunicable diseases and mental health offers a crucial opportunity to advance global health governance. This editorial argues that while the draft declaration represents a vital step forward, its potential to address global mental health needs is complicated by several paradoxes that merit careful consideration. First, its targets for financing and access may not fully reflect the ambition needed to overcome systemic underinvestment. Second, the "integration paradox" champions a cohesive approach while setting different types of targets for mental health and NCDs. Finally, an implementation paradox is evident in the ongoing focus on individual behavior rather than on the upstream social and commercial determinants of health. Using Slovenia's experience as a national case study, we illustrate how these global challenges can complicate efforts to translate high-level commitments into national reality. We conclude that for the UN Political Declaration to be truly transformative, it must inspire a shift from cautious frameworks to more ambitious financing, authentic integration, and the political courage to prioritise population needs over siloed institutional legacies.

Introduction: To describe climate change worry on a sample of adult residents of Slovenia and analyse its associations with socio-demographic variables, including mental wellbeing.

Methods: Data from the cross-sectional study among online panellists, SI-PANDA 2024/2025, were analysed. A survey (n=1522 adults, aged 18-74) was conducted in September 2024. To measure climate change worry, a Climate Change Worry Scale (CCWS) was used, and mental wellbeing was assessed using the WHO-5 Well-Being Index.

Results: The mean CCWS score in a sample of adults was 22.6, on a scale from 10 to 50 (higher score, higher level of worry). Regarding age (p<0.001), those most worried about climate change were people aged 55-64 years (M=24.1), followed by the 25-34 age group (M=23.6) and the oldest (65-74; M=23.1). People with risk of depression (M=25.1) and people with poor mental wellbeing (M=24.6) reported significantly higher (p<0.001) levels of climate change worry than people with excellent wellbeing. Higher CCWS scores were also achieved by people with risky stress behaviour (p=0.004) and those with a worse financial situation (p=0.001).

Conclusions: There are medium levels of climate change worry in a sample of adult residents of Slovenia. Climate change is perceived as a threat not only by young people, but also by older adults. Individuals with poor mental wellbeing, a risk of depression, or risky stress behaviour were more likely to report higher levels of climate change worry. Public health measures should reduce climate change worry by empowering vulnerable groups through environmental, group and community-based activities.

Introduction: Diabetes mellitus (DM) requires effective and accessible management strategies to reduce complications and improve patient outcomes. The aim of this study is to evaluate the effects of a standardised diabetes service delivered by trained community pharmacists on glycaemic control, cardiovascular risk parameters and self-care behaviours among patients with DM.

Methods: This retrospective cohort study included adults with type 1 or type 2 DM (HbA1c ≥7%) who visited community pharmacies in Southeastern Serbia. Patients were offered a structured, four-month service with individualised counselling, monitoring and support from trained pharmacists. Based on willingness to participate, patients were assigned to the intervention (received all four sessions) or control group (received usual pharmacy care). Data on HbA1c, fasting blood glucose, lipid profile, blood pressure and self-care (assessed by Diabetes Self-Management Questionnaire) were collected at baseline and after four months.

Results: Among 390 consenting patients, 213 met the eligibility criteria (intervention: n=105; control: n=108). In the intervention group, HbA1c significantly decreased from 8.61±1.26% to 7.68±0.92% (p<0.001), with 20% of patients achieving target levels (<7%). LDL cholesterol also decreased significantly (from 2.31±0.70 to 1.46±0.66 mmol/L, p<0.001), while no significant changes were observed in HDL, triglycerides, or blood pressure. Self-care behaviour improved across all five subscales, especially medication-taking, where non-adherence decreased from 43.8% to 22.9%. Greater improvements were noted among patients with type 2 DM and those with a family history of diabetes.

Conclusions: The pharmacist-led service significantly improved glycaemic control, LDL cholesterol, and self-care behaviour. These findings highlight pharmacists' potential to enhance diabetes management and support public health efforts.

Introduction: This study examines the prevalence of bullying among primary school students in the Federation of Bosnia and Herzegovina (FBiH), analyses gender differences, and assesses its association with traumatic and psychosomatic symptoms.

Methods: This cross-sectional study was conducted among students in grades seven to nine. Participants were categorised based on bullying involvement as victims, bullies, bully/victims, or uninvolved. Validated self-report questionnaires were used to measure bullying exposure and assess psychosomatic and trauma-related symptoms.

