The Impact of Physical Activity on Adolescent Idiopathic Scoliosis.

The prevalence of adolescent idiopathic scoliosis (AIS) is increasing, partly due to a lack of physical activity. In a cross-sectional study with 18,216 pupils (5th, 6th, and 8th grades) from four Croatian counties using the forward bend test (FBT; presumed AIS), the prevalence of AIS and its correlation with physical activity were evaluated. Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). Abnormal FBT was more prevalent among girls than boys (8.3% vs. 3.2%). Boys were more physically active than girls (p < 0.001). Pupils with presumed AIS were less physically active than their peers without scoliosis (p < 0.001). A higher prevalence of presumed AIS was found among inactive or just recreationally active schoolchildren than among those engaged in organized sports (p = 0.001), girls especially. Pupils with presumed AIS were less active and had fewer weekly sports sessions than their peers without scoliosis (p < 0.001). Notably low prevalence of AIS was detected among pupils engaged in soccer (2.8%, p < 0.001), handball (3.4%, p = 0.002), and martial arts (3.9%, p = 0.006), while it was higher than expected in swimming (8.6%, p = 0.012), dancing (7.7%, p = 0.024), and volleyball (8.2%, p = 0.001) participants. No difference was detected for other sports. A positive correlation was found between time spent using handheld electronic devices and the prevalence of scoliosis (rs = 0.06, p < 0.01). This study confirms the increasing prevalence of AIS, particularly among less athletic girls. Further, prospective studies in this field are required to explain whether the higher prevalence of AIS in these sports is due to referral or other aspects.

Personality Traits of Croatian University Students with Internet Addiction.

Specific personality traits may predispose individuals to various forms of addictive behaviors. This study aimed to investigate the association between personality traits of university students and Internet addiction (IA). A sample of 1051 university students was recruited from the largest university in Eastern Croatia. A structured anonymous questionnaire that included questions regarding students' sociodemographic information and Internet usage patterns, the Young Internet Addiction Test and Big Five Inventory served as a research tool. The study revealed that 1.0% of the studied sample expressed severe IA while 24.6% of study participants expressed some signs of addiction. The IA was detected in 576 (80.0%) students who used the Internet mainly for social networking, in 30 (78.9%) students who mainly used it for online gaming, and in 153 (52.2%) students who mainly used it for university assignments (p < 0.001). Higher neuroticism, higher extraversion, and higher openness to new experiences were connected with IA in general (p < 0.001). Higher neuroticism, higher extraversion, and higher openness to new experiences were significantly associated with addictive behavior during social networking (p < 0.001). Higher extraversion and higher openness to new experiences were significantly associated with addictive behavior during Internet usage for university assignments (p = 0.025), while there were no significant associations between specific personality traits and addictive behavior during online gaming (p = 0.059). Personality traits must be taken into account while developing programs and implementing interventions for preventing IA in the university student population.

The Nutrition Knowledge of Croatian General Practitioners.

Nutrition care delivered in primary health care setting is an effective and necessary preventive health care measure. General practitioners (GPs) nutrition knowledge is related to their nutrition care practice. The aim of this study was to explore the nutrition knowledge of Croatian GPs, and to investigate its connection with the implementation of nutrition care in GPs' offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July 2013, via an anonymous questionnaire. The study showed that only 35.8% of the Croatian GPs had an adequate level of nutrition knowledge (five or more correct answers to nutrition questions). The study further revealed that females, GPs with additional education in nutrition and GPs who had not suffered from chronic diseases with poor nutrition posing as a risk factor had better nutrition knowledge (p = 0.029, p < 0.001 and p = 0.041, respectively). The Spearman rank correlation between GPs' nutrition knowledge and the implementation of nutrition care in their offices during daily work with patients was rs = -0.190 (p < 0.001). To provide nutrition care in GPs' offices in Croatia, strategies for improving GPs' nutrition knowledge are needed.

Association between socioeconomic status and obesity in children.

The perception of obesity among people has not changed significantly regardless numerous public educational programs. Reasons for obesity pandemics are numerous and complex, but can be mostly resumed to life-style changes. The aim of this research was to determine connection between socioeconomic factors and obesity with children of our region. Study included pupils aged 7-8 from 19 first grades in 8 primary schools in Osijek-Baranya County. Body height and weight were measured and socioeconomic data status were collected. Socioeconomic status included data on marital status, educational level, employment, number of children in the family, kindergarten attendance and urban/rural location and also smoking habits of parents. BMI was calculated as a parameter for obesity assessment according to Croatian reference values. Total of 372 children were measured. There were 6.5% of overweight children (BMI between 90th and 97th percentile) and 2.4% of obese children (BMI above 97th percentile). The prevalence of obese children in our research was 8.9%. Obesity is not influenced by rural/urban residence, marital status of parents, number of children in the family, mother's education, or by parents' smoking habits. Positive correlation between obesity and father's education and parents' unemployment was found. Available literature data, same as our study, did not show consistent association between socioeconomic factors and obesity with children. Contradictory results of different studies can be a result of a small sample, difference in study design and different criteria for defining categories within investigated socioeconomic factor.

