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Personalized medicine refers to sophisticated diagnostic and therapeutic interventions tailored to the patient’s individual needs. The development of personalized medicine in the last two decades created a global movement of person-centered medicine and health care...

During the COVID-19 pandemic, given the global epidemiological circumstances, distance learning has become a fundamental component of educational institutions. Distance learning, not including “face-to-face” contact, delivers educational content through online communication. Some areas, like foreign language studies, were more prepared for this kind of education due to more feasible adaptations of their educational content. In biomedical area, teaching relies on both, theoretical and practical (clinical and laboratory skills) approach to knowledge acquisition, which was considered inappropriate for distance learning. Due to the COVID-19 pandemic, contact teaching has been largely restricted, so adjustments have been necessary to continue the educational process. In biomedical field, teaching related to theoretical knowledge has been adapted to distance learning, while practical training has been reduced, being held either in an epidemiologically appropriate manner or temporarily postponed, but not discontinued. The lack of practical training is being compensated by developing a number of digital materials, including 3D models and simulations, videos of laboratory exercises, and live tutorials. Nonetheless, these substitutes are not an adequate replacement for live practical demonstrations, ones that incorporate patient interaction. Precisely because of the various forms of teaching and education, distance learning poses a number of challenges to organizers of such teaching methods. Student satisfaction and achievement of educational goals are the greatest indicators of the success of such studies. Our goal is to develop a reliable, valid, and widely applicable questionnaire for assessing quality of distance learning in the biomedical area. In the initial phase, we formed a focus group of three members. Reflecting on problems that students encounter during distance learning, we developed 24 questions that we examined on a test sample of 62 randomly selected students. Analysis of pre- existing questionnaires for assessing quality of distance learning enabled adaptation of components to the specificities of biomedical studies. Furthermore, our analysis showed a large disparity in the obtained answers. Ultimately, we decided to construct a larger set of questions that assess identical issues in order to determine the consistency of the answers delivered by the respondents. In the next phase of the survey, two students were added to the existing focus group. Questions were formulated in a more acceptable manner for students, and further analysis of the potential shortcomings of the survey was done. Thus, a new template for the questionnaire was created, consisting of seven open-ended questions focusing on students’ sociodemographic data, and 70 items examining students' perceptions of several segments of the quality of distance learning. These are Teachers’ Performance, Personal Performance, Educational Quality and Organization, Cooperation, and Conditions for Participation. Preliminary results of the development of the questionnaire were presented at the EDULEARN21 conference.

Different studies clearly show that posttraumatic stress disorder (PTSD) is important factor in a reduction of the overall quality of life. PTSD remains a substantial problem in Croatia, nearly three decades after the beginning of the Croatian Homeland war. In this paper, we present results of our original research about impact of PTSD on the self-perceived health-related quality of life and social support in Croatian Homeland war veterans.A total of 277 war veterans were included from all Croatian counties. 158 (57.03%) veterans has PTSD and 119 (42.47%) are without PTSD. Strucured questionnaire was designed for socio-demographic data and information about combat experience and health problems. SF-36 was used in the estimation of health-related quality of life and Multidimesional Scale for Perceived Social Support for estimation of social support. Research was performed from June 2017 till November 2017.Main results of the study suggest that Croatian veterans with PTSD have lower health-related quality of life in almost all doimains, and that they perceive less social support from family, friends and significant others in comparison to veterans without PTSD.The results of this study reiterate strong impact of PTSD on quality of life and perception of social support. The research speaks in favor of the need to develop person-centered interdisciplinry health-care programs for this population, with special emphasis on their overall quality of life.

Communication in medicine is a fundamental clinical skill and one of the most important tools we have for provid- ing quality patient care and improving patient satisfaction. Good communication between health professionals and patients is mutually beneficial and essential in the thera- peutic process. The patient can receive a better and more personalized care, while the health worker will find it eas- ier to perform his work. Communication in medicine has evolved from the paternalistic model to the current model of collaborative partnership, which highlights the impor- tance of informed consent and shared decision making. In person-centered medicine and people-centered health care, an effective communication is regarded as the best example of ars medica (the art of medicine), while the com- munication skills training has become internationally ac- cepted as an essential component of medical education.

Different studies clearly show that doctor-patient relationship and communication are extremely important. They have a big influence on the outcome of medical treatment, but also on the cooperability, quality of life, safety of patients, teamwork, cultural sensitivity and fewer complaints to the doctor+s work. In this paper, we present results of our original research about attitudes of doctors and their perception related to the importance of communication between doctors and patients and person-centered approach.This cross-sectional study used a 28 items on-line survey to collect data from doctors in the period from 29 September 2015 till 23 November 2015 by using the Google forms. Total of 939 doctors from the entire Croatia responded.Main results of the study suggest that doctors are aware of the importance of communication between doctors and patients and that education about communication skills was not appropriate during their study. Doctors have undoubtedly expressed their desire for further development and learning about a better communication between doctors and patients and they have showed in this research that they love their job.The research unambiguously speaks in favor of the need of the significant strengthening of this segment within the program of the School of Medicine and support the current changes in the medical curriculum at the School of medicine University of Zagreb.

The latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013) included a number of evidence-based changes to the diagnostic criteria for posttraumatic stress disorder (PTSD) (1). PTSD is now classified in a new category, Trauma-and Stressor-Related Disorders. The rate of lifetime PTSD is two to four times higher among war veterans than in the general population (2). Chronic PTSD is associated with various somatic illnesses, from autoimmune to cardiovascular, and especially with chronic pain (3). During the Croatian Homeland War (1991- 1995) and its aftermath, a considerable number of people in Croatia were exposed to long-term and intense traumatic experiences. In this essay we would like to emphasize the importance of adequate communication in the treatment of war veterans with chronic PTSD and chronic pain, especially since communication has an important role in treatment outcomes

Aim: To determine the prevalence of muscular dystrophy (MD) and spinal muscular atrophy (SMA) in Croatia by use of multiple epidemiological tools. ----- Methods: This epidemiological study collected data from three national patient registries and one database of a non-governmental organization (NGO) of MD and SMA patients. The study involved all individuals who either had undergone hospital treatment for MD or SMA, had consulted their primary health care providers for MD- and SMA-related symptoms, were listed as disabled due to MD or SMA, or were members of the mentioned NGO in 2016. In order to prevent double entries, we created a new database of all living individuals, each with a unique identification number. The prevalence rates for 2016 were calculated by age and sex groups. ----- Results: There were 926 patients diagnosed with MD (544 men). Most men diagnosed with MD were in the age group 10-19, whereas most women were in the age group 50-59. MD prevalence in Croatia was 22.2 per 100 000 population. There were 392 patients diagnosed with SMA (198 men). Most men with SMA were in the age group 50-59, whereas most women were in the age group 60-69. SMA prevalence in Croatia was 9.3 per 100 000 population. ----- Conclusion: SMA prevalence rate in Croatia is similar to SMA prevalence worldwide. However, MD prevalence rate is higher than worldwide estimates. This difference could be attributed to the fact that we could not confirm whether every patient registered in these databases actually met the diagnostic criteria for MD and SMA.

Cilj je istraživanja ispitati povezanost tjelesne aktivnosti kvalitete života starijih osoba. Ispitanici su pokretni građani starije životne dobi od 70 do 90 godina (N = 100). Rezultati su dobiveni na temelju ispunjenog Indeksa osobne kvalitete života. Ispitanici su podijeljeni u dvije skupine s obzirom na učestalost bavljenja tjelesnom aktivnošću. U skupinu aktivnih svrstani su oni koje se bave tri ili više puta tjedno nekom od tjelesnih aktivnosti dulje od 30 minuta (N = 56), a u skupinu neaktivnih oni koji nisu tjelesno aktivni (N = 44). Utvrđena je niska, ali značajna pozitivna korelacija učestalosti bavljenja tjelesnom aktivnošću i kvalitete života na domeni zdravlja (r = 0,202; p < 0,05) i kvalitete života na domeni uspješnosti (r = 0,198; p < 0,05). Slijedeći preporuke Svjetske zdravstvene organizacije i rezultate niza istraživanja te dijela rezultata i ovog istraživanja koje ukazuje na znatnu povezanost učestalosti tjelesne aktivnosti i domene zdravlja kvalitete života, stalna tjelesna aktivnost mora biti neizostavna mjera primarne prevencije zaštite zdravlja starijih osoba, iako rezultati ovog istraživanje ne ukazuju na statistički značajnu povezanost tjelesne aktivnosti i ukupne kvalitete života., The aim of the study was to investigate the correlation between the physical activity and quality of life of older people. Respondents were movable, older citizens of 70-90 years (N=100). Results were obtained on the basis of the completed Quality of Life Index. Participans were divided into two groups considering the frequency of physical activities. In the 'active' group were participants who participated in some sort of physical activity two or three times a week for more than 30 minutes (n=56), and a group of inactive people included participants who were not physically active (n=44). There was a low but significant positive correlation frequency of doing physical activity and quality of life in the domain of health (r=0.202;p

