Tendencies towards emigration and their association with introversion and ethnocentrism among final-year medical students from Osijek, Croatia: a cross-sectional study.

BACKGROUND: The migration of healthcare workers is attracting growing attention worldwide. Attitudes towards emigration develop over the years, and it is possible that, in addition to social factors, they are influenced by the characteristics of a person's personality and the sense of belonging to the social environment. This study aimed to determine the tendencies of final-year medical students' from Osijek, Croatia, towards emigration after graduation and after specialization, as well as their specialty preferences and to investigate whether introversion and ethnocentrism have an impact on attitudes toward leaving the country in search of employment elsewhere. METHODS: A cross-sectional study was conducted among final-year (6th year) medical students from Osijek, Croatia, in two consecutive academic years - 2014/2015 and 2015/2016. Students completed a questionnaire about sociodemographic characteristics, academic and scientific performance, preferences about their future medical career, the medical specialty of choice, emigration tendencies after graduation and specialization, ethnocentrism and introversion. RESULTS: There were 124 students who participated in the study (response rate: 96%). A quarter of participants agreed that they are likely or very likely to emigrate after graduation (25.0%) or after specialization (23.39%). Variables associated with the intention to emigrate were specialty preferences (students that prefer endocrinology and psychiatry had the highest emigration tendencies), academic year in which the participants were included (students included in 2014/2015 were more prone to emigrate after specialization, p = 0.060), prior involvement in scientific projects (students with experience in scientific projects expressed higher tendencies to emigrate after graduation, p = 0.023), and ethnocentrism (higher ethnocentrism was associated with a lower tendency towards emigration after specialization, Spearman's rho = -0.191). CONCLUSION: Our finding that a quarter of final-year medical students from the Faculty of Medicine Osijek were considering emigrating from Croatia in search of employment elsewhere after graduation or specialization is not as high as in previous Croatian studies or studies conducted in other European countries. Even though these data may be encouraging, considering the lack of physicians in Croatia, interventions are needed to prevent permanent emigration to protect the future functioning of the Croatian health system. Furthermore, our study did not find significant associations between levels of introversion and ethnocentrism and tendency to emigrate from Croatia. It seems that the phenomenon covering the emigration of students is more complex and influenced by many other factors which were not included in our study.

THE EFFECT OF DAILY PHYSICAL ACTIVITY ON THE ACTIVITY OF INFLAMMATORY BOWEL DISEASES IN THERAPY-FREE PATIENTS.

It has been suggested that various environmental factors play a very important role in the etiology of inflammatory bowel diseases (IBDs) and that they have a significant effect on the course of these diseases. The aim of this study was to investigate the effect of daily physical activity on the activity of IBDs in therapy-free patients. This cross-sectional population based study was conducted in eastern Croatia from January to June 2016. The study included 312 patients, mean age 49.9±15.0 years, 53.2% of males and 46.8% of females; there were 63.4% of ulcerative colitis (UC) and 36.6% of Crohn's disease (CD) patients. Sociodemographic characteristics of patients, data on their daily physical activity and type of therapy taken were collected through a specifically designed and validated questionnaire, while the activity of UC and CD was evaluated using the Mayo index and Harvey-Bradshaw index. The study showed that 24.0% of patients were not taking therapy. Daily physical activity was connected to IBD in study patients when taking both diseases collectively (Fisher exact test; p<0.001), as well as to the inactivity of CD (Fisher exact test; p=0.001) and UC (Fisher exact test; p=0.006), when observing each disease separately. Daily physical activity was connected to the inactivity of IBDs in patients not taking therapy. It is necessary to educate all IBD patients about the importance of physical activity in order to control their disease.

Alcohol-Related Injuries Among Eastern Croatian University Students.