Diagnostic value of cytology of voided urine.

There are 961 new cases and approximately 366 deaths from urothelial carcinoma registered annually in Croatia. Exfoliative urinary cytology has important role in detection of high grade urinary tumors, invasive and in situ lesions respectively. In contrast to cystoscopy and biopsy, cytology is a noninvasive method which is easily repeated. The aim of this retrospective study was to assess value of urinary cytology in our institution. For this purpose only patients with histological diagnosis and clinical follow up were considered. There were 138 urine specimens with cytological diagnosis of dyskaryosis, suspicious for malignancy or malignant and histology and follow up data examined at our Department of Clinical Cytology between 2004 and 2011. Cytological diagnosis suspicious for malignancy and malignant were considered positive and the results were correlated with histological diagnosis according to the WHO histological classification of tumors of the urinary tract. Patients with negative histological findings were followed for the next two years. The positive predictive value of cytological detection of malignant urothelial lesions was 91.8%. In 10 cases cytological diagnosis of malignancy was not confirmed histologically or clinically which makes the total of 8.2% of false positive reports. Of the total of detected malignant urothelial lesions 90.9% are high grade lesions and only 9.1% low-grade lesions; 67.3% are invasive lesions and 32.7% non-invasive lesions. Cytological findings of dyskariotyc cells requires further urological investigation because such findings in further processing prove the presence of tumor in 93.8% of cases. In conclusion: cytology is very good diagnostic tool for detection of high grade invasive and noninvasive carcinomas of the urinary tract. In order to make it more efficient we need to study its limits carefully, define diagnostic criteria and reach consensus in nomenclature.

Influence of health education regarding correct diet on anthropometric indexes in children.

Obesity is one of the leading public health issues in the world whose significance lies, not only in its prevalence, but also in its consequences i.e. diseases that gradually develop in obese people. The aim of the study was to determine obesity prevalence among school children and the influence of health education on its prevalence. Study included pupils of 19 first grades in 8 primary schools of Osijek-Baranja County, Croatia. Body weight and height, waist and hip circumference were measured. Parameters for assessing obesity: body mass index (BMI, according to Croatian referral values), waist circumference (WC), waist and hip circumference ratio (WHR) and waist circumference and height ratio (WHtR) were measured. In order to determine whether the health education of pupils and their parents influences children's anthropometric indexes, health education regarding correct diet, obesity and its consequences and the need for life style changes in terms of daily physical activity was conducted in four primary schools. Pupils of other four primary schools were measured as a control group. Prevalence of overweight children according to BMI before education was 8.9% (6.5% of overweight and 2.4% of obese children). In intervention group of children, according to BMI, there was no decrease in proportion of obese after the health education was conducted and prevalence was 2% before and after the education. On the second measurement, pupils in control group showed increase in proportion of obese from 2.9% to 3.5%. According to weight circumference and height ratio before education there were 10.2% of obese children. After six months, there was an increase in proportion of obese to 11.3%. According to this index there was an increase in proportion of obese in all groups of pupils regardless of gender and conducted education. This study shows that in school-based obesity programs it is necessary to apply more intense interventions with another type of methodology; program should be conducted continuously during longer period, otherwise this condition will continue to rise.

Enuresis in school children from eastern Croatia.

The aim of this study was to establish the prevalence of nocturnal incontinence (NI) in 6-to-7-year-old children from eastern Croatia, to determine the factors associated with NI and to evaluate parental perception of the problem. From May to September 2004, the parents of 3,011 children were asked to complete an anonymous validated questionnaire. The overall prevalence of reported NI was 1.2% (35/3011). All of the cases were cases of secondary NI. NI was significantly more frequent in boys than in girls. Family history of enuresis was present in 68.6% (24/35) of enuretic children. Only 17.1% (6/35) of parents expressed some concern about the effect of the researched problem on their child's future development. The frequency of NI in this study group is much lower than that reported in other European countries. The reason for this is still not known, although parental perception of this problem is certainly a significant factor. Further investigations are needed.