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Background Diagnostic accuracy of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in identification of intracranial abnormalities detected by computed tomography (CT) in mild traumatic brain injury (mTBI), and in patients with mild neurological symptoms not caused by head trauma but suspected with a neurological disorder, was examined. Methods GFAP and UCH-L1 were determined using the chemiluminescence immunoassays on the Alinity i analyzer (Abbott Laboratories). Results Significantly higher GFAP (median 53.8 vs 25.7 ng/L, P <.001) and UCH-L1 (median 350.9 vs 153.9 ng/L, P <.001) were found in mTBI compared to non-head trauma patients. In mTBI diagnostic sensitivity (Se) and specificity (Sp) for the combination of GFAP and UCH-L1 were 100% and 30.9%, respectively, with area under the curve (AUC) 0.655. GFAP alone yielded Se 85.7%, Sp 41.8%, and AUC 0.638, while UCH-L1 yielded Se 57.1%, Sp 56.4%, and AUC 0.568. In non-head trauma patients, the combination of GFAP and UCH-L1 showed Se 100%, Sp 87.9%, and AUC 0.939, while GFAP alone demonstrated Se 100%, Sp 90.9%, and AUC 0.955. Conclusions If these results are reproduced on a larger sample, GFAP and UCH-L1 may reduce CT use in patients with mild neurological symptoms after systemic causes exclusion and neurologist's evaluation. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA—Play for Health" obesity prevention program in urban and rural areas in Croatia. Methods: This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used. Results: The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. Conclusion: The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention. [ABSTRACT FROM AUTHOR]

Patient satisfaction is a crucial measure of the quality of healthcare, especially with regard to nursing services in hospital settings. Understanding and increasing patient satisfaction with nursing care is critical to improving overall healthcare and ensuring positive patient experiences during their hospital stay. The aim of this research was to evaluate the psychometric properties of the Croatian version of the Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), test the reliability and validity of the tool after translation, and investigate differences in patient satisfaction based on demographic variables, as well as their contribution to satisfaction with the quality of nursing care. After translation and adaptation, the Croatian version of the PSNCQQ was applied to 350 hospitalized patients (average age 51.19 years (range: 18–87)), of whom 194 (55.4%) were men and 156 (44.6%) were women. The results showed high internal consistency (Cronbach's α = 0.977) and confirmed the one-factor structure of the questionnaire, explaining 70.64% of the total variance. Confirmatory factor analysis supported the unidimensional model, showing strong fit indices (χ2 = 583.047, df = 149, p < 0.001, GFI = 0.861, AGFI = 0.818, NFI = 0.936, TLI = 0.946, CFI = 0.955, RMSEA = 0.080, PCLOSE < 0.001). In conclusion, the validation of the PSNCQQ in the Croatian language increases resources for evaluating and improving the quality of nursing care. This research lays the foundation for future studies and practical applications aimed at improving patient satisfaction and nursing care outcomes in Croatia, but there are also limitations to this study, including its one-institution scope, the possible influence of factors outside the current treatment on satisfaction, and the lack of comparison with objective clinical indicators. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the level of daytime sleepiness and sleep-related behaviors in preschool children and compared their self-evaluations with the evaluations of their parents. It was conducted in Split-Dalmatian County, Croatia, among 196 preschool children aged 6–7 years seen at regular medical examinations, accompanied by their parents, using the Epworth sleepiness scale for children and parents/caregivers. Compared to their child's reports, parents tended to underestimate their child's sleepiness while sitting in a classroom at school (p = 0.001) and overestimate their child's sleepiness when lying down to rest or nap in the afternoon (p < 0.001). Boys were sleepier while sitting in a classroom at school during the morning than girls (p = 0.032). As much as 48.2% of preschool children had their own cellphones/tablets. Boys used video games (p < 0.001) and cellphones/tablets more than girls did (p = 0.064). Parental estimation of children playing video games at bedtime was lower than the child's report (p < 0.001). Children who had a TV in their bedroom reported more daytime sleepiness (p = 0.049), and those who played video games at bedtime went to sleep later during the weekend (p = 0.024). Also, children owning cellphone/tablets had longer sleep latency during the weekend compared to children not owning a cellphone (p = 0.015). This study confirmed that parents tend to underestimate children's habits of playing video games at bedtime and children's sleepiness during morning classes. Preschool children who use electronic devices at bedtime more frequently have prolonged sleep latency. These findings provide further evidence of the effects of electronic media devices on preschoolers' sleep patterns and daytime sleepiness. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this research is to investigate the characteristics and surgical techniques for repairing rhegmatogenous retinal detachment (RRD) and their influence on anatomical and functional success of the treatment with a special emphasis on the economic costs and outcome quality-adjusted life years (QALYs) of the procedures. Methods: This retrospective study analyzed data from 151 patients with RRD treated at the Department of Ophthalmology, Clinical Hospital Centre Split, Croatia, in a 3-year period, using one of three surgical techniques: pneumoretinopexy (PR), scleral buckling (SB) or pars plana vitrectomy (PPV), followed-up for at least 6 months. Demographic, pre- and post-operative ophthalmic exam parameters and surgical technique used were collected accordingly. Statistical analysis of the influence of the studied parameters upon anatomical and functional outcomes was performed, as well as health economic analysis on costs and derived utilities/QALYs of these surgical methods. Results: Of all patients, 130 (86%) were successfully operated on, and 21 patients (14%) required another surgical procedure. No statistically significant differences in the anatomical success between the 3 surgical techniques were found. However, the functional outcome (based on the final best corrected visual acuity (BCVA)) differed significantly. Despite improvement in the final BCVA, BCVA ≥ 0.5 was achieved in only 52 (34.4%) patients. The final BCVA showed significant association with the time elapsed from the onset of RRD to the surgical intervention, pre-operative BCVA, macular- and preoperative lens- status and type of surgery. The estimated diagnosis-related group (DRG) cost for day and inpatient surgery was based upon existing DRG cost for PPV, which for PR and SB was calculated accordingly. Based upon the success of the procedure and visual outcome, the overall calculated QALYs for PR and SB appeared to be similar, while the QALYs were lower for PPV. Conclusions: The success rate of treating RRD mostly depends on performing an early surgical procedure (especially in the case of attached macula), identification of all retina tears and, most importantly, choosing the appropriate surgical technique. Decisions on treatment for RRD should also be based upon cost-effective and QALYs-assessed procedures, especially in countries like Croatia, where limited healthcare resources exist. This study shows PR to be efficient and most cost-effective for RRD repairment in appropriate cases. [ABSTRACT FROM AUTHOR]

