HIV-infected children in Croatia--medical care versus ethical and social issues

The era of pediatric HIV-infection in Croatia began in 1987 when the first child from an HIV-infected mother was born. The authors present some medical data of children diagnosed as HIV-infected or observed because of maternal HIV-infection in Croatia until the end of 2005. Although the number of HN-infected children in Croatia is still relatively small, in the last two decades the Croatian society was confronted with many ethical and social issues regarding HIV-infection and discrimination. There were many obstacles in providing proper care and integrating HIV-infected children in the Croatian society. Stigmatisation, fear and lack of knowledge were major contributors. For the first time, the integration of an HIV-infected child with revealed HIV-status into school was described. Changes in attitudes towards HIV-infected people can only be achieved through planned permanent educational programs.     

Adjustment of adolescent refugees in Croatia

The cultural similarity of Bosnian refugees in Croatian Society and their fluency in the Croatian language make it difficult to grasp the reality of complex social relations integral to the community of Bosnians in Croatia. The study focuses on adolescent refugees, a particularly vulnerable population, who face a double challenge in integrating past traumas and defining a new identity within and between the two cultures. School as an educational institution stimulates and directs socialization, while all the processes present in a wider sociocultural context, including the problems of immigrants and the host society, affect in a special way the school life. The analysis attempts to define the nature of relational outcomes resulting from the interaction of refugee and host acculturation orientations in terms of intercultural communication and/or intergroup discrimination, and social distance among pupils attending elementary and secondary schools (aged 12–18). Evaluation of the quality of existing contacts and communication between refugee children and their host peers will be discussed in relation to potential acculturative stress and its consequences on psychological well being.     

The Croatian model of university education for health professionals

In all European countries healthcare professions are regulated by law. In Croatia, the legally--regulated professions are: medicine, dentistry, pharmacy, nursing, physiotherapy and midwifery, as well as radiographers, occupational therapists and medical laboratory technicians. Current education of health professionals in Croatia is traditional, inadequate and poorly harmonized with current educational trends, as well as with requirements and directives of European Commission. This Croatian model for education of health professionals at university level follows the recommendations specified in Croatian Qualification Framework: (i) learning outcomes are competency-based; (ii) mobility of students and faculty is encouraged; (iii) the means of quality assurance are anticipated. The Croatian model of university education for health professionals will make sure that all procedures, specified in the European and Croatian Qualification Framework addressing recognizability of study programs, mobility, learning outcomes, quality assurance and reliability of required qualifications are successfully completed.     

On German-Croatian and Italian-Croatian language contact

Croatia has always been a multilingual environment. The influence of German and Italian was empowered through direct political influence. During the second part of the 18th and in the 19th century native speakers of German and Italian used Croatian as a second language carrying out their duties at work. This bilingualism can tentatively be referred to as bureaucratic bilingualism. Native Croatian speakers used Italian and German as a second language in certain social areas. Such bilingualism can tentatively be called civic bilingualism. It can be assumed that starting with the 1960s civic German and Italian bilingualism no longer existed. Language contact within the daily life results in German and Italian loan words in Croatian which are still actively present and used in daily communication.     

Current status of iodine intake in Croatia--the results of 2009 survey

In 1996, due to persistence of mild to moderate iodine deficiency, new law on obligatory salt iodination with 25 mg of potassium iodide (KI) per kg of salt was implemented in Croatia. Along with a new law, a new program for monitoring of iodine prophylaxis was implemented. Investigations of goiter and iodine intake performed in 2002, demonstrated sufficient iodine intake in Croatia with overall median of urinary iodine concentration (UIC) for schoolchildren in Croatia of 140 microg/L. In 2002, thyroid volumes (TV) measured by ultrasound in schoolchildren from all four geographic regions of Croatia were for the first time within the normal range according to ICCIDD reference values. Nowadays, Croatia is internationally recognized as iodine sufficient country. The aim of the present study was to assess current status of iodine intake in Croatia. The investigation was carried out in 2009. A total of 386 schoolchildren aged 7-10 years from all four major geographic regions of Croatia, 103 euthyroid pregnant women and 36 women of child-bearing age from Zagreb, the capital, were included in the survey. Urinary iodine concentration (UIC) was measured in all participants. Thyroid volumes were measured by ultrasound in schoolchildren from the capital of Zagreb (N = 101) and the village of Rude (N = 56). In the time period 2002-2009, the content of KI was analyzed in 384 salt samples from Croatian salt plants and samples of imported salt. An overall median UIC for schoolchildren in Croatia was 248 microg/L. Median UIC in pregnant women was 159 microg/L, with 50% of samples below and under 150 microg/L. Median UIC in women of child-bearing age was 136 microg/L. Thyroid volumes in schoolchildren were within the normal range according to the new reference values. Mean value of KI/kg of salt in samples from Croatian salt plants was 25.5 mg/kg and 24.9 mg/kg in samples of imported salt. A total of 72/384 (18.8%) of salt samples didn't corresponded to the Croatian law on obligatory salt iodination. Presented data indicate sufficient iodine intake of the Croatian population. Current medians of UIC in schoolchildren in Croatia are significantly higher than medians measured in 2002. This indicates that other potential sources of iodine are present in Croatian diet that may contribute to overall iodine intake. Due to rising medians of UIC in schoolchildren in Croatia, it is important to conduct nutrition studies to identify potential sources of "silent prophylaxis" in order to avoid iodine excess.     

Nutritional studies in Croatia--a century of research

This paper is dedicated to the pioneers of nutritional research in Croatia: to Professor Edvin Ferber, Professor Hubert Maver and Professor Ratko Buzina, to whom we owe exceptional contribution in the development of science of nutrition, as well as for many scientific publications from the fifties to the eighties in the 20th century, leaving us great information about nutritional state in Croatian population. The paper brings a review of nuitritional research in Croatia with an emphasis on history of research and papers published in Collegium Antropologicum. Since first publications on the subject, a number of institutions and scholars participated in numerous research projects which resulted in a vast number of published papers, depicting a multidisciplinary approach to the subject. In addition, the results of 44 analyses that have been a part of doctoral (18) and master's research (26) are discussed.     

Croatian national reference Y-STR haplotype database

A reference Y-chromosome short tandem repeat (STR) haplotype database is needed for Y-STR match interpretation as well as for national and regional characterization of populations. The aim of this study was to create a comprehensive Y-STR haplotype database of the Croatian contemporary population and to analyze substructure between the five Croatian regions. We carried out a statistical analysis of the data from previously performed genetic analyses collected during routine forensic work by the Forensic Science Centre "Ivan Vu?eti?". A total of 1,100 unrelated men from eastern, western, northern, southern and central Croatia were selected for the purpose of this study. Y-STRs were typed using the AmpFISTR Yfiler PCR amplification kit. Analysis of molecular variance calculated with the Y chromosome haplotype reference database online analysis tool included 16 population samples with 20,247 haplotypes. A total of 947 haplotypes were recorded, 848 of which were unique (89.5%). Haplotype diversity was 0.998, with the most frequent haplotype found in 9 of 1,100 men (0.82%). Locus diversity varied from 0.266 for DYS392 to 0.868 for DYS385. Discrimination capacity was 86.1%. Our results suggested high level of similarity among regional subpopulations within Croatia, except for mildly different southern Croatia. Relative resemblance was found with Bosnia and Herzegovina and Serbia. Whit Atheys' Haplogroup Predictor was used to estimate the frequencies of Y-chromosome haplogroups. I2a, R1a, E1b1b and R1b haplogroups were most frequent in all Croatian regions. These results are important in forensics and contribute to the population genetics and genetic background of the contemporary Croatian population.     

Epidemiology of monosymptomatic optic neuritis in Rijeka County, Croatia: meteorological aspects

In order to analyze the meteorological factors possibly influencing the monosymptomatic optic neuritis in Rijeka County, northwestern part of Croatia, retrospective analysis of all cases diagnosed in Rijeka County in period from 1977 to 2001, was done. Meteorological data on monthly and yearly temperature, humidity, insolation in Rijeka County were collected from Croatian Meteorological and Hydrological Service. In the observed period there were 173 cases of monosymptomatic optic neuritis, female/male ratio was 1.66, and overall incidence was 2.18/100,000 inhabitants. There was no correlation of incidence with average yearly and monthly temperature, humidity, insolation, or month of birth. This is the first study on meteorological factors and optic neuritis in Croatia.     

Physical inactivity changes in Croatia: the CroHort study

The aim of this paper was to compare the surveys conducted respectively in 2003 and 2008 within the Croatian Adult Health Cohort Study (CroHort) regarding the physical activity/inactivity of the inhabitants of the Republic of Croatia. The collected data show a significant decline in the intensity of physical activity in 2008 with regards to 2003, regarding the way of getting to work (60.7%), the level of physical strain at work (72.2%), and the frequency of physical activity taken in the subjects' spare time (55.8%). In order to prevent the risk of cardiovascular diseases and to raise the public awareness of the potential health threat physical inactivity poses, a number of thoroughly conceived health promotion strategies should be implemented, which would equally encompass all the segments of Croatian society.     