The aim of this study was to describe the alcohol consumption patterns and to identify the association of injury with excess drinking among Croatian students. This cross-sectional study was conducted among 845 university students by the use of the WHO AUDIT questionnaire. A total of 39.9% of the university students reported some level of excess drinking and 21.3% reported that injury to themselves or others occurred as a result of their alcohol use. Conclusively, these results demonstrate a significant need for comprehensive programs to reduce alcohol intake and associated alcohol problems, as well as programs to reduce injuries among Croatian university students.

Depression and Suicidality during Pregnancy.

BACKGROUND: Pregnant women experience a set of biological and psychological disturbances. The aim of this study was to assess the appearance of depressive symptoms and suicidal thoughts in pregnant women during the third trimester of pregnancy. SUBJECTS AND METHODS: A total of 110 pregnant women were included in the study. All of them filled out an anonymous questionnaire about sociodemographic data, Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS: Study participants were between 18-46 years of age. 45.45% of the pregnant women were between 37 and 39 weeks pregnant. According to the EPDS, the risk for perinatal depression was observed in 29 (23.36%) pregnant women: 15 (13.64%) of them had a total score on EPDS from 10-12, and 14 (12.72%) had a total score of 13-20. A higher score on both Beck scales was characteristic for pregnant women with a higher risk for the development of perinatal depression based on the results on EPDS. The prevalence of suicidal thoughts was 2.73%. CONCLUSIONS: Perinatal depression is a state which should be given more attention. The recognition of perinatal depression during pregnancy allows health medical workers to observe pregnant women at risk and then to make preventive and clinical interventions. The risk for perinatal depression is higher in pregnant women with more expressed depressive and anxiety symptoms. Pregnant women with suicidal thoughts are more anxious and depressed.

Comparison of knowledge, attitudes and behaviour of health professionals and parents regarding child injuries.

OBJECTIVE: We wanted to primarily examine the knowledge, attitudes and behaviour of parents and health workers (community nurses and paediatricians) regarding child injuries in order to understand the essence of the problem and to find out the most common misconceptions. METHODS: Respondents were tested through an anonymous, self-administered questionnaire and all p values below 0.05 were considered significant. RESULTS: Of all respondents, paediatricians answered accurately most of the questions considering knowledge than the other groups. More than 90% of respondents, in all groups, identified correct answers to 10 questions about attitudes towards child injury prevention and safety promotion. CONCLUSION: This study, which shows the current level of knowledge, attitudes and behaviour patterns of parents and health professionals in Croatia, could help in the preparation of appropriate prevention programmes.

Malignant neoplasms of digestive organs (C15-C26) in the Osijek-Baranja County, Croatia.

The Institute of Public Health for the Osjek-Baranja County (OBC) has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of digestive organs (C15-C26). The aim of this article is to show the size of the problem and the burden of the health care system caused by cancers of the digestive system (C15-C26) in the OBC in the period 2001-2006. This article deals with cancer incidence and mortality data, appertaining age distribution, cancer survival, median age at diagnosis and at death and length of stay in hospitals. The overall incidence and mortality rate from cancer group C15-C26 (101.1 and 80/100,000, respectively, EU standard population) declined in all age groups, comparing the data originating from the 2001-2003 period to the data referring to the 2004-2006 period. The median age at diagnosis of cancer was 67.8 years with a shift of 0.91 year up in second period (the median age in the first period was 67.3 years and in the second one 68.2 years). The median age at diagnosis of cancer in females was 69.7 years while in males was 66.3 years, which represents a difference of 2.9 years in favour of females. The overall relative survival rate of all ages was 23.6%. This figure was slightly bigger for females (24.3%) than for males (23.1%). Concerning all age groups, the number of hospital admissions of males increased during the observation period while the number of hospital admissions of women decreased at the same time. The average length of stay over the six years did not changed significantly. Group of cancer C15-C26 was the most common group of cancers regarding both genders. The five-year relative survival as one of the reliable benchmarks of the quality of the health care system needs to be raised to a great extent in order to come nearer to the EU average within a short period of time.