Malnutrition is often observed in pediatric cancer patients and has been recognized as a risk factor for relapse and survival. Maintaining an appropriate nutritional status during anticancer treatment has, therefore, been more and more frequently perceived as an additional requirement for optimal therapy outcomes. The aim of our study was to establish alterations of nutritional status in 26 children and adolescents treated for acute lymphoblastic leukemia (ALL) at the Children's Hospital in Zagreb, Croatia, between 2016 and 2021, by using anthropometric measures and serum albumin levels. The majority of patients (53.8% female, median 4 years, 52.2% intermediate-risk leukemia group) had normal weight at the beginning of chemotherapy. The percentage of overweight/obese patients increased from 4.2% at diagnosis to 37.5% at the end of intensive therapy. Apart from a significant increase in body weight (BW) and body mass index (BMI) for age, a notable decline in body height/body length (BH/BL) for age in the observed period was recorded, especially in high-risk leukemia patients. The alterations in serum albumin values were not significant, nor was their correlation with BMI. Dietary consultation was offered to all patients, while children with a decline in BMI and BH/BL received additional nutritional support. [ABSTRACT FROM AUTHOR]

Adverse events lead to the emergence of several groups of victims, among which the second victims are medical staff involved in them. The suffering of second victims can lead to new adverse events and new victims. This study describes the cycle of an adverse event and its victims. Using the example of the largest Croatian hospital centre, authors try to understand how deep medical staff experience adverse events, and how different groups of medical staff (by profession, gender, qualification, and position) perceive adverse events. With the help of a special survey using the Bonferroni method from ANOVA, it was established that males feel more mental stress after adverse events than females. The results indicate that medical staff of different professions perceive adverse events differently, e.g. they are the least painful for psychiatrists and microbiologists and the most stressing for emergency and intensive care workers. In addition, nurses are more vulnerable to adverse events and experience various types of mental disorders more deeply than doctors. However, qualifications do not seem to affect the extent to which medical staff perceive adverse events. The results of this study differ from previous data for other countries and suggest new implications. [ABSTRACT FROM AUTHOR]

The most widespread chronic condition observed amid children globally is asthma. Only half of children with asthma adhere to their prescribed inhaled corticosteroids (ICS) therapy. Parents' emotions and perspectives regarding asthma have an impact on inhalation corticosteroid adherence. The participants in this study were 148 parents of children with asthma, with the aim to redintegrate their beliefs about medicines in general and specifically of ICS and the impact on ICS adherence in children with asthma. Children were mostly male (66.9%), older than five years (58.8%), parents were female, mean age 38, employed, and with a history of consumption of some form of corticosteroids. Parents' answers show that 50% of them disagreed with the statement that medicines are addictive, and 90% agree that medicine helps many to live better. A percentage of 77.7% of parents acknowledge that their child's health relies on inhaled corticosteroids (ICS), and 86.5% of parents agree that these medications safeguard their child from worsening health. Most of the parents (93.2%) adhere to the guidelines and instructions of the doctor. In summary, parents who hold the belief that medicines are neither overused nor harmful tend to exhibit a higher adherence. Furthermore, those with elevated adherence levels express lower levels of concern regarding the use of inhaled corticosteroids (ICS) in their children's asthma therapy. [ABSTRACT FROM AUTHOR]

Introduction: Personal narratives are monological stories based on a personal experience that help children explain and understand their emotional states, as well as process positive and negative experiences. The aim of this study was to identify age- and emotion-related traits of lexical and grammatical abilities and coherence of personal stories produced by school-aged children between 7 and 13 years. Methods: A total of 60 typically developing children, speakers of Croatian, were stratified into three groups according to age. Using the Global TALES protocol, each child was asked to produce six personal stories prompted by different emotional states. The personal narratives were analysed using measures of lexical diversity (lemma-token ratio and number of different words), productivity (total number of words), and syntactic complexity (mean length of utterances and clausal density). Based on the Narrative Coherence Coding Scheme, three coherence dimensions (context, chronology, and theme) were rated. Results: Age group was shown to explain 18% of the variance in the ability to produce personal narratives. Personal narratives elicited through positive prompts were overall more lexically diverse but were significantly less elaborated chronologically and thematically than negative and neutral narratives. Conclusion: This study showed that coherence of the produced stories was connected with the child's lexicon and that both variables – lexicon and coherence – were influenced by emotional valence of the story. In contrast, grammatical aspects of the narrative were influenced only by age. Finally, it is possible to state that the Global TALES protocol is sensitive enough to capture specificities of creating personal stories, both developmental ones and those created under the influence of the emotional valence of the prompts. [ABSTRACT FROM AUTHOR]