Results: In total, 13.3% of the students identified as victims, 3.1% as bullies, and 4.4% as both. Victims and bully/victims reported significantly higher rates of psychosomatic symptoms (e.g., pain, fatigue, gastrointestinal complaints) and trauma-related symptoms (e.g., anxiety, depression, dissociation) than uninvolved students. Bully/victims showed the highest overall burden, suggesting compounded vulnerability.

Conclusions: These findings highlight the urgent need for trauma-informed, context-sensitive prevention strategies. Training school staff to recognise emotional and somatic distress, integrating basic screening tools into school and primary health services, and enhancing intersectoral collaboration are critical steps in ensuring early identification and adequate support for affected students.

Introduction: Available research on the recognition and prehospital management of allergic reactions is limited. The aim of this study was to characterise emergency medical calls related to allergic reactions, with a focus on suspected allergens, patient characteristics and the use of prescribed emergency therapy prior to the arrival of EMS.

Methods: We conducted a retrospective, dispatch-based observational study of emergency calls related to allergic reactions in Slovenia in 2023, using data from the Slovenian Emergency Medical Dispatch Service database. Descriptive statistics were used to present the results.

Results: A total of 849 emergency calls were analysed. In most cases, the caller was a family member (35.3%; 300/849). A known history of allergic reactions was reported in 21.8% (185/849) of patients. The most common allergens were medications (22.3%; 189/849), insect stings or bites (19.3%; 164/849), and food (17.1%; 145/849). Medications were most frequently reported in winter (60.5%; 69/114), while insect stings and bites predominated in summer (53.1%; 86/162). Among children, food was the leading allergen (56.7%; 55/97), whereas medications were most common in the elderly (61.9%; 70/113). In adults, insect stings or bites (34.5%; 110/319) and medications (33.9%; 108/319) were equally prevalent. Prescribed emergency therapy was used in 31.3% (266/849) of cases, including an epinephrine auto-injector in 8.5% (72/849).

Conclusions: Emergency calls for allergic reactions vary in clinical severity, underscoring the critical role of Emergency Medical Dispatchers in early identification and prioritization. Medications, insect stings and bites, and food were the leading allergens, with distribution influenced by age and season.

[This corrects the article DOI: 10.2478/sjph-2024-0012.].

Introduction: In addition to sufficient trunk muscle endurance, adequate trunk flexibility, i.e. trunk muscle extensibility and spinal mobility, is an important element for the stability of the spine and pelvis. The aim of this intervention study was to investigate the effects of a preventive exercise programme on trunk flexibility.

Methods: The participants were healthy adults without pain or injury in the lower back. They were divided into two groups: the exercise group (EG), which performed a hatha yoga exercise programme with segmental stabilisation exercises (12 weeks), and the control group (CG), in which they maintained their previous lifestyle during the study period. Before and after the intervention the measured variables, the extensibility of the trunk muscles and the mobility of the thoracolumbar spine were compared.

Results: Seventy-two participants (n_EG=36, age 32.2±6.8 years; n_CG=36, age 29.9±7.8 years) took part in the study. After the exercise programme, the EG participants achieved significantly better extensibility of the iliopsoas muscle (p≤0.001), the V-Sit and Reach Test (p=0.001) and the mobility of the thoracolumbar spine (p<0.05). Significant differences between the two groups were found in four of five extensibility tests (p≤0.041) and in flexion, left lateral flexion and right rotation of the spine (p≤0.036).

Conclusions: The proposed exercise programme indicated a significant improvement in trunk flexibility. Future studies should investigate the long-term effects of the proposed exercise programme on a larger number of participants.

Aim: To investigate the reasons for leaving the hospital and recommending the hospital among nurses employed at internal diseases and surgical departments.

Methods: A cross-sectional explorative design was employed. Eight general hospitals and two clinical centres participated in the study. All adult surgery and internal medicine departments were included. A total of 1010 registered nurses and healthcare assistants filled out the questionnaire. Demographic and job characteristics data were collected. Permission to conduct the study was obtained from the National Medical Ethics Committee.

Results: A total of 51.5% of respondents expressed the intent to leave the hospital within the next year and 14% of them considered leaving nursing. The "intention to leave the hospital" was explained in 37.7% - 50.3% by younger age (p<0.001), poor evaluation of the professional aspect of the work (status of nurses) (p<0.001), emotional exhaustion (p<0.001), non-resolution of problems by leaders and managers (p<0.001), dissatisfaction with the current work (p<0.001) and overtime hours (p=0.005).

Conclusions: Our study highlights the role of hospital management and leadership as an important factor in nurse retention. The most critical group showing the intention to leave the hospital are the younger employees. There is therefore a need to design strategies for their adequate introduction to work and to implement professional development in nursing in accordance with international recommendations.