Malignant neoplasms of respiratory and intrathoracic organs (C30-C39) in the Osijek-Baranja County, Croatia.

The Institute of Public Health of the Osijek-Baranja County in collaborate with different county institutes provide updated information on the cancer occurrence and trends in the Osijek-Baranja County (OBC). The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of respiratory and intrathoracic organs (C30-C39). The aim of this article was to show the size of cancer problem with the C30-C39 cancer group in the Osijek-Baranja County (OBC). This article processes data on cancer incidence and mortality, appertaining age distribution, median age, cancer survival and length of stay in hospital collected in period 2001-2009. Out of all patients diagnosed with C30-C39 cancers, there were 18.2% of females and 81.8% of males. The total incidence rate in males (119.5/100,000) decreases while the total mortality rate (110.9/100,000) does not change in 9-year period. In the same period, the total mortality rate in females (15.7/100,000) increase moderately. The age-standardized incidence rate was six times higher in males than in females. The overall median age at diagnosis of C30-C39 cancers of both genders was 64.5 years, which exceeds the average age at diagnosis of cancer in general in the OBC by 4.8 years. Five-year relative survival rate was 14.8%, 19.7% for females and 13.7% for males. Male lung and bronchus cancer patients (C34) were 1 year younger at diagnosis of cancer than the respective female patients. An average C30-C39 cancer patient was hospitalized 2.0 times during the course of their illness while the median length of stay in hospital amounted to 16.1 days. The number of hospital admissions in both genders decreased over the 2001-2009 period. In both genders, the total length of stay in hospitals was slightly reduced. Females spent 0.4 days more in hospital than males. The overall incidence and mortality rate in the OBC were among the highest in Europe. However, these rates in females reached neither the Croatian nor the EU average. Other data are similar to those in Europe.

Sexual behaviour and condom use as a protection against sexually transmitted infections in student population.

The aim of the study was to determine the differences in sexual behaviour and condom use as a protection against sexually transmitted infections (STI) between the first-year and the last-year students. Data were collected by filling anonymous and consented questionnaire in June of 2011 at University of Josip Juraj Strossmayer in Osijek, Croatia. Out of 857 students in the planned sample, 462 (53.9%) filled out the questionnaire, and 353/462 (76.4%) were sexually active. Data from sexually active students were processed and statistically significant results between first-year and the last-year students were presented. Studied sample consisted of 192/353 (54.4%) first-year students and 161/353 (45.6%) last-year students. Average age of sexual initiation for the first-year students was 17.28 +/- 1.29 years, a for the last-year students 18.45 +/- 2.14 years, and the difference is significant (Man-Whitney test = 10335.00, p < 0.01). First-year students have lower number of sexual partners (chi2 = 28.005, p < 0.01), during relationship they had lower number of intercourses with the third person (2 = 17.947, p < 0.01), and feel that lower number of their friends were already sexually active at the time of their own sexual initiation (chi2 = 18.350, p < 0.01). First-year students more often inform their partners about existing or previous STI (chi2 = 14.476, p < 0.01) and curiosity significantly influenced their decision regarding sexual initiation (chi2 = 8.689, p < 0.05). First-year students more often used condom at their first sexual intercourse (chi2 = 7.275, p < 0.01), and more rarely used withdrawal (chi2 = 6.380, p < 0.05). At their last sexual intercourse, first-year students more often used any kind of protection (chi2 = 3.853, p < 0.05),more often used condom (chi2 = 11.110, p < 0.01) and withdrawal (chi2 = 5.156, p < 0.05), and more rarely used contraceptive pills (chi2 = 4.405, p < 0.05). First-year students more often use condom in a permanent relationship (chi2 = 13.384, p < 0.05), and also plan to use it during following intercourse in the permanent relationship (chi2 = 17.575, p < 0.01). Growing condom use and decreasing risky sexual behaviour among students, as well as other adolescents and young adults needs to be maintained. Youth should learn before sexual initiation that only correct condom use at every sexual intercourse protects them against STI and human immunodeficiency virus (HIV). Sexual education and STI/HIV prevention programmes, positive role of media (television) and civil organisations that communicate with the youth can help that. Such changes among adolescents and young adults should have to be seen in student population as well.