This study aimed to determine the contribution of family, school, and peer characteristics in alcohol and marijuana use. Since it is focused on adolescent relationships with their environment, the Primary Socialisation Theory was used as a theoretical background. A total of 6788 adolescents from different secondary school programmes participated in the research. The CTC questionnaire for children and youth, the School Attachment Scale and the Commitment Scale, and the Adapted Resilience and Youth Development Module were used. Besides calculating the descriptive parameters, the univariate and multivariate logistic regression were used. The results indicate an increasing number of alcohol and marijuana use among male at higher school classes. Caring family relations have shown to be a strong protective factor for alcohol and marijuana use. In a school context, a low commitment to school tasks, skipping school, and low school success are predictors of alcohol and marijuana use. Caring peer relationships have also shown to be predictors of drinking and marijuana use, while the probability for consumption got lower among adolescents reporting about hanging out with peers who hold high expectations. Presented results are emphasizing the importance of investing in quality of adolescent relationships with their environment, and making a strong case for preventive investments. [ABSTRACT FROM AUTHOR]

Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves. [ABSTRACT FROM AUTHOR]

The most prevalent children's chronic disease worldwide is asthma which has notable negative impacts on patients' and parent's quality of life. Daily inhaled corticosteroids (ICS) therapy is a preferred controller choice. This study was conducted on 148 parents of asthmatic children to establish parents' perception of illness and fear of inhaled corticosteroids using B-IPQ and TOPICOP questionnaires. Children were in the majority male (66.9%), older than five years (58.8%), with comorbidities, and family history of atopy. Parents were female, with a mean age of 38, employed, and with a history of some form of corticosteroid use. Most parents were not afraid of ICS usage (71.6%). Unemployed parents and parents who had no medical education had a statistically significantly higher fear of using ICS (p = 0.002, p = 0.03). A child's illness affects the parents' lives and parents who are afraid of using ICS react more emotionally to the child's illness. Better understanding and less concerned about child's disease are parents of children with controlled asthma. The parents' perspective of children's asthma will affect the duration and dose of ICS treatment they will give to their children and directly influence the level of asthma control. [ABSTRACT FROM AUTHOR]

Epilepsy causes a significant burden to patients as it is linked with various somatic and psychiatric comorbidities, social issues, impaired quality of life, and increased mortality. Improving the population's knowledge and attitudes about epilepsy patients could be beneficial as it could raise social awareness and lead to more social support for patients. For those reasons, a survey-based cross-sectional study was conducted to determine Croatian students' knowledge and attitudes toward epilepsy. A previously developed survey questionnaire was adapted for the Croatian setting and distributed online to the students (n = 544). Croatian students generally had positive attitudes towards people with epilepsy (median score 28.0, interquartile range 29.0–26.0, with the minimum possible score being 0.0 and the maximum 30.0), with the female gender (B (male) = 0.664 (95% CI −1.158, −0.170), p = 0.009), biomedical education (B (other) = −0.442, (95% CI −0.823, −0.061), p = 0.023), and personal experience in the form of witnessing the seizure (B = 0.519 (95% CI 0,098, 0.940), p = 0.016) as predictors of more favorable attitudes. Overall knowledge was satisfactory concerning most items, with the exception of first aid measures and risk factors. Educational intervention targeting bio-medical students and other students who might, in their future professional lives, be responsible for people suffering from epilepsy is needed to improve the gaps in their knowledge. [ABSTRACT FROM AUTHOR]

Soils with elevated arsenic contents are common in the Pannonian Basin. However, little is known about their distribution and occurrence. The subject of this study is the distribution of arsenic in Gleysol developed on an agricultural field in the Podravina region, Croatia. The main objective was to determine which soil parameter has the greatest influence on the overall distribution of arsenic in the area. Mineralogical, geochemical, and physico-chemical characteristics of 56 topsoil samples in were analyzed with statistical analyses, and the spatial distribution of the most important soil parameters was determined and presented. Mineralogical analysis revealed the presence of quartz, plagioclase, clays and micas, and Fe-oxyhydroxide goethite. Geochemical analysis determined elevated contents of iron (max. 23.37 mass. %) and arsenic (max. 824 mg/kg). The spatial distribution of eight parameters indicates overlap in the distribution of iron and arsenic, influenced by the topography of the area. The hierarchical cluster analysis resulted in two main groups: Fe-rich samples (Group 1) and Si-rich samples (Group 2). The Si-rich group of samples has lower arsenic contents, while the Fe-rich group has elevated arsenic contents. This indicates that iron content is the parameter that has the largest influence on the overall distribution of As. Although Fe-oxides can be dissolved under reductive conditions, the predominant presence of well-crystalized goethite implies that As is not mobilized under reductive conditions and remains adsorbed onto goethite mineral phase. [ABSTRACT FROM AUTHOR]

This study aimed to examine the frequency of temporomandibular disorder among biomedical students and relate its occurrence to lifestyle habits. A cross-sectional collection of data was carried out and included a total of 676 examinees through a questionnaire that had 73 questions: general information and lifestyle habits, the Fonseca Anamnestic index (FAI), the Jaw Function Limitation Scale (JFLS), and the Perceived Stress Questionnaire (PSQ). The statistical analyses between three or more groups were conducted using the one-way analysis of variance (ANOVA) with post hoc Scheffé test or Kruskal–Wallis test with post hoc Dunn's test for quantitative variables. The comparison of qualitative variables was conducted using the Chi-square test, while the correlations were determined using Spearman's correlation test. The analysis showed that a higher frequency of moderate or severe TMD was observed in subjects who were smokers (p < 0.001) compared to non-smokers. Subjects who consumed more coffee had moderate to severe TMD compared to subjects who consumed a lesser amount (p < 0.001). Furthermore, a positive correlation between the amount of stress and the severity of TMD was found. Our study implies that students of biomedical studies have an increased risk for TMD and that there is a link with their lifestyle habits. [ABSTRACT FROM AUTHOR]

Nautical tourism in the Republic of Croatia represents an important segment of Croatian tourism. Due to the natural conditions that Croatia possesses, it is recognized as one of the most desirable European and world destinations for boaters. The increase of nautical tourism activities in the Adriatic in recent years also increases the possibility of accidents at sea. In order to reduce the risk of accidents, analyses of available data on accidents from the National Maritime Rescue Coordination Center (MRCC) were carried out. In the aforementioned database, recreational vessels were selected and analyzed. The compiled data refers to sailing vessels, yachts, small fishing vessels, boats, and inflatable boats regardless of their flag state. Based on the research conducted, suggestions were made to optimize the existing way of filling out reports in order to better manage statistical data, and potentially identify the causes of recreational vessel accidents. [ABSTRACT FROM AUTHOR]

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Simple Summary: Metastatic colorectal cancer is one of the most common causes of cancer-related mortality in adults. New therapeutic strategies are currently being implemented for the treatment of colorectal cancer which require new predictive markers. Metastatic colorectal cancer often presents microsatellite instability which is associated with a positive response to immune therapy. The findings of the present study demonstrate and discuss the DNA sensor cGAS and cyclic GMP–AMP receptor stimulator of interferon genes (STING) as potential new targets for novel therapeutic approaches based on immune checkpoint inhibitors in microsatellite unstable stage IV colorectal cancer. Colorectal cancer is the second most common cause of cancer-related mortality in adults. Understanding colorectal tumorigenesis at both the cellular and molecular levels is crucial for developing effective treatment options. Forty-one biopsy samples from patients with metastatic CRC (mCRC) were collected at Split University Hospital in Croatia. A total of 41 patients (21 with microsatellite unstable tumours and 20 with microsatellite stable tumours) were randomly included in the study. Immunolabelling of cGAS and STING in metastatic CRC was performed and further complemented by histological classification, tumour grade, and KRAS, NRAS, and BRAF mutational status of mCRC. In bivariate analysis, elevated expression of cGAS and STING was positively associated with MSI-H colon cancer (Fisher's exact test, both p = 0.0203). Combined expression analysis of cGAS and STING showed a significantly higher percentage of patients with mCRC MSI-H with a fully or partially activated cGAS-STING signalling pathway (chi-square test, p = 0.0050). After adjusting for age, sex, and STING expression, increased cGAS expression remained significantly associated with MSI-H colon cancer in a multiple logistic regression model (β = 1.588, SE = ±0.799, p = 0.047). The cGAS-STING signalling axis represents a compelling new target for optimization of immune checkpoint inhibitor therapeutic approaches in patients with MSI-H stage IV CRC. [ABSTRACT FROM AUTHOR]

In 2020, Croatia was hit by the COVID-19 pandemic and two earthquakes. As previous research showed that Internet use (IU) increased during the COVID-19 pandemic, we carried out an online survey to determine the levels of problematic Internet use (PIU) and problematic specific Internet activities before and during the prolonged stress caused by the COVID-19 pandemic as well as earthquakes. We also determined the correlation between the PIU and specific Internet activities and anxiety, depression, and stress symptoms. According to the responses of 1,118 participants from all Croatian regions, PIU increased by 14.1 percent (odds ratio [OR] 6.2), problematic social media use by 12.6 percent (OR 4.8), and uncontrolled online shopping by 5.3 percent (OR 5.8) in comparison with presurvey period. The PIU increase was significantly higher in participants reporting only pandemic-related stress than in those reporting both pandemic- and earthquake-related stress. Problematic social media use increased in those reporting only pandemic-related stress and both pandemic- and earthquake-related stress. The strongest correlation between PIU and problematic social media use and anxiety, depression, intrusion, and avoidance symptoms was found among those reporting both pandemic- and earthquake-related stress. The correlation between psychiatric measures and PIU and problematic specific Internet activities varied depending on the source of experienced or perceived stress. Our findings show the relationship between the problematic stress-related Internet behaviors, different types of stressors, and their impact on the overall PIU and problematic specific Internet activities in situations of prolonged stress. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the attitude of general dentists in the Republic of Croatia toward working with children. The questionnaire survey involved 361 general dentists. The questionnaire was divided into three parts and contained 34 questions. The first part of the questionnaire survey contained demographic data questions. In the second part, dentists answered questions about the characteristics of the dental offices where they work, the materials that they mostly use, and how they work with children. The third part of the questionnaire referred to attitudes about working and treating young children and consisted of 12 statements, to which the answers were offered on a Likert scale from one to five. This study showed that only 12.46% of dentists have a positive attitude toward treating children and 30.19% of dentists have a negative attitude toward treating children. In addition, the attitude toward working with children correlates with both the knowledge they acquired during dental studies (R = 0.355; p ≤ 0.001) and gender (R = −0.103; p = 0.035). This study confirmed that women have a more often positive attitude toward treating young children. There was a major correlation between the level of education and positive attitudes toward treating children. The child's non-cooperative behavior was the main reason why general dentists refuse to work with children. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate the interplay between moral distress and moral injury among nurses working in palliative and oncology wards and to assess its impact on nursing leadership. Background: The past 2 years have been particularly challenging for nurses and nursing leaders in Croatia. The coronavirus disease pandemic and the subsequent earthquakes in the country significantly impacted the work of nurses. Moral distress has been well‐known to nursing professionals, but recent studies warn about cofounding it with moral injury and their possible intercorrelation, deserving more attention from an empirical perspective. Methods: We conducted quantitative cross‐sectional research in palliative and oncology wards in 11 Croatian health care facilities on 162 nurses, using a questionnaire and paper/pencil method over 6 months (1 January 2021 to 1 July 2021). The questionnaire consisted of three parts: sociodemographic data, a Measure of moral distress for health care professionals and Moral injury symptoms scale for health care professionals. The research protocol was approved by the Ethics committee of the Catholic University of Croatia under no. 1‐21‐04. Results: The findings of our study demonstrated that the current average levels of moral distress might be characterized as low, but the moral injury symptoms are severe. The results of our study bring interesting novel insights, such as the strong correlation between moral distress and moral injury, but also in terms of nurses' decision to leave or consider leaving their position. The nurses who experience higher levels of moral distress experience severe symptoms of moral injury, while nurses who score higher in moral distress and moral injury have left, considered or consider leaving their positions. Conclusions: This study highlighted the need to pay attention to the emerging phenomenon of moral injury that has been unaddressed and overshadowed by moral distress, their intercorrelation, and the importance of addressing them timely and adequately within health care organizations with their leadership and management. Implications for Nursing Management: These findings provide a significant insight that may assist nursing managers and leaders to act and respond in time to develop various prevention and mitigation measures and help resolve situations leading to moral distress or moral injury. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

To assess differences in the amount of plate waste (PW) and food preferences among food categories containing vegetables and fruit and which of the student-centered reasons may influence PW. A cross-sectional study (from December, 2017 to June, 2018); the aggregate selective plate waste method; the taste-and-rate method (food preferences); the multiple-choice survey (student-centered reasons for the PW occurrence). Fourteen primary schools (Zagreb). Students aged 7–10 years; 17,163 meals (PW); 11,960 meals (PW and food preferences for meals containing vegetables and fruit); 6,507 meals (student-centered factors). Plate waste, preferences, and student-centered reasons for PW occurrence. Continuous and categorical data were analyzed using a 1-way analysis of variance for nonnormal distribution with post hoc Dunnett's test and chi-square test of homogeneity, respectively. Spearman's rank correlation coefficient was performed to examine the correlation between the amount of PW and served food. All statistical analyses were constructed with robust standard errors clustered at the school level. Among the different types of vegetables and fruit meals, students wasted lower amounts of fruit (10.3%; P = 0.005). Plate waste was positively correlated with the amount of served food (r = 0.93; P < 0.001) containing vegetables and fruit. Students preferred fruit and starchy food with vegetables. Among personal factors for not finishing meals, the most frequent reason was they did not like the taste of the food. Findings highlight the importance of food preferences and other student-centered reasons in explaining PW by primary school students. [ABSTRACT FROM AUTHOR]

Background: While academic dishonesty among nursing students is becoming a global problem, the instruments used in studies on this topic are heterogeneous and, in many cases, not even validated. This makes it difficult or impossible to compare the findings on a global scale. Objectives: To investigate the profile of Croatian nursing students' dishonest behaviour in classroom and clinical settings and to examine the relationship between the incidence of dishonest behaviour in both settings. Research design: A quantitative cross-sectional study using a Croatian online version of the Nursing Student Perceptions of Dishonesty Scale (overall Cronbach's alpha 0.933). Participants and research context: 446 nursing students from a higher education institution in Croatia, EU, in the academic year 2020/21. Ethical considerations: The study was approved by the relevant committee of the higher education institution. Findings/results: Almost all participants (91.3%) performed dishonest behaviour on two or more occasions in the classroom and 32.5% did so in the clinical setting. The incidence of dishonest behaviour increased with the students' year of BSc study (p =.008). All subscales of dishonest behaviour in the classroom were significantly and positively associated with dishonest behaviour in the clinical setting, except for the Not My Problem and Non-Compliance subscales. Discussion: Based on these results, the following should be taken into consideration: 1) dishonest behaviour in the classroom is associated with dishonest behaviour in the clinical setting; 2) even the slightest occurrence of dishonest behaviour in the clinical setting can lead to fatal events. Conclusions: The gradual increase in BSc nursing students' dishonest behaviour with their year of study raises several questions regarding the development of ethical and moral values in this population. This raises the need for early and continuous exposure of students to ethical content from the beginning of their studies and support from competent educators. [ABSTRACT FROM AUTHOR]

The prediction of future weather patterns has recently become a very important research area due to the ongoing climate change process which causes extreme weather events and rapidly changing weather patterns. In this paper we compare the prediction accuracy of eight data-driven methods, which had been developed for time series prediction, on future weather patterns in central Croatia. The evaluated methods are Seasonal naïve, AutoRegressive Integrated Moving Average (ARIMA), Error-Trend-Seasonality (ETS), Exponential smoothing state space model with Box-Cox transformation (TBATS), Dynamic Harmonic Regression (DHR), Neural Network AutoRegression (NNAR), Support Vector Regression (SVR) and Long Short-Term Memory (LSTM). In our experimental evaluation, we use a historical data from 1961 to 2017 that contains temperature, air pressure and precipitation values for eight weather stations in central Croatia, and indices from two atmospheric oscillations, namely North Atlantic Oscillation (NAO) and Arctic Oscillation (AO). The results of our evaluation show that SVR is the best method, and that DHR and NNAR methods are also better than the other evaluated methods, as far as the accuracy of prediction is concerned. Among DHR and NNAR methods, DHR method is better for the prediction of temperature and air pressure, while NNAR method is better for the prediction of precipitation. Additionally, our evaluation shows that SVR, DHR and NNAR methods achieve a better prediction accuracy when oscillation indices are included as additional predictors. [ABSTRACT FROM AUTHOR]

The paper discusses the role of the government of the Kingdom of Croatia and Slavonia as a self-governing unit within the Austro-Hungarian Monarchy within creation of a public, general and compulsory system of public education. Based on the analysis of various statistical data, an attempt is made through selected indicators to establish basic theses about whether the initiated educational and school reforms were successful or unsuccessful in practice. An additional task of the paper is to provide more detailed indicators of the structure of education and schooling in the area of north-western Croatia by means of analysing statistical data. Although the emphasis is on public education, the paper presents basic data for other school and educational levels of secondary education as well, so that we can get the most complete picture of education as one of the most important areas in shaping a modern state. [ABSTRACT FROM AUTHOR]

The paper discusses the role of the government of the Kingdom of Croatia and Slavonia as a self-governing unit within the Austro-Hungarian Monarchy within creation of a public, general and compulsory system of public education. Based on the analysis of various statistical data, an attempt is made through selected indicators to establish basic theses about whether the initiated educational and school reforms were successful or unsuccessful in practice. An additional task of the paper is to provide more detailed indicators of the structure of education and schooling in the area of north-western Croatia by means of analysing statistical data. Although the emphasis is on public education, the paper presents basic data for other school and educational levels of secondary education as well, so that we can get the most complete picture of education as one of the most important areas in shaping a modern state. [ABSTRACT FROM AUTHOR]

Copyright of Polemos is the property of Croatian Sociological Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Filologija is the property of Croatian Academy of Sciences & Arts (HAZU) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Oeconomicus is the property of Znanstvena Rijec d.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Collected Papers of the Law Faculty of the University of Rijeka / Zbornik Pravnog Fakulteta Sveučilišta u Rijeci is the property of Pravni fakultet Sveucilista u Rijeci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The procedure of correlation analysis is based on the determination of direction and strength indicators between the observed phenomena or variables. Correlation analysis, in addition to determining the numerical indicator (linear correlation coefficient), includes a graphical representation (scatter diagram, scatter plot) from which it is seen whether or not there is a connection of the observed phenomena and if so, what is the shape, direction and strength of this connection. The paper also describes the procedure for conducting a test of the significance of the calculated linear correlation coefficient. Based on statistical data, the relationship between the number of sick days and the number of injuries at work in the Republic of Croatia and in Karlovac County in the period from 2012 to 2019 was analyzed. The conducted correlation analyzes indicate a strong correlation between the number of used sick days and the number of injuries at work (total number of injuries at work and injuries at work) both in the Republic of Croatia globally and in Karlovac County locally. On the other hand, it has been shown that there is a weak correlation between the number of injuries on the way to / from the place of work and the total number of injuries at work, both in Karlovac County and at the level of the Republic of Croatia. [ABSTRACT FROM AUTHOR]

This paper examines sports, cultural, historical, and urban geography to analyse hodonyms (names of streets and squares) and ergonyms (names of hospitality establishments) located in the proximity of sports centres. The research examines whether there is a link between the hodonyms and ergonyms associated with sports and the location of sports facilities. The starting point of this research was the assumption that spatial proximity influences the motivation for naming streets, squares, and hospitality establishments. Accordingly, this paper approaches the concept of sports in the urban landscape from a spatial aspect. Case studies were conducted in the two largest cities of the Republic of Croatia: the capital city Zagreb, and Split. The main methodological approach used in the analysis of data was statistical and interpretative. The research showed that there is a degree of association between hodonyms and ergonyms and the location of sports facilities. Sports transform and shape the urban landscape, not only the sports landscape (in the form of infrastructure), but also other parts of the city. [ABSTRACT FROM AUTHOR]

Tourism data is crucial for effective tourism management since it enables national and local authorities to shape public policies in tourism and also enables the tourism industry to make appropriate business decisions. In 2016 new tourism data information system, called eVisitor, was introduced in Croatia, and this new system significantly eased collection and data processing. The aim of this paper is to assess the quality of statistical data on tourist traffic and to determine whether the technical improvement of the data collection system, which eased reporting on tourist traffic to information providers, contributed to the quality of collected data. This is done by applying Benford's distribution of first digits, i.e. Benford's law, to the collected data. Benford's law is based on the thesis that the first digits in numbers are not uniformly distributed and gives an expected pattern of numbers in the tabular data. Data that is not manipulated, accidentally or intentionally, should follow Benford's distribution of first digits, and deviations from Benford's distribution indicate that the data is compromised in some way. The conducted analysis has shown that the introduction of a new user-friendly data system did not affect the quality of collected data, but that the origin of the tourists was more important: data for domestic tourists have shown a statistically significant deviation from the expected Benford's distribution, so it can be concluded that their quality is lower than the data for foreign tourists. [ABSTRACT FROM AUTHOR]

The Coronavirus Pandemic (COVID-19) has a significant impact on countries around the world and many states have introduced restrictions to transport. This includes keeping essential transport moving, for example to transport medical supplies and other essential goods. Many countries have closed their borders and imposed curfews in sharp reductions in transport demand also on regional and continental level. Public transport but also shared mobility services are vectors for distribution of the virus, on the other hand, they are severely impacted by travel bans and individual concerns in order to avoid public gatherings leading to reduced travel and transport demand. Different countries have dealt with these challenging circumstances in different ways - and, in some cases, the directives vary from city to city. Cities in developing countries and emerging economies face bigger challenges than ever before. At the beginning of the Coronavirus Pandemic (COVID-19) google maps started to collect detailed statistics on the movement of people using location data from mobile devices. The paper analyzes the data obtained and shows the results for various areas of movement such as shops, recreation areas, parks, public transport and other. A comparison was made of the collected data in the Republic of Croatia, which had a solid measures, Italian Republic which had many affected during the pandemic and Kingdom of Sweden which had very mild measures during a pandemic. Therefore, a study was made on how measures affected the mobility of people in individual countries with different measures. [ABSTRACT FROM AUTHOR]

Copyright of Napredak is the property of Croatian Pedagogical-Literary Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

One of the current leading causes of death in pet cats is neoplasia. The scarcity of data on tumor prevalence in cats from south-eastern Europe led to this retrospective study which reports an abundant collection of tumors diagnosed in cats living in Croatia. Archived histopathology findings (diagnosis, cell origin, and biological behavior), and epidemiological data (breed, sex, age, and anatomical site of the tumor) of the cats diagnosed with at least one tumor were collected and statistically analyzed. For the research, 2338 archived feline samples, obtained from 2009-2019, have been reviewed. In 659 samples (28.1%) one or more tumors were diagnosed. Tumors have most often affected non-pedigree cats, cats between 7 and 15 years of age, and female cats. Most tumors showed malignant behavior (85.7%). The most frequent diagnoses were mammary adenocarcinoma, lymphoma, and squamous cell carcinoma. Regarding origin, most samples were epithelial (46.9%), but mesenchymal (28.7%) and lymphoid tumors (17.0%) were also frequently found. Tumors most often occurred in the skin and subcutis, mammary gland (in females), digestive system, and hemolymphatic system (in males). Statistical analysis did not reveal breed, sex, and age predisposition, but female animals and non-pedigree cats were significantly more likely to develop malignant tumors. This detailed study gives insight into the most frequent tumors that occur in cats from Croatia, and the data reported here is likely applicable to other countries. This data will contribute to clinical veterinary oncology, as it presents the most extensive tumor index of cats in south-eastern Europe., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Using only classical methods based on the calculation of objective statistical risk after the traffic accident expertise, it is very difficult to select the traffic accidents that were probably caused by fatigue of road vehicle drivers. The iRAP methodology can significantly assist in the selection of road traffic accidents which were probably caused by the driver's fatigue, because by using the iRAP methodology the static safety of road infrastructure elements can be quickly and objectively evaluated, and then excluded as a possible cause of a traffic accident. According to dynamic and open TCI Fuller's model "task demand - driver's capability", drivers dominantly influence the desired level of task demand while driving by choosing the speed, which in the case of choosing the unacceptable speed or speed unsuited for the environmental conditions on the road, among the rest, may depend on whether the driver is under the influence of fatigue. On the example of six traffic accidents that occurred on motorways in the Republic of Croatia and were selected for statistical analysis by characteristic criteria from the recent scientific literature, it will be presented how by using the iRAP methodology the factors of road infrastructure from the group of "traffic environment" factors can be completely excluded as the cause of traffic accidents. The more accurate selection of road traffic accidents that were caused by driver's fatigue will help researchers from other scientific fields to select and explore the characteristic factors of fatigue-related traffic accidents in order to suggest measures to reduce the fatigue effect on the driver's performance. [ABSTRACT FROM AUTHOR]

