Zdravstveno Varstvo最新文献

Introduction: The COVID-19 pandemic has strongly affected global healthcare systems. Prior epidemiological studies on different infectious diseases have shown a strong correlation between serum vitamin D levels and the incidence of certain infectious diseases. Vitamin D has an important immunomodulatory effect on innate immunity and exhibits several other mechanisms in the pathogenesis of the cytokine storm, which is one of the main contributing factors to fatality in COVID-19 patients.

Methods: A keyword search was conducted in the PubMed and Google Scholar research databases. The abstracts and/or full texts of selected papers were further evaluated. Articles that fulfilled the inclusion criteria were included in the systematic review.

Results: The 28 studies summarized in this review provide observational findings that vitamin D levels are related to the incidence, severity, and mortality rate of COVID-19 infection. The literature does not suggest that COVID-19 could be eliminated with supplementation of vitamin D, but there are implications that vitamin D deficiency might increase the risk for COVID-19 infection and severity of the disease progression.

Discussion: Current literature and several guidelines support the supplementation of vitamin D as a reasonable strategy for correcting and preventing vitamin D deficiency. The recommended dose for maintaining normal 25(OH)D levels by consensus is 1000 to 2000 IU vitamin D daily for at-risk teens and adults.

Conclusion: Vitamin D supplementation might play an important role in protecting from acute respiratory infections like the SARS CoV2, and in high-risk individuals with COVID 19 from progressing to critical clinical condition and reducing mortality.

Introduction: Studies have shown the importance of self-efficacy in the domain of risky sexual behaviour. The aim of this study was to examine the association of unwanted sexual intercourse among secondary-school students with socio-demographic factors and perceived self-efficacy, and to assess the effectiveness of the programme on reproductive health.

Methods: The study involved 5,026 second-grade students in 72 high schools in the Province of Vojvodina, Serbia (APV). They were surveyed before and after the implementation of the extracurricular 'Reproductive health education programme for secondary-school students in APV'. A questionnaire consisting of 57 questions (socio-demographic characteristics, knowledge, attitudes, and behaviour of students regarding reproductive health, and a general self-efficacy scale) was used as the research instrument.

Results: One quarter of students had engaged in unwanted sexual intercourse on one or more occasions. Students with poor material status were twice as likely to engage in unwanted sexual intercourse (ОR=2.01; 95%CI=1.07-3.75) as students with average or good material status. Students who did not engage in unwanted sexual intercourse had a higher self-efficacy score than students who who did (t=2.903; p<0.01). After the programme was completed, there was an increase in general self-efficacy.

Conclusion: Poor material status is a predictor of unwanted sexual intercourse. Students who have a higher level of self-efficacy engaged to a lesser degree in unwanted sexual intercourse. The programme is effective in terms of increasing general self-efficacy, and can be applied to encourage responsible sexual behaviour.

Introduction: Professional drivers' knowledge about driving-impairing medications is not satisfactory. The aim of this study was to develop and test the reliability and validity of the questionnaires designed to measure the knowledge and attitude of professional drivers about the influence of various medications on driving ability.

Methods: The questionnaires for assessing professional driver's knowledge (performance-based) and attitudes about influence of various medications on driving abilities were developed by creating the item pool, testing reliability and validity, and factor analysis. The study was conducted as a multicenter, cross-sectional study in Serbia and Bosnia and Herzegovina. The study population consisted of professional drivers, who filled out both questionnaires in three time intervals.

Results: Both questionnaires showed great internal consistency and temporal stability. Cronbach's Alpha for the first questionnaire was 0.984 and for the second it was 0.944. The Kaiser-Meyer-Olkin test for the first questionnaire confirmed sampling adequacy with its value of 0.964 and for the second questionnaire it was 0.933. Exploratory factor analysis of the questionnaire showed that three factors were revealed after rotation for the first questionnaire and they explained 78.0% of variance. Both questionnaires showed high degree of correlation between scores after the first and repeated administration, Spearman's rho coefficient of correlation for was 0.962 and 0.980.

Conclusion: Based on the results of this study, we believe that both questionnaires are useful tools for testing professional drivers' knowledge and attitudes about the influence of medications on driving ability.

Background: In the first months of 2020, the SARS-CoV-2 virus spread all over the world and numerous measures were adopted that had a strong impact on both personal and public life. This contribution explores changes in alcohol and tobacco use during the first months of the COVID-19 pandemic in Slovenia.