Imbalanced concentrations of serum lipids and lichen planus.

The aim of this study was to analyze possible connection between the lichen planus and imbalanced concentrations of serum lipids and to evaluate the impact of various dietary regimes (used in the regulation of imbalanced concentrations of serum lipids) on the regression of lichen planus lesions. Research was conducted as a case-control study comprised of 72 patients with Lichen Planus and 30 participants from control group, treated at the Clinic for Dermatology and Venereology of the Clinical-Hospital Centre Osijek, Eastern Croatia, during 2010 and 2011. LP cases were diagnosed with both a clinical examination conducted by a dermatovenerology consultant and by patohistological diagnostic. Serum lipid levels (total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol) were determined by the classic laboratory diagnostics in both investigated groups (LP patients and control group). The present study has confirmed that there is a strong connection between the imbalanced concentrations of one or more serum lipids (cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) and the occurrence of LP which is important in the therapeutic approach to patients with this disease.

HEALTH CARE IN SLAVONIAN PROVINCE DURING THE 19th CENTURY / Zdravstvena skrb u slavonskom Provincijalu tijekom 19. stoljeca

Due to its proximity to the Ottoman Empire, Slavonia was constantly exposed to the threat of invasion by numerous infectious and non-infectious diseases. An additional aggravating circumstance was the poor living and hygienic conditions in Slavonia, poverty, droughts, and floods. After the withdrawal of the Ottomans at the end of the 17th century, medical care was provided only by a few barbers and 'ranarniks' (i.e., feldshers) who remained in the Slavonian province. Due to the poor medical care, in 1770, the Empress and Queen Maria Theresa issued the General Health Law, which applied to the entire Habsburg Monarchy, including Slavonia. Among other things, it provided for the introduction of formal training for health personnel, ultimately leading to a better quality medical workforce. At the same time, charlatans were increasingly prohibited from working. The shortage of trained physicians, dentists, midwives, pharmacists, and veterinarians was addressed through various measures to promote their education and training. After obtaining their diplomas, these professionals were employed in hospitals, old people's homes, nursing homes, homes for people with disabilities, and other healthcare institutions where the inhabitants of the Slavonian province received medical care.

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.

Neoplasms (C00-D48) in Osijek-Baranja County from 2001 to 2006, Croatia.

The Institute of Public Health of the Osijek-Baranja County has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms (C00-C97), in situ neoplasms (D00-D09) and neoplasms of uncertain or unknown behaviour (D37-D48). The aim of this article was to show the size of the cancer problem in Osijek-Baranja County (OBC) according to the all ICD-10 cancer groups. The cancer incidence and mortality estimated in period 2001-2006 were prepared for all cancers based on gender and for age groups 0-19, 20-44, 45-64, 65+ by the year of the first diagnosis of cancer. The median age at cancer diagnosis was 62.7 years, 61.2 years for females and 64.1 years for males. Applying the EU age-standardized rate, the average annual incidence and mortality rates in the OBC were 411.6/ 100,000 and 240.7/100,000, respectively. The incidence rates in both genders were highest for neoplasms of digestive organs (C15-C26), respiratory and intrathoracic organs (C30-C39) and for breast (C50) (101.1, 63.6 and 44.3/100,000, respectively). The first two groups of cancer in both genders were also the leading groups of cancer in males (141.6 and 124.9/100,000). The third position in males belonged to neoplasms of male's genital organs (C60-C63, 58/100,000). The leading group in females was C50 (79.3/100,000), followed by groups C15-C26 (73.2/100,000) and in situ neoplasms (D00-D09) (51.4/100,000). The course and shape of mortality rate in the whole corresponded to the incidence rate, but at the lower level. The only exception referred to group C15-C26 (56.8/100,000) as leading mortality cancer group in females. The overall 5-year relative survival was 40.1%. Considering females, this rate amounted to 48.8% while this figure was much lower in men--32.4%. In age group 65+, 52.6% of cancer patients developed a cancer and 65.4% of patients died at the same age. These basic parameters indicate that the OBC must put great efforts in creating a long-term strategy for cancer prevention and early diagnostics in order to prolong life and improve the quality of life of cancer patients and raise the proportion of 5-year survival.