The State Audit Office of the Republic of Croatia audits companies' performance and gives recommendations for performance improvement. The Office reviews the implementation of the recommendations and establishes whether the companies acted in accordance with the recommendations. The aim of this paper is to determine whether local and regional self-government units-owned companies, whose supervisory boards' performance were audited, implemented the recommendations given. In this context, it analyses the types of recommendations given, their occurrence, and failure to implement them. The analysis was conducted into the recommendations' implementation reports. On the basis of the data collected, the recommendations were surveyed by application of statistical analysis method, comparison, and synthesis. In conclusion, the research results confirmed for a large number of non-implemented recommendations, the assumption that it is necessary to set the written rules and criteria for the appointment of the members of the Supervisory Boards. The results also show that the implementation of the recommendations both affects the line of business and has a positive impact on the public sector. [ABSTRACT FROM AUTHOR]

Aim: To analyse the occurrence of sexual dysfunction in patients with multiple sclerosis. Design: A quantitative cross-sectional study. Methods: The study was conducted in cooperation with the Croatian Association of Patients with Multiple Sclerosis, in the form of a questionnaire. A total of 106 patients responded: 24 (23%) male and 82 (77%) female. All subjects were in the age group 21-63 years. Data were analysed using descriptive statistics and the Mann-Whitney test, Kruskal-Wallis test, ANOVA test, and Spearman's rank correlation coefficient. Results: Primary sexual dysfunction (lack of sexual interest and desire), Secondary sexual dysfunction (the occurrence of bladder or urinary symptoms), and Tertiary dysfunction (caused by emotional aspects of MS) were present in most patients. There were no statistically significant differences between subjects within individual categories. Conclusion: Sexual dysfunction is very common among patients suffering from multiple sclerosis, significantly impairing quality of life since sexual and intimate expression are basic human needs which persist in spite of disability or illness. However, patients are reluctant to talk about this highly sensitive issue. [ABSTRACT FROM AUTHOR]

Using morphometric, meristic and qualitative characters, we confirmed a specific status of a clade discovered based on molecular data only. The newly described species Phoxinus krkae has a very local distribution in the upper Krka River but is easily morphologically distinguished from geographically neighbouring species with much wider ranges: Phoxinus lumaireul, Phoxinus marsilii and Phoxinus csikii. Phoxinus krkae is well differentiated in statistical analyses and differs from other species of Phoxinus in northern Adriatic Sea drainages and right‐bank tributaries of the middle and lower River Danube by a combination of characters, none of them unique: caudal peduncle length 1.9–2.2 times minimum depth of caudal peduncle; upper lip not projecting beyond lower lip; rostral fold absent; total number of scales in lateral series 74–84; lateral line incomplete and interrupted, commonly 17–49 (< 60% of total number of scales in lateral series) with no or few canal segments on posterior body and caudal peduncle; scales on belly extending forward to over middle of distance between pelvic‐fin base and pectoral‐fin origin; patches of breast scales commonly connected by scattered scales or forming 1–3 regular rows of scales; total vertebrae commonly 38–39 (22 + 17, 22 + 16 or 21 + 17). The study reveals unrecognised morphological diversity within the group and provides the groundwork for future taxonomic study in Phoxinus in the Adriatic region and the Danube Basin. [ABSTRACT FROM AUTHOR]

Infographics are a communication tool used in the digital environment that can present information, data or knowledge in an easy and understandable way to a wider audience. This article presents infographics as a form of communication and describes and outlines its possibilities in the field of public health and health care, with special emphasis on health and safety at work. Visualization of key statistical data, standardized elements, systems and practices in the style of infographics enables health and safety specialists to easily educate their employees about the consequences of poor health, the risks involved in work processes and the non-implementation of work safety processes and safety measures. The paper analyzes available infographics of leading institutions in the field of health and work safety in Croatia and in the world. Infographics are a recognizable form of communication worldwide. However, there is only a small number of infographics in the field of health and work safety in Croatia. It is important to raise awareness of the importance of infographics among Croatian experts working in the field of health and work safety because of the possibilities that infographics offer as a form of communication. Infographics should not be neglected because they can be used to present important information and directions in an easily understandable and universal way to various audiences. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: One of the resources that may prevent burnout and foster the work engagement of teachers is Principal support. In this study we aimed to further explore the links between Principal support and work engagement and burnout, by testing the role of the teachers' emotions and the educational levels of primary schools. OBJECTIVES: Testing 1) the mediating role of teachers' emotions in explaining the relationship between perceived Principal support and work engagement and burnout, 2) differences in tested constructs, and the structural equivalence of the proposed relationship among constructs, between teachers from two educational levels of primary schools. METHODS: The study included subsamples of 868 class teachers (lower grades) and 1057 subject teachers (upper grades) employed at 104 primary schools in Croatia. Teachers filled out self-report scales measuring burnout, work engagement, perceived Principal support and the positive and negative emotions experienced in relation to students. RESULTS: Emotions partially mediate the relationship between perceived Principal support and work engagement and burnout among teachers. Although class teachers experience higher levels of positive emotions and work engagement compared to subject teachers, the results confirmed the structural equivalence of the hypothesized model across two education levels of primary school. CONSLUSION: The Principal support predicts work engagement and burnout in teachers both directly and indirectly via emotions. [ABSTRACT FROM AUTHOR]