Methods: Self-reported changes in alcohol and tobacco use during the first few months of the Covid-19 pandemic were recorded in 495 Slovenian adults, as part of the European Alcohol Use and COVID-19 survey.

Results: About half of the Slovenian sample indicated that the frequency of drinking occasions did not change in the months after the pandemic's outbreak, while the remainder stated either a decrease (26.0%) or an increase (24.2%). 23.1% reported a decrease and 17.3% an increase in the quantity of alcohol consumed per occasion. Respondents who reported that their overall alcohol consumption decreased were more likely to be male than female and more likely to be younger than middle-aged. Those who reported experiencing at least a substantial level of distress due to financial loss were at a four-times increased risk of reporting an increase in their alcohol consumption compared to individuals who reported no or only some financial distress. Of the 120 people reporting the use of tobacco, almost half indicated an increase in tobacco consumption within the previous month, and about 20% reported a decrease in use. The differences in the results between Slovenia and other European countries are small and the overall pattern suggests that the situation in Slovenia was comparable to other European countries.

Conclusion: As this pandemic continues to evolve, further monitoring is needed to identify the long-term effects of alcohol and tobacco use on public health in relation to the management of COVID-19.

Introduction: Primary care physicians use various tools and methods to identify medically unexplained symptoms (MUS). The main purpose of our study is to determine the views of Slovenian family medicine trainees (FMT) about using the "Careful Assessment" tool for managing patients with MUS.

Methods: A qualitative study using open survey questions focused on the experience of family medicine trainees in managing patients with MUS. The sample consisted of surveys from 184 family medicine trainees. These trainees analysed a total of 702 patients with MUS. Manual coding was used for quantitative content analysis.

Results: In the coding process, 49 codes were developed that included broader research fields about using the "Careful Assessment" tool for managing patients with MUS. The codes were grouped into four theoretically grounded, logical categories in accordance with the elaborated theoretical concept: multi-purpose utility; improved patient management; in-depth knowledge and new skills; and patient response.

Conclusion: The study demonstrated that, in the view of Slovenian FMT, the "Careful Assessment" tool has multi-purpose utility. The study showed that FMT felt that this tool helps them in systematic patient management. Their opinion is that it helps them establish a trusting relationship with patients, which is a precondition for providing further treatment.

Aim: Vitamin D (VitD) is involved in calcium and phosphate homeostasis, bone health, and normal functioning of the immune system. VitD status is monitored using serum 25-hydroxy-vitamin D (25(OH)D) as a biomarker. Serum 25(OH)D concentrations below 30 nmol/L indicate VitD deficiency and below 50 nmol/L indicate insufficiency. VitD can be synthesised endogenously in human skin when exposed to ultraviolet B (UVB) radiation. In the absence of sufficient UVB-light exposure, VitD intake becomes the main source of VitD, with a recommended daily intake of 20 μg. The aim of this study was to conduct a review and meta-analysis on the abovementioned topics, focusing on scientific studies in various Slovenian populations.

Methods: We conducted a systematic review and meta-analysis of published scientific papers, academic theses, or conference contributions reporting serum 25(OH)D status and VitD intake across various Slovenian populations. A search was carried out using Web of Science, Scopus, Medline, and the Slovenian library database.

Results: We identified 43 pertinent studies that addressed 25(OH)D status and 16 that addressed VitD intake. Serum 25(OH)D status was generally low across all populations, and notable seasonal variability was observed. VitD intakes were below 5 μg in all studies.

Conclusions: A general observation is that various population groups across Slovenia are at high risk of vitamin D insufficiency and deficiency, particularly during wintertime. Regarding vitamin D intake, all included studies reported daily intakes below the recommended level. We also identified key research gaps that need to be addressed to support further public health decision-making.

For decades, research has been highlighting the positive impact of physical activity on health. Despite the immense efforts made by many professional and scientific organizations to raise individual and societal awareness about the role of a sufficient quantity and intensity of physical activity in everyday life and to increase the level of adherence, the situation is still very worrying. Even more worrying is the fact that increasingly prolonged periods of physical inactivity are insidiously and aggressively taking over modern people's lives - at school, at work, at home, even at leisure. It is probably incomprehensible and difficult for many to accept, but physical inactivity is becoming the first and worst enemy of health in today's society.

Introduction: Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners' (PCPs') clinical decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania).

Methods: PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer.

Results: The survey was completed by 475 PCPs. There were significant national differences in PCPs' direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs' country had a significant effect on their likelihood of investigating or referring the patient.

Conclusions: There are large differences between Balkan region countries in PCPs' levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed.