Psychogeriatric Diagnoses in Old People's Homes and Negative Health Behavior.

BACKGROUND: The study was designed as a gerontologic-public health analysis of the relationship between the leading and accompanying psychogeriatric diagnoses and negative health behaviors recorded in the old people's home users, with the aim to evaluate and redefine gerontologic-public health priorities and geroprophylactic measures, with special reference to persons suffering from Alzheimer's disease and other dementias. SUBJECT AND METHODS: Gerontologic-public health indicators obtained by monitoring health care needs of the elderly in specific institutional primary health care at 10 old people's homes (N=1185) in Croatia in 2013 were analyzed using the professional methodology developed at Department of Health Gerontology, Andrija Stampar Teaching Institute of Public Health (Registry List 1 that refers to monitoring specific primary health care needs of elderly at old people's homes). RESULTS: Study results revealed that essential arterial hypertension was the principal (leading) principal diagnosis in the old people's home users as of 2013, accounting for 13% of all leading diagnoses recorded in the elderly in institutional health care. In the study population, psychogeriatric diagnoses were recorded among the first five accompanying and leading diagnoses. Refusal of occupational therapy was the most common unfavorable health behavior recorded in the old people's home users, accounting for 22%, followed by poor personal and environmental hygiene (19%), physical inactivity (18%), mental inactivity (15%), obesity (13%) and smoking (5%) of 861 unfavorable behaviour characteristics recorded in study subjects. Study results showed the leading diagnoses in the old people's home users (such as circulatory system diseases, hip fracture, non-insulin dependent diabetes mellitus) to be associated with negative health behaviors that can be considered as risk factors for the development or progression of the disease, in psychogeriatric patients in particular. CONCLUSIONS: The results obtained by gerontological-public health indicator analysis indicate that programs of geroprophylaxis, gerontologic and psychogeriatric measures should be implemented in old people's homes as a priority, with day centers for Alzheimer's disease patients. It is necessary to identify and evaluate risk factors for the occurrence of preventable diseases, change the negative health behaviors in the elderly, and apply the nutritional-gerontologic dietary standards at old people's homes including follow up of dietary intake of nutrients such as vitamins and mineral, with special reference to psychogeriatric patients.

Sex differences in morphological dimensions in twelve-year-old children from Imotska krajina.

The aim of the study was to identify and compare morphological characteristics of 12-year-old male and female children from Imotska krajina. The structure of a set of 23 morphological space variables were determined in a sample of 75 male and 67 female children by use of factor analysis for each sex in separate. Factor structure showed two basic superior latent dimensions responsible for directly measurable manifestations of morphological parameters in both male and female children. One of these two dimensions behaved as a general mechanism of growth and development, whereas the other showed a bipolar pattern. Bipolarity was almost exclusively determined by adipose tissue on one pole, and by skeletal longitudinal growth on the opposite pole. Rotation of the main components to varimax position yielded two morphological dimensions that were well balanced in both sexes (slightly better in girls); besides the predominant increase in adipose tissue, one of these dimensions was also responsible for the development of muscular tissue and skeletal transverse development, whereas the other was responsible for skeletal transverse development and muscular tissue development in addition to the predominant longitudinal skeletal growth. These observations suggested two developmental processes, i.e. transverse morphological development (first factor) and longitudinal morphological development (second factor), to be almost equally involved in the morphological development of 12-year-old male and female children. These developmental processes are highly genetically determined and can only in part be explained by the intensity of kinesiologic engagement. Based on the morphological structures defined, discriminative function of the morphological space primarily differentiated two developmental processes, i.e. longitudinal skeletal development (hand length in particular) in female children relative to transverse skeletal development (knee diameter in particular) in male children, pointing to the presence of full-swing puberty in female children, while yet to be expected in male children; thereafter, the differences in the ectomesomorphic morphological characteristics would be by far more pronounced in favor of male children.

The ageing of Croatian population.

With a share of people older than 65 years of 16.64 per cent in total population, Croatia is considered a very old country regarding it's population. This percentage is one of the highest in already old Europe. Demographic projections reveal a further increase of share of people older than 65 years in future. There are many causes of this condition. This fact carries negative economic and health care implications which burden Croatia. Many administrative reforms are necessary to resolve this issue and to avoid economy problems and intergenerational conflicts.

The story of the Croatian village of Rude after fifty years of compulsory salt iodination in Croatia.

The village of Rude is situated near Zagreb, the capital of Croatia in the last Alpine valley on Balkan. In the past, the village was well-known area of severe iodine deficiency disorders (IDD). In 1952', distinguished Croatian endocrinologist Professor Josip Matovinovic carried out detailed village survey. Goiter prevalence in school-age children was 85.0% (with 2.3% of cretins in the village). In 1953, the first regulation on compulsory salt iodination with 10 mg of KI/kg of salt was established in former Yugoslavia. Ten years later a dramatic decrease in goiter prevalence was recorded in all endangered areas of the country and no new cretins appeared. However, at the beginning of 1990' mild to moderate iodine deficiency still persisted in Croatia. In 1991, the village of Rude survey demonstrated goiter prevalence in school-age children of 35.0% and median of urinary iodine excretion (UIE) of 7.4 microg/dL. In 1996, the new obligatory regulation with 25 mg of KI/kg of salt was established in Croatia. The study aim was to monitor IDD status in the village after the new law on compulsory salt iodination. Measurements of UIE and thyroid volumes (Tvol) by ultrasound were performed in 7-11-y-old schoolchildren living in the village of Rude. Medians of UIE and body surface area (BSA)-adjusted Tvol in boys and girls were calculated. The study included 84 children in 1997, 132 in 2000, 72 in 2002, 85 in 2003 and 46 in 2004 for UIE measurement. Thyroid volumes were measured in 1999 (43 boys and 26 girls) and in 2005 (22 boys and 26 girls). Data were compared with the new WHO/ICCIDD reference values. Medians of UIE in schoolchildren from the village of Rude demonstrated rising values in microg/dL: 11.4 in 1997, 14.3 in 2000, 17.3 in 2002, 15.4 in 2003 and 19.0 in 2004. Significant decrease in BSA-adjusted Tvol was recorded from 1999-2005 in boys and girls from the village of Rude and in 2005 Tvol were within the normal range according to the new international reference values for Tvol in iodine-sufficient schoolchildren. As a result of increased iodine prophylaxis, IDD no longer exist in Croatia. Monitoring of IDD status in the village of Rude after new law on compulsory salt iodination in Croatia demonstrated rising medians of UIE together with significant reduction of Tvol. In 2005, Tvol in schoolchildren from the village of Rude were within the normal range according to the new international reference values for Tvol in iodine-sufficient schoolchildren.