Educational environment is an environment of an institution perceived by students. It has an important role in motivating students. It influences how, why and what students learn, determines the overall quality of students' learning process and success in school, so it is highly connected with the success of the institutional curriculum itself. Thus we decided to investigate the operational components in the educational environment in order to determine students' perception of teaching, school organisation, atmosphere in classes or teachers' attitudes to students. Method and Respondents: We used the Dundee Ready Education Environment Measure (DREEM), which is a valid instrument for educational environment assessment from students’ point of view. DREEM is a 50 item questionnaire that contains five subscales which include: students' perception of teaching, teachers, and atmosphere ; and students' academic and social self-perceptions as well. In Croatia, the DREEM questionnaire hasn't been used to evaluate educational environment in medical schools. The study population included randomly selected students from first to sixth year of School of Medicine, University of Zagreb, in order to assess differences between them based on experience and perception of education environment. The DREEM questionnaire was available in an online format and was distributed to the students through social networking, including anonymity, with a short written explanation of the importance of their participation. Results: Regarding to perception of teaching, mean for preclinical years is 22.47+/-10.10, and for clinical is 17.84 +/- 8.37. The lowest mean is found for 6th year which is 15.85+/-7.94. For perception of teachers mean of preclinical years is 26.50 +/- 8.10, clinical 26.44 +/-7.12, and the lowest mean is in the 6th year, 21.55+/- 6.72. Mean of preclinical years for perception of atmosphere is 28.13+/- 9.04, clinical years 27.35+/- 7.94, and the lowest mean is again for the 6th year, 24.24+/-7.63. The results in our country are more positive than negative. The positive and important result is that the perception of teachers is 'Moving in the right direction'. And also the perception of atmosphere is 'A more positive attitude'. What is considered more negatively is academic self-perception which is considered as 'Many negative aspects', social self-perception, which is considered as 'Not a nice place' and perception of teaching as 'Teaching is viewed negatively'. The lowest Cronbach's alpha was for students' social self-perception. Conclusion: The students showed most interest in first years of medical school and as the years passed the perception of the medical school learning environment worsened. The lowest result in subscales perception of teachers, teaching and atmosphere was for the sixth year. Understanding students' educational environment and problem targeting can be used to improve the environment and those implemented changes should be evaluated over time. Proper problem targeting and evaluation of those implemented changes is very important because within health professional education, students' educational environment surely has an impact on educational outcomes and success.

Croatia was among the first countries in the world to ratify the United Nations Convention on the Rights of Persons with Disabilities. By signing the Convention, Croatia comitted itself to implement this document in its entierety, which will ensure equal opportunities and improve the quality of life for persons with disabilities and their families. One of the most important areas of the Convention is education. The signatory countries must recognize the right of persons with disabilities to education. In order to realize this right without discrimination and on the basis of equal opportunities, the participating countries will ensure the inclusion of the education system as well as enabling lifelong learning for persons with disabilities. The signatory countries are also obliged to enable persons with disabilities to learn life and social development skills to facilitate their full and equal participation in education and life as members of the community. To this end, the signatory countries will, among other things, promote peer support. In 2015, Croatia presented the first results of work done on the basis of the signed Convention. The United Nations Committee was generally satisfied with Croatia's efforts and implementations, but found and expressed some concerns and recommendations for specific areas of the Convention.The Committee recommended that Croatia, as a signatory state, takes immediate steps to ensure that all persons with disabilities have access to inclusive primary, secondary and tertiary education, and in addition, reasonable adjustment for persons with disabilities within regular education. One of the activities that enable reasonable adjustment is promoting peer support. The project "Let them learn" is a project of the student association at Faculty of Economics in Zagreb (Association of Managers of the Faculty of Economics) and organized with the intent to enable students with disabilities at the Faculty of Economics to overcome everyday obstacles during their stay at the faculty as easilly as possible. This project enables students with disabilities to have an educational assistant who is attending lectures with them and helps them with everyday faculty activities such as: going to a lecture, making notes and following lectures, dressing and undressing, communication with professors and assistants, feeding assistance in a faculty restaurant if necessary, accompanying a disabled student to the toilet if necessary as well as socializing and integrating the disabled student in society and encouraging the creation of self- confidence. The "Let them learn" project has left a significant impression in academic circles, and positive comments about educational assistance are continually coming in. In the period of two and a half years, 8 disabled students were provided with educational assistance and were extremely satisfied. This project is extremely innovative and useful and we believe that it must continue in the generations to come, because persons with disabilities require actual help during their stay at the faculty, and the UN Convention itself advises it.

The aim of the study was to determine the prevalence of newly detected asymptomatic hypertension in a random sample of urban and rural population of the Posušje community, and to assess the possible age and sex differences between these two population groups. The study included 2000 subjects that underwent blood pressure measurement. Elevated blood pressure was detected in 532 (26.60%) subjects that were divided into three groups according to the level of hypertension: mild, moderate and severe hypertension. Study results showed that there were no statistically significant age or sex differences according to the levels of asymptomatic hypertension, or between the urban and rural populations of the Posušje community.

Cilj rada je utvrditi prevalenciju novootkrivene asimptomatske hipertenzije u slučajno odabranom uzorku pučanstva gradske i seoske regije na području općine Posušje te postoji li razlika između stanovnika gradskog i seoskog područja s obzirom na spol i dob. Istraživanje je provođeno na 2000 ispitanika kojima se mjerio krvni tlak. Povišeni krvni tlak otkriven je u 532 osobe (26,60 % ispitanih), prema visini kojeg su ispitanici razvrstani u tri stupnja hipertenzije: blaga, srednja i teška hipertenzija. Ispitivanje je pokazalo da nema statistički značajnih razlika u spolu i dobnim skupinama prema stupnjevima asimptomatske hipertenzije, te između gradske i seoske populacije općine Posušje., The aim of the study was to determine the prevalence of newly detected asymptomatic hypertension in a random sample of urban and rural population of the Posušje community, and to assess the possible age and sex differences between these two population groups. The study included 2000 subjects that underwent blood pressure measurement. Elevated blