Lack of Informations about COVID-19 Vaccine: From Implications to Intervention for Supporting Public Health Communications in COVID-19 Pandemic.

Lack of knowledge and mistrust towards vaccines represent a challenge in achieving the vaccination coverage required for population immunity. The aim of this study is to examine the opinion that specific demographic groups have about COVID-19 vaccination, in order to detect potential fears and reasons for negative attitudes towards vaccination, and to gain knowledge on how to prepare strategies to eliminate possible misinformation that could affect vaccine hesitancy. The data collection approach was based on online questionnaire surveys, divided into three groups of questions that followed the main postulates of the health belief theory-a theory that helps understanding a behaviour of the public in some concrete surrounding in receiving preventive measures. Ordinary least squares regression analyses were used to examine the influence of individual factors on refusing the vaccine, and to provide information on the perception of participants on the danger of COVID-19 infection, and on potential barriers that could retard the vaccine utility. There was an equal proportion of participants (total number 276) who planned on receiving the COVID-19 vaccine (37%), and of those who did not (36.3%). The rest (26.7%) of participants were still indecisive. Our results indicated that attitudes on whether to receive the vaccine, on how serious consequences might be if getting the infection, as well as a suspicious towards the vaccine efficacy and the fear of the vaccine potential side effects, may depend on participants' age (<40 vs. >40 years) and on whether they are healthcare workers or not. The barriers that make participants' unsure about of receiving the vaccine, such as a distrust in the vaccine efficacy and safety, may vary in different socio-demographic groups and depending on which is the point of time in the course of the pandemic development, as well as on the vaccine availability and experience in using certain vaccine formulas. There is a pressing need for health services to continuously provide information to the general population, and to address the root causes of mistrust through improved communication, using a wide range of policies, interventions and technologies.

Prescribing Analgesics to Older People: A Challenge for GPs.

BACKGROUND: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. OBJECTIVES: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. METHODS: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. RESULTS: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50-79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60-79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. CONCLUSION: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs' prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.

The Effect of Hypertension Duration and the Age of Onset on CV Risk Factors Expression in Perimenopausal Women.

BACKGROUND: The impact of hypertension duration and the time of onset on the expression of metabolic syndrome (MS) and other CV risk factors, in perimenopausal women, have not been studied so far. Methods. A total of 202 women, old 47-59 years, and diagnosed with hypertension, were recruited from primary care practices in eastern Croatia. The categories of hypertension duration were defined as <5, 5-10, and >10 years. Data were analyzed by standard statistical procedures. RESULTS: The proportion of women with MS increases in parallel with hypertension duration (p = 0.025). Among the examined CV risk factors, significant increase in parallel with hypertension duration was found for body mass index (p = 0.007) and triglycerides (p = 0.07). The highest proportion of women with diabetes duration of less than 5 years, indicating recent diabetes onset, was found in the category of hypertension duration of less than 5 years, corresponding with the onset of hypertension in the time around menopause (p = 0.003). The strongest linear correlations with BMI and waist circumference were found for total serum cholesterol (r = 0.355 and 0.499, respectively). CONCLUSION: Hypertension onset at the time around menopause appears together with abdominal obesity and may be a driving force for CV risk factor accumulation in postmenopausal women.

Seasonality of the Cardiac Biomarker Troponin in the Eastern Croatian Population.

BACKGROUND: The seasonality of acute myocardial infarction and progressive heart failure has been well established so far. Cardiac troponins (cTns) are organ-specific, not disease-specific, biomarkers. The seasonality of cTns has not been reported before. METHODS: Data were collected from the emergency admission unit of a community hospital in eastern Croatia for each month of the year 2014 covering the number of patients whose doctors requested high-sensitivity cTn I (hs-cTn I) testing, the number of positive test results and hospital admissions. RESULTS: The proportion of patients with positive test results was 15.75% (350 patients out of 2221 patients referred to testing), with the males being outnumbered by the females (F: 57.15%, M: 42.85%) (p = 0.069). The month with the highest number of patients with positive test results was December, whereas the month with the lowest number of those patients was January (p < 0.001). The highest numbers of patients referred to testing (30.9%) and of those with positive test results (50.8%) were found in the oldest age group (76+). CONCLUSION: Tracking the results of cTns testing during patient admissions to emergency departments would be a more effective approach from a public health perspective than tracking the number of patients diagnosed with a particular cardiovascular (CV) disease and could be used as a research approach to guide a search for precipitating factors for CV disease specific to a local community.

The prevalence and the risk factors of the cervical colonization by the genital mycoplasmas among pregnant women from Eastern Croatia.

The aim of this study was to determine the prevalence of the genital mycoplasmas cervical colonization among the pregnant women from the Eastern Croatia and to evaluate its correlation with the demographic and the behavioural risk factors. Study was conducted from March 2010 to April 2011 at the Microbiology Department of the Institute of Public Health for the Osijek-Baranja County. The study included 456 pregnant women in the first and the second trimester of pregnancy. Demographic data and data on their possible risk behaviour during the lifetime were collected with the usage of an anonymous questionnaire consisting of the 16 questions. The Mycoplasma Duo kit test was used to diagnose the mycoplasma infections. Due to the fact that the results were generally similar for the women with U. urealyticum or M. hominis and in order to dichotomize the analyses, 164 (36%) participants with U. urealyticum, M. hominis or both were considered positive, whereas 292 (64%) participants without U. urealyticum or M. hominis were considered negative. A higher genital mycoplasmas prevalence was statistically significantly associated with the younger group of the pregnant women (16-29 y), 5 or more sexual partners during lifetime and the age on the first intercourse < or = 16. The study has showed that both the demographic and the behavioural risk factors were associated with the higher genital mycoplasmas colonization in the observed population.

Prevalence and risk factors for herpes simplex virus type 2 infections in East Croatia.

The aim of the study was to establish the seroprevalence of herpes simplex virus type 2 (HSV-2) among sexually active adults from East Croatia and to evaluate its correlates with demographic and behavioural risk factors. This cross-sectional study was conducted from the 1st June until the 30th September 2005 at the Department of Transfusion Medicine, Osijek University Hospital Center. The study included 423 blood donors composed of 366 (86.5%) men and 57 (13.5%) women. Demographic data and data on the risky sexual behaviour during the lifetime were collected with usage of an anonymous questionnaire consisting of 15 questions. Western blot testing revealed that 3.3% (14/423) subjects were positive for the presence of IgG antibodies to herpes simplex virus 2, i.e. 10 (2.7%) men and 4 (7.0%) women. A higher HSV-2 seroprevalence was associated with female sex, older age, marital status (with single subjects been under the greater risk), irregular condom use on sexual intercourses with new partners and with higher number (five or more) of sexual partners during lifetime. Among determined risk factors in the study population, only the connection between the HSV-2 positivity and the older age was statistically significant. The study has showed that the demographic rather than the behavioural risk factors are associated with higher prevalence of HSV-2 antibodies in the observed population.

Cervical cancer in Osijek-Baranja County--possibilities for prevention.

In Osijek-Baranja County, there was a rise in the number of non-invasive and fall of invasive cervical cancer in the period 2000-2008, but cervical cancer still represents an important public health problem in Osijek-Baranja County. Cervical cancer in 2008 was the ninth female cancer site and represents 3.5% of all malignant diseases in women. In the same year it was also at the ninth place of all cancer deaths in women with a share of 3.3%. The large number of women cervical cancer was detected at an advanced stage of the disease so that there is an pincrease in mortality from cervical cancer. Although the incidence of cervical cancer is lower in relation to Croatia and other countries in the region, the mortality rate is still higher than in the countries of Western Europe. In order to reduce the incidence and mortality of cervical cancer primary task of the public health system is the introduction of secondary prevention through properly organized screening program. The program should be tailored to the financial and human resources and local specificities, with the agreement on a strategy that will give the best results.

Prevalence and risk factors of alcohol abuse among university students from eastern Croatia: questionnaire study.

The aim of the study was to examine the prevalence of alcohol abuse among university students in Osijek, Croatia and its possible interconnections with gender, year of study, repetition of year of study, faculty subject area, sources of financing and type of residence during study. A validated questionnaire was self-administered to cross-faculty representative student sample of "J. J. Strossmayer" University of Osiek in June 2006. General demographic data, as well as data on academic features and student socio-economical status were obtained. The Alcohol Use Disorders Identification Test (AUDIT) was used for assessing the extent of alcohol consumption, with cut off value of 8 indicating possible alcohol problems. The majority of study participants 90.9% (755/831) had tried alcohol at least once in their life. Among this group, 43.8% (331/755) had an AUDIT total score of 8 or more: 69.2% (229/331) were males and 30.8% (102/331) were females. Among the study participants who screened positive, 70.4% (233/331) responded positively to simple advice focused on the reduction of hazardous drinking (AUDIT 8-15), 14.5% (48/331) needed brief counseling and continued monitoring (AUDIT 16-19), and 15.1% (50/331) clearly warranted further diagnostic evaluation for alcohol dependence (AUDIT 20 and above). Significantly different statistical data was found within the following factors: gender, repetition of year of study, faculty subject area and type of residence (chi2 = 76.232, p = 0.0000; Fisher exact test = 31.828, p = 0.0000; chi2 = 11.667, p = 0.0086 and chi2 = 6.639, p = 0.0362 respectively). Alcohol consumption resulting in risk behaviors is common among university students from eastern Croatia. These findings emphasize the need for comprehensive and effective preventative strategies directed towards student population.

Effect of aminglycoside administration on the occurrence and multiplication of resistant bacteria.

In the prospective study the susceptibility of 41 Escherichia coli strains and 55 Pseudomonas aeruginosa strains to gentamicin, netilmicin and amikacin was tested at a 2-year interval (period I April 1998 to March 1999, and period II April to July 2001). Genotyping was performed by pulsed-field gel electrophoresis, and a clone based on 80% or 90% similarity was determined for each of the study bacteria. In 24 (32.0%) clones, strains showed no variation over 2-year interval, supporting the hypothesis on a priori susceptible strains. Transformation from susceptibility in period I to resistance in period II was demonstrated in 5 (6.7%) clones, a pattern consistent with the concept of bacterial development of resistance under the influence of antibiotics. However, there were 10 (13.3%) clones whose strains exhibited an inverse pattern. Accordingly, two-way transformation of susceptibility took place during the study period. The utilization of the study aminoglycosides had no major impact on the variation of microbial susceptibility. Changes in microbial susceptibility were found to follow some regular patterns, which were not influenced by the study aminoglycosides. Two phenomena were observed: (i) there were stable clones that did not develop resistance in spite of selective antibiotic challenge; and (ii) changes of susceptibility in isolated bacteria from both inpatient and outpatient strains of the same clone were two-way and reversible.