Bone fragment or bone powder? ATR-FTIR spectroscopy-based comparison of chemical composition and DNA preservation of bones after 10 years in a freezer.

Freezing bone samples to preserve their biomolecular properties for various analyses at a later time is a common practice. Storage temperature and freeze-thaw cycles are well-known factors affecting degradation of molecules in the bone, whereas less is known about the form in which the tissue is most stable. In general, as little intervention as possible is advised before storage. In the case of DNA analyses, homogenization of the bone shortly before DNA extraction is recommended. Because recent research on the DNA yield from frozen bone fragments and frozen bone powder indicates better DNA preservation in the latter, the aim of the study presented here was to investigate and compare the chemical composition of both types of samples (fragments versus powder) using ATR-FTIR spectroscopy. Pairs of bone fragments and bone powder originating from the same femur of 57 individuals from a Second World War mass grave, stored in a freezer at - 20 °C for 10 years, were analyzed. Prior to analysis, the stored fragments were ground into powder, whereas the stored powder was analyzed without any further preparation. Spectroscopic analysis was performed using ATR-FTIR spectroscopy. The spectra obtained were processed and analyzed to determine and compare the chemical composition of both types of samples. The results show that frozen powdered samples have significantly better-preserved organic matter and lower concentrations of B-type carbonates, but higher concentrations of A-type carbonates and stoichiometric apatite. In addition, there are more differences in the samples with a low DNA degradation index and less in the samples with a high DNA degradation index. Because the results are inconsistent with the current understanding of bone preservation, additional research into optimal preparation and long-term storage of bone samples is necessary.

An international cross-cultural study of nursing students' perceptions of caring.

BACKGROUND: Single studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures. OBJECTIVE: To determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students. DESIGN: A cross-sectional descriptive study design was used. SETTINGS AND PARTICIPANTS: The study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation. METHODS: The 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results. RESULTS: The results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the 0.05 significance level. The main effect for country was F(3, 596) = 3.591, p < 0.0136 indicating a significant difference in CDI-25 between Slovenia (M = 108.9, SD = 9.2), Russian Federation (M = 107.1, SD = 8.2), China (M = 102.8, SD = 9.7) and Croatia (M = 110.0, SD = 8.6). CONCLUSIONS: Perceptions of caring in nursing students differ across countries, probably due to different educational systems, curricula, cultural differences and societal values. Implementing caring theories in nursing curricula could help students to cultivate caring during their education.

Observations on Osteoporosis in Three Generations of Descendants of Holocaust Survivors.

BACKGROUND: Throughout history, studies on episodes of famine have led to the discovery of metabolic abnormalities and hormonal aberrations as well as an increased incidence of cancer and mental health conditions. Starvation during early life is thought to nfluence the programming of childhood and adult bone metabolism, which may result in poor bone health in later life. This observational case series includes a small group (with no control group) of famine-exposed Holocaust survivors and their descendants. We proposed an investigational mechanism to determine any association between starvation and osteoporosis, both in the individual survivors and in their descendants.

Intercultural Competence of Western Teachers for Nepalese Rescuers.

INTRODUCTION: Educational projects in mountain rescue in Nepal have a long tradition. They are usually led by Western experts who train their Nepalese colleagues using teams of people with diverse cultural background. To better understand the challenges of these encounters, we conducted a prospective cohort study during the first mountain rescue instructor course in Nepal. METHODS: Western instructors (WIs) and Nepalese instructor candidates (NICs) were asked to self-assess their intercultural competence with the help of questionnaires. The responses were compared and analyzed for differences between WIs and NICs and differences in a pre-post assessment of the WIs. In addition, semistructured interviews were conducted with randomly selected NICs. RESULTS: We found significant differences in communication styles between NICs and WIs: NICs showed a preference to establish relationships before discussing business and not to speak openly in conflict situations. WIs were much more direct and preferred dispassionate exchanges. In an assessment after the course, WIs had changed their attitude toward the host culture. CONCLUSIONS: We found differences in communication styles between WIs and NICs that are relevant to globalized medical education. Faculty members should be prepared before implementing medical training abroad and should have time to experience the host culture.