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.

Effects of magnesium, chromium, iron and zinc from food supplements on selected aquatic organisms.

The aim of this study was to determine the effect of uncontrolled environmental disposal of food supplements containing magnesium (Mg), chromium (Cr), iron (Fe) and zinc (Zn) on selected aquatic organisms including freshwater algae Scenedesmus subspicatus and Raphidocelis subcapitata, water flea Daphnia magna and duckweed Lemna minor. Thirty different food supplements containing Mg, Cr, Fe and Zn were analyzed. Results were expressed as effective concentration 50 (EC50), i.e. growth inhibiting Mg, Cr, Fe and Zn (mg/L) concentration immobilizing 50% of treated organisms. Particular metal EC50 differed significantly (p < 0.001) among study organisms, as follows (in ascending order): Scenedesmus subspicatus EC50 Fe (median 46.9 mg/L) < Zn (59.8 mg/L) < Mg (73.0 mg/L) < Cr (88.1 mg/L) (KW-H(3;120) = 36.856; p < 0.001); Raphidocelis subcapitata EC50 Fe (median 44.9 mg/L) < Zn (52.6 mg/L) < Mg (62.2 mg/L) < Cr (76.8 mg/L) (KW-H(3;120) = 44.0936; p < 0.001); Daphnia magna EC50 Zn (median 59.4 mg/L) < Cr (79.2 mg/L) < Fe (80.8 mg/L) Mg (82.0 mg/L) (KW-H(3;120) = 39.2637; p < 0.001); and Lemna minor EC50 Zn (median 131.0 mg/L) < Fe (186.8 mg/L) < Mg (192.5 mg/L) < Cr (240.4 mg/L) (KW-H(3;120) = 58.6567; p < 0.001). Uncontrolled environmental disposal of food supplements containing Mg, Cr, Fe and Zn exerts adverse effects on aquatic organisms. Therefore, legal provisions should regulate both the utilization and disposal of food supplements into the environment.

Red and processed meat and cardiovascular risk factors.

AIMS: The British National Diet and Nutrition 2000/1 Survey data set records on 1,724 respondents (766 males and 958 females) were analyzed in order to assess the potential influences of red and processed meat intakes on cardiovascular risk factors. METHODS: Linear regression of the associations of the red, processed, combination of red and processed, and total meat intakes with body mass index (BMI), systolic blood pressure and plasma total cholesterol as cardiovascular risk factors was conducted, paying due attention to the subject age and sex as potential confounders. RESULTS: Linear analyses showed the total meat intake and combined red and processed meat intake to cause a 1.03 kg/m2 rise in BMI each, while the red and processed meat intakes analyzed as separate categories caused 1.02 kg/m2 rise each. The greatest effects were observed on the systolic blood pressure with a 1.7 mm Hg rise for the total and the red and processed meat intakes, 1.5 mm Hg rise for the red meat intake, and 1.02 mm Hg rise for the processed meat intake. There were no associations between different meat intakes and plasma total cholesterol. DISCUSSION AND CONCLUSION: Study results revealed the interquartile ranges of the mentioned meat type intakes to increase BMI by around 1 kg/m2 and systolic blood pressure by around 1.5 mm Hg, while they had no influence on plasma total cholesterol.

Adherence to Dietary Recommendations in Organized Living Beneficiaries with Severe Mental Disorders and Their Caregivers.

People with severe mental disorders often require special care. Other than institutionalized care, some organizations provide housing options and special care in the form of organized living. Few studies provide a detailed description of nutrient intake in this type of care. The aim of this prospective study was to assess nutritional status and adherence to dietary recommendations in both people with mental disorders (beneficiaries) and their caregivers. Across three levels of care, 46 beneficiaries and 19 caregivers participated in the study. The mean intakes of energy (kcal/day) and macro- and micronutrients (g/day) were estimated from a 3-day dietary record and compared with dietary reference values (DRVs) set by the European Food Safety Authority (EFSA). The majority of participants did not meet energy intake recommendations (kcal/day). The contribution of total fat to energy intake (% E) was higher than recommended in both beneficiaries and caregivers with 42.1 ± 4.4% and 38.5 ± 6.5%, respectively. A total of 45.2% of beneficiaries and 61.1% of caregivers had their carbohydrate intake within the recommended range. Fiber intake was well below the recommendations (25 g/day) in all groups. Across all levels of care, lower micronutrient intake for pantothenic acid, biotin, folate, potassium, magnesium, copper, selenium, and iodine was observed. Based on the current results, the development and implementation of nutritional guidelines may be targeted to specific populations and nutrient intakes.

The Attitudes and Practices Regarding COVID-19 among General Practitioners from Croatia and Bosnia and Herzegovina: A Cross-Sectional Study.

Attitudes toward COVID-19 (coronavirus disease 2019) prevention and control may have influenced general practitioners' (GPs') work during the COVID-19 pandemic. The present study aimed to investigate the attitudes and practices of GPs from Croatia and Bosna and Herzegovina regarding COVID-19 prevention and control as well as the factors which may have influenced them. A cross-sectional study using a self-administered, anonymous questionnaire was conducted between February and May of 2022 on 200 Croatian and Bosnian GPs. The study revealed that the attitudes and practices of the surveyed GPs regarding COVID-19 prevention and control were satisfactory. The Croatian GPs reported a larger number of positive attitudes toward COVID-19 prevention and control (p = 0.014), while no significant differences in practices were established. Among the Croatian GPs, more positive attitudes toward COVID-19 prevention and control were reported by participants who had finished a formal education on the prevention of infectious diseases and occupational safety (p = 0.018), while among the Bosnian GPs, more positive attitudes were reported by older GPs (p = 0.007), males (p = 0.026), GPs with a longer length of service (p = 0.005), GPs who had finished a formal education on the prevention of infectious diseases and occupational safety (p < 0.001), GPs who had finished a formal education on adequate hand hygiene (p < 0.001), and GPs who had finished a formal education on COVID-19 prevention for GPs (p = 0.001). Considering GPs' practices regarding COVID-19 prevention and control, among the Croatian GPs, more positive practices were reported by older GPs (p = 0.008), females (p = 0.002), GPs who had a partner (p = 0.021), GPs who were specialists in family medicine (p = 0.014), GPs with a longer length of service (p = 0.007), and GPs who had finished a formal education on the prevention of infectious diseases and occupational safety (p = 0.046), while among the Bosnian GPs, no significant correlations were determined. The general practitioners' sociodemographic and employment characteristics strongly influenced their attitudes and practices regarding the prevention and control of COVID-19. The cultural differences between Croatia and Bosnia and Herzegovina, as well as the organizational specificities of their healthcare systems, probably modified the observed differences in the individual patterns of associations between the outcome and explanatory variables in the surveyed neighboring countries.

Objective identification of sexual risk behavior among blood donors in Croatia: is it reality?

BACKGROUND: The objective of this study is to determine the prevalence of blood donors positive for herpes simplex virus type 2 (HSV-2), to identify the patterns of sexual risk behavior responsible for HSV-2 positivity and to assess the reliability of HSV-2 positivity as a marker of sexual risk behavior in the study population. METHODS: This cross-sectional study included 423 blood donors of both sexes from eastern Croatia. Their blood samples were tested by ELISA IgG test kit for HSV-2 IgG and Western blot. Data on sexual risk behavior were collected by use of an anonymous questionnaire. RESULTS: Western blot testing showed HSV-2 IgG antibodies in 14 of 423 (3.3%) donor blood samples. The most common patterns of sexual risk behavior potentially associated with test positivity were irregular condom use during sexual intercourse with new partners (294/423; 69.5%) and > or = 5 sexual partners during lifetime (213/423; 50.4%). CONCLUSIONS: The population of blood donors from eastern Croatia included subgroups of subjects characterized by sexual risk behavior. Study results pointed to a relationship between various forms of sexual risk behavior and HSV-2 positivity, which could therefore serve as a reliable marker of sexual risk behavior in the study population.

Polymorphisms of vitamin D receptor gene in the population of eastern Croatia with psoriasis vulgaris and diabetes mellitus.

The aim of this study was to evaluate the possible association between polymorphisms in the Vitamin D receptor gene (VDR gene) and tendency for development of psoriasis vulgaris and diabetes mellitus in the population of Slavonia, which is a region in the Eastern Croatia. In order to conduct the mentioned evaluation the restriction fragment length polymorphisms (ApaI, BsmI and TaqI) in the Vitamin D receptor gene were researched in three groups of patients: patients suffering only from psoriasis vulgaris, patients suffering only from diabetes mellitus, and patients suffering at the same time from both diseases. Four most common genotypes were found in all standardized control patients: triple heterozygotes BbAaTt (in 29.3% of the studied patients), bbAaTT (in 18.6% of the studied patients), bbaaTT (in 12.9% of the studied patients) and BbAATt (in 8.6% of the studied patients). Three most common VDR 3'-RFLP haplotypes determined in this study were: three-component baT, Bat and bAT haplotype. Results of the Hardy-Weinberg equilibrium showed presence of BsmI polymorphism genotype frequencies disequilibrium in the group of patients suffering from psoriasis and ApaI polymorphism in the group of patients suffering from both diseases. According to the same statistical test all conditions for TaqI polymorphism genotype frequency were fulfilled in all groups of studied patients. There was no significant difference in distribution of BsmI, ApaI or TaqI polymorphism genotype frequencies between control patients and any of the subgroup of studied patients. In studied population none of analysed polymorphisms individually was associated with the risk of development of psoriasis, diabetes or combined phenotype.

Vaccination Attitudes and Experiences of Medical Doctors in Croatia amid the COVID-19 Pandemic: A Social Roles Conflict?

The study aimed to investigate the range of experiences and attitudes of Croatian medical doctors (MDs) related to vaccination and vaccine hesitancy. In January 2021 three asynchronous online focus groups were held using MRQual, a web-based platform, which included 46 MDs from all three levels of the healthcare system in Croatia. NVivo, a qualitative data analysis software package, was used for the thematic analysis of collected data. The participants expressed a high level of support for the Croatian immunization program and vaccines in general. However, some skepticism was expressed regarding new vaccines and the regulatory processes of their approval. A significant number of participants raised concerns over the approval of COVID-19 vaccines, especially given their rapid development. The results also revealed that the process of communication with patients is often based on the very elaborate categorizations of patients based on previous experience, which leads to prioritizing and a communication breakup when dealing with "problematic patients". MDs find themselves in a delicate situation where a fine balance between time-consuming communication with patients and the demands for maintaining satisfying vaccination uptake is needed. The situation arises from a social roles conflict that is embedded in wider social values and expectations, since communication problems do not arise in the doctor's office, and therefore cannot be solved without addressing the social forces that cause trust deficiencies. To achieve better immunization results public health leaders need to better understand the social contexts and constraints of MDs vaccine-related behaviors.