Cardiovascular risk factors and visiting nurse intervention--evaluation of a Croatian survey and intervention model: the CroHort study

The aim of this study is to identify factors that influence the success of the implementation of the primary and secondary prevention programs in Croatia by the visiting/community services. Two main sources of information were used: reports about regular visiting nurse services in Croatia and research about visiting nurse participation in the Croatian Adult Health Cohort Study (CroHort) 2008. Out of the total number 9,070 respondents who participated in CAHS 2003 survey, during CroHort 2008 program 3,229 (35.6%) participants were re-interviewed. The qualitative analysis was done with a sample of 34 visiting nurses, which participated in the CroHort 2008. Results show that there are three key problems which limit preventive programs: inability of the health care system to recognize the importance of the primary prevention; visiting nurses' lack capacity to implement prevention and populations' lack of motivation and education.     

Croatian bibliometric analysis, 2000-2007

To develop search filters and retrieve information estimating the Croatian scientific output (SO) focusing on Public Health (PH) and Preventive Medicine (PM) in MEDLINE. A PubMed search of the MEDLINE database was performed to retrieve articles added to this database between 2000 and 2007. Search filters inspired by previous strategies were applied involving 'geographical', 'place of publication', 'subject' and 'language of publication' aspects. An evaluation of the geographical filter performance was done and sensitivity and specificity were calculated. There were obtained publications in several languages, originated in Croatia, published in Croatia and/or abroad. The Croatian SO in the field of PH-PM was obtained for the same period of time by combining search filters. The evaluation of the filter performance showed sensitivity 95.56% and specificity 100%. The filters constructed permitted the retrieval of the Croatian eight years research output. Increased tendency was observed in the global SO evolution and in the PH-PM area as well. The main languages of publication were English and Croatian. This study is a contribution to research in the field of scientific documentation and further analysis is recommended in constructing and developing search filters to retrieve and focus on specific information.     

The Croatian Adult Health Cohort Study (CroHort) --background, methodology & perspectives

Health interview surveys are important source of health information. All previous adult population-based health interview surveys in Croatia until CroHort, were one-off projects with very limited possibility of data comparison. CroHort enabled repeated survey of CAHS 2003 respondents with almost identical questionnaire, thus providing comparable data on trends of different risk factors as well as their relation to the specific outcomes. Next follow-up survey of the CroHort cohort is foreseen for 2013. Health interview survey according to Eurostat methodology (EHIS) on the new representative sample of adult Croatian population is planned for 2014. As the data from health interview surveys are valuable in health policy, efforts should be made to increase their use by policymakers in Croatia.     

An evaluation of floristic diversity in Medvednica Nature Park (northwestern Croatia)

Abstract

Mount Medvednica (northwestern Croatia), mostly consisting of slates and marls, rises to the north, above the Croatian capital of Zagreb, from 300 to 1,035 m a.s.l. A floristic research was carried out in the area of Medvednica Nature Park, which consists mainly of the western part of the mountain. On the whole, 1,352 taxa of vascular plants were recorded from all sources (field observations, literature and herbaria). Out of these, 48 taxa are strictly protected, 228 are protected, 67 taxa are considered threatened according to the IUCN categories, and 9 taxa are endemic for the Croatian flora. The life-form analysis of the investigated flora shows the predominance of hemicryptophytes, followed by therophytes and geophytes, while the chorological analysis has evidenced the prevalence of Euro-Asiatic, South European and cosmopolite geographical groups. The biological/chorological cross-spectrum was laid out by considering the percent of every life-form for each geographical element. In order to evaluate the floristic richness of the studied area, the α-index was calculated and then compared with the α-indices of similar regions in Croatia and several European countries. A floristic diversity map of Medvednica Nature Park is presented here for the first time.     

Time trends in testicular cancer in Croatia 1983-2007: rapid increases in incidence, no declines in mortality

Testicular cancer, although a rare malignancy, represents the most common cancer in young male populations of Western origin. While increasing incidence trends of testicular cancer have been reported, mortality is declining in many high-resource settings. Using national data from the Croatian National Cancer Registry for the period 1983-2007, time trends were analysed by joinpoint regression and Age-Period-Cohort models. The present study is the first to analyse the testicular cancer trends in the Croatian population. Over the 25-year period, a mean number of 89 incident cases and 13 deaths were reported annually. The observed mean annual increases in age-standardised rates were 7.0% for incidence and 1.6% for mortality, with no abrupt linear changes (joinpoints) identified. The incidence rates of testicular cancer incidence have been steeply increasing in successive cohorts born since the mid-1930s. The rapid rise in testicular cancer incidence in the Croatian population appears to be one of the highest rates of increase recorded in Europe and worldwide. The lack of decline in the mortality rates over time, while based on relatively few deaths, highlights a need for improvements in diagnostics and management of therapy in Croatia in order to improve the survival and quality-of-life of testicular cancer patients.     