Attitudes of the Prekmurje Roma towards health and healthcare.

BACKGROUND: Knowledge of the culture, traditions and values of the Roma is important for understanding their relationship to health and the health system. The Roma in Prekmurje, the far northeastern part of Slovenia, are a unique ethnic group and in many respects different from other Roma. The aim of the study was to determine their attitudes towards health and the healthcare system. METHODS AND MATERIALS: We conducted 25 interviews in Roma settlements. The participants were between 18 and 64 years of age, with the average age being 23.46 years old; 48 % were men and 52 % women. We used qualitative content analysis as the data analysis technique. As a tool to facilitate the qualitative data analysis, we used the software Atlas.ti. In the study, we used a data-driving coding scheme. Two independent coders carried out the coding. RESULTS: We determined eight logical categories that explain the attitudes of the Roma towards health, satisfaction, problems and prospects and the functioning of the health system at the local level. These are experiences with the healthcare system, personal healthcare, the perception of health and illness, suggestions for improvement, common diseases as perceived by the Roma, poverty and socioeconomic status of the Roma, discrimination and the need for a better understanding of the Roma. CONCLUSION: Roma culture and their customs affect the Roma's relationship with health and the healthcare services in Prekmurje. The Roma are willing to participate in health status improvement, but require special attention within the national healthcare system.

Slovenian population data for five new European Standard Set short tandem repeat loci and SE33 locus.

AIM: To establish the allele distribution and statistical parameters of forensic interest for the D10S1248, D22S1045, D2S441, D1S1656, D12S391, and SE33 loci in Slovenian population and to compare allele frequencies with those from other populations. METHODS: We analyzed blood and buccal swab samples from 333 unrelated, healthy Slovenian individuals. All samples were genotyped using the AmpFlSTR NGM Kit to obtain the allele frequency data for the loci D10S1248, D22S1045, D2S441, D1S1656, and D12S391. Samples from 113 individuals were also analyzed using the PowerPlex ESX 17 system to obtain the allele frequency data for the SE33 locus. Allele frequencies and statistical parameters of forensic interest were determined and frequency profiles compared between Slovenian and other European Caucasian populations using the Arlequin software, version 3.5.1.3. RESULTS: The investigated short tandem repeat (STR) loci in Slovenian population had a great discriminating potential with a combined discrimination power of 0.99999998. The highest discrimination power and polymorphism information content were observed for the SE33 locus, followed by loci D1S1656, D12S391, D10S1248, D2S441, and D22S1045. When Slovenian allele frequency distribution was compared with other European populations, deviations were found only for Spanish and Italian population for D2S441 and D12S391. CONCLUSION: Slovenian population does not differ significantly from other European populations in terms of allele frequency distributions for the six analyzed STR loci. Based on forensic efficiency values, SE33 may be considered the most informative locus, which makes it especially useful in forensic investigations.

Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study.

BACKGROUND: Several studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the U.S.A., limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further. METHOD: Data were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data. RESULTS: The analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p<0.001). However, the findings varied significantly across countries, with the difference being significant only in the U.K., where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59­4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event. CONCLUSIONS: These results do not support the notion that religious and spiritual life views enhance psychological well-being.

Recent trends of cancer mortality in Romanian adults: mortality is still increasing, although young adults do better than the middle-aged and elderly population.

We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population. Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men-1.5% from 1997, women-1.2% 1997-2004 and -3.8% 2004-2009), male lung cancer (-2.8% from 1997), female breast (-3.5% from 1999) and cervical (-5.4% from 2004) cancers, mortality has increased in middle-aged and elderly patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians.

Hierarchization and segmentation of informal care markets in Slovenia.

The article is the result of qualitative research of informal care markets in Slovenia in the field of childcare, elder care, and cleaning. The author assesses Slovenia's position in the "global care chain" and finds that "local care chains" prevail in the field of childcare and elder care, while a co-occurrence of female gender, "other" ethnicity, and poverty is typical in the field of household cleaning. The main emphasis of the article is on the analysis of hierarchization of the informal market of care work according to following two criteria: social reputation of individual type of care work and citizenship status of care workers.

Economic participation and national self-identification of refugees in the Netherlands.

This study examines whether refugees self-identify as a member of the host society. We use survey data of more than 2,500 Somali, Iraqi, Afghani, Iranian, and ex-Yugoslavian refugees in the Netherlands. The results show that economic participation in the host country is positively related to refugees' national self-identification. In addition, we find that refugees' social ties with Dutch natives are associated with national self-identification and that the relationship between economic participation and national self-identification is partially explained by these social ties. Perceived discrimination is not related to refugees' national self-identification. Implications of these findings for debates on immigration and integration are discussed.

Social policies related to parenthood and capabilities of Slovenian parents.

We apply Sen's capability approach to evaluate the capabilities of Slovenian parents to reconcile paid work and family in the context of the transition to a market economy. We examine how different levels of capabilities together affect the work­life balance (WLB) of employed parents. We combine both quantitative and qualitative methodological approaches. The results of our quantitative and qualitative research show that increased precariousness of employment and intensification of work create gaps between the legal and normative possibilities for successful reconciliation strategies and actual use of such arrangements in Slovenia. The existing social policies and the acceptance of gender equality in the sphere of paid work enhance capabilities for reconciliation of paid work and parenthood, whereas the intensification of working lives, the dominance of paid work over other parts of life, and the acceptance of gender inequalities in parental and household responsibilities limit parents' capabilities to achieve WLB.

Work, family, and managerial attitudes and practices in the European workplace: comparing Dutch, British, and Slovenian financial sector managers.

Managers are key actors shaping employees' capabilities to utilize work­life policies. However, most research on managers' implementation of these policies has been conducted in liberal welfare states and ignores the impact of institutional context. In this study, we situate managers within specific workplace and national layers of context. We investigated how managers in financial organizations in the Netherlands, UK, and Slovenia talk about the utilization of work­life policies. Managers' discourses stressed disruption and dependency considerations in these case studies, as in the US research. However, a further management discourse of the moral case or right thing to do also emerged. The lack of resources for replacing staff on leave creates disruption and reduces managers capability to support the use of work­life policies, even when they are statutory or if managers are inclined be supportive (dependency or moral argument). This is likely to impact on parents' capabilities.

Use of 3-dimensional surface acquisition to study facial morphology in 5 populations.

INTRODUCTION: The aim of this study was to assess the use of 3-dimensional facial averages for determining morphologic differences from various population groups. METHODS: We recruited 473 subjects from 5 populations. Three-dimensional images of the subjects were obtained in a reproducible and controlled environment with a commercially available stereo-photogrammetric camera capture system. Minolta VI-900 (Konica Minolta, Tokyo, Japan) and 3dMDface (3dMD LLC, Atlanta, Ga) systems were used. Each image was obtained as a facial mesh and orientated along a triangulated axis. All faces were overlaid, one on top of the other, and a complex mathematical algorithm was performed until average composite faces of 1 man and 1 woman were achieved for each subgroup. These average facial composites were superimposed based on a previously validated superimposition method, and the facial differences were quantified. RESULTS: Distinct facial differences were observed among the groups. The linear differences between surface shells ranged from 0.37 to 1.00 mm for the male groups. The linear differences ranged from 0.28 and 0.87 mm for the women. The color histograms showed that the similarities in facial shells between the subgroups by sex ranged from 26.70% to 70.39% for men and 36.09% to 79.83% for women. The average linear distance from the signed color histograms for the male subgroups ranged from -6.30 to 4.44 mm. The female subgroups ranged from -6.32 to 4.25 mm. CONCLUSIONS: Average faces can be efficiently and effectively created from a sample of 3-dimensional faces. Average faces can be used to compare differences in facial morphologies for various populations and sexes. Facial morphologic differences were greatest when totally different ethnic variations were compared. Facial morphologic similarities were present in comparable groups, but there were large variations in concentrated areas of the face.

Promoter and functional polymorphisms of HTR2C and suicide victims.

In Europe, the countries with the highest suicide rates form a so-called J-curve, which starts in Finland and extends down to Slovenia-a country with one of the world's highest suicide rates. So far, the strongest association between suicide and genes has been shown for the serotonergic system. A functional polymorphism 68G>C (Cys23Ser) and a promoter polymorphism-995G>A of serotonin receptor 2C (HTR2C) have already been investigated, but no associations with suicide were determined. In the present study 334 suicide victims and 211 controls of Slovenian origin were genotyped for the above-mentioned polymorphisms using standard methods. In the case of the polymorphism-995G>A no association with suicide was found. However, a significant association was observed between female suicide victims and polymorphism 68G>C. The significance remained when we combined alleles of female and male populations. An excess of GG genotype and allele G was observed. However, no statistically important differences were present when only males were analyzed. Haplotype analysis on female population showed marginal association of haplotype G-C with suicide. The present study speaks for the plausible implication of the HTR2C in suicide susceptibility.

INHA promoter polymorphisms are associated with premature ovarian failure.

Inhibin is an important glycoprotein that is involved in folliculogenesis. INHA, the gene encoding the inhibin alpha subunit, was recently proposed as a candidate for premature ovarian failure (POF), a syndrome that leads to the cessation of ovarian function under the age of 40 years. 70 POF patients and 70 controls were screened for the previously identified INHA -16C>T transition mutation. The T allele was found in 31/70 (44.3%) of controls, but only 18/70 (25.7%) of POF patients. This result indicates that the T allele is significantly underrepresented in the POF patient population (Fisher's exact test, two-tail: P = 0.033). Sequence analysis of the INHA promoter in 50 POF patients and 50 controls identified a highly polymorphic imperfect TG repeat at approximately -300 bp, that consisted of four common haplotypes (A, B, C and D). The -16T allele is linked to the shortest repeat haplotype (haplotype C). Despite the association between haplotype C and POF, no significant difference was found between the promoter activity of a luciferase reporter construct containing haplotype C, and most of the other haplotypes tested. Interestingly, haplotype B failed to show any promoter activity. We conclude that the inheritance of specific INHA promoter haplotypes predispose to the development of premature ovarian failure.

Distribution of surnames and linguistic-cultural identities of the Slovenian and German minorities of northeastern Italy.

In this study we have compared the structure of surnames of Slovenian and German (Carinthian) minorities of northeastern Italy with other municipalities of the neighbourhood. The analysis has been carried out by using estimates of the similarities between populations and the topological representation obtained by them, as well as the spatial autocorrelation. On the whole, this research shows some distinctions which depend on the territorial geography, especially in the mountainous area. Moreover, movements of individuals in the limited zones of the plain are evident, probably due to socioeconomic conditions, the moving of the people and their change of dwelling. Finally, it is probable that different Slovenian dialects generated characteristic structures of surnames which were well preserved in the most peripherical municipalities of the territory.

An evaluation of patient satisfaction amongst family practice patients with diverse ethnic backgrounds.

OBJECTIVE: The aim of this study was to examine the impact of patients' ethnic diversity on the patient satisfaction rates. DESIGN: We used the methodology developed in an international EUROPE study. The patients were asked to fill in self-administered questionnaires on their evaluations of the care received in the year prior to the survey. The instrument consists of 23 questions regarding specific family physicians' tasks evaluated on a 5 point Likert scale. SETTING: Primary care practices of the National Railway Primary Health Care Services in Slovenia. STUDY PARTICIPANTS: A questionnaire was handed out to 600 patients cared for by 10 physicians. MAIN OUTCOME MEASURES: Percentages of highly satisfied patients in groups of patients with different ethnic backgrounds. RESULTS: We achieved 65.7% response rate. The overall satisfaction was lower in non-Slovenian patients, however was not significant (83.6 vs. 85.8 points, p = NS). Non-Slovenian patients were less satisfied with regard to: "quick relief of their symptoms", "helping them to feel well so as to be able to perform their normal daily activities", physicians'"thoroughness" and their explanations concerning what the patients wanted to know about their symptoms and/or illness. In a multivariate analysis Slovenian nationality predicted higher patient satisfaction with the clinical "performance" of physicians. CONCLUSIONS: As family practice remains an important source of primary health care for all patients, the providers should address the needs of all members of society regardless their social or cultural background. Undergraduate and postgraduate curricula have to address communication skills emphasising cultural differences.