Q fever in Croatia: war-induced changes in epidemiological characteristics

The article describes the epidemiological characteristics of Q fever in Croatia, during the period before and after the Homeland War. In the ten years prior to the Homeland War (1983-1992) 1053 cases of Q fever were recorded, 16.2% (171) of which on islands and in coastal areas. In the period after the Homeland War (1995-2008), a total of 654 cases was recorded, 59.9% (392) of which on islands and in coastal areas. In addition to reduced incidence, geographic distribution of the disease also changed. Before the war, the highest morbidity rate was recorded in the Sisak-Moslavina County. After the war, the Split-Dalmatia County recorded the highest morbidity rate because in the post-war period sheep from Bosnia and Herzegovina went to this county for winter grazing. The disease might be relevant to the Croatian Army and other armed forces that stay in Croatia as part of NATO forces.     

Distribution of halophilous species of horse flies in Croatia (Diptera: Tabanidae)

In the past 20 years, fauna and ecology of horse flies (Tabanidae) were intensively studied in Croatia, especially in the Ramsar sites as wetlands of international importance. Different habitat requirements of larvae were recognised and adults of 78 species in 10 genera were recorded. The true aquatic and semiaquatic larvae are represented by several species of the genera Chrysops Meigen, 1803 Hybomitra Enderlein, 1922. Some species from this ecological group are typical inhabitants of saline biotopes. In the Croatian fauna three halophilous species were recorded: Chrysops italicus Meigen, 1804, Hybomitra acuminata (Loew, 1858) and H. expollicata (Pandellé, 1883). The distribution of these species in Croatia covers 7, 17 and 3 UTM (Universal Transverse Mercator) grids, respectively. Specimens were primarily collected in habitats with brackish water along the Adriatic coast, such as Vransko Lake, the mouth of the River Cetina, the delta of the River Neretva and Mljet Island. Only specimens of H. acuminata were recorded in the continental part of Croatia. They were sporadically collected on localities along the Danube floodplain and on four localities near the river Drava. The distribution of H. acuminata in the continental part indicates otherwise rare saline habitats along the Drava and Danube rivers (1.38% of the total catch of the Hybomitra – species from the floodplain).     

Haloarchaeal communities in the crystallizers of two adriatic solar salterns

Solar salterns operate only for short dry periods of the year in the north shore of the Adriatic Sea because of its relatively humid and cold Mediterranean climate. In a previous paper, we showed that the NaCl precipitation ponds (crystallizers) of Northern Adriatic Secovlje salterns have different haloarchaeal populations from those typically found in dry and hot climates such as Southern Spain. To check whether there is a common pattern of haloarchaeal diversity in these less extreme conditions, diversity in crystallizers of other Adriatic solar salterns in Ston, Croatia was ascertained by molecular and culture methods. In addition, the cultivation approach was used to further describe haloarchaeal diversity in both salterns. Over the period of two solar salt collection seasons, isolates related to species of the genera Haloferax, Haloarcula, and Haloterrigena were recovered from both salterns. Within the same sampling effort, relatives of the genus Halorubrum and a Natrinema-like isolate were cultivated from Slovenian Secovlje salterns while Halobacterium related isolates were obtained from the Croatian Ston salterns. Concurrent with our previous findings, a library of Croatian saltern crystallizer PCR-amplified 16S rRNA genes was dominated by sequences related to the genus Halorubrum. The microbial community structure was similar in both salterns but diversity indices showed greater values in Slovenian salterns when compared with Croatian salterns.     

Social conditioning of health behaviors among adults in Croatia: the CroHort study

The aim of this study was to examine the social conditioning of health behaviors of adults in Croatia, based on the data from Croatian Adult Health Survey 2003. This cross-sectional study on a representative random sample of 9070 Croatian adults showed that obesity was significantly and socially conditioned in women, whereas for men the indication of social conditioning has not reached a statistically significant level. Health behaviors were socially conditioned in both sexes. Men's living habits were more irregular than those of women. Compared with women, men consumed more cured meat products, consumed alcohol excessivelly and smoked cigarettes more often, whereas they ate less fruits and vegetables. Health promotion strategies based on the behavioral correlates of overweight and obesity are needed to prevent excess weight gain in the Croatian population. While for men a unique educational model is applicable, women require more specialized programs, adapted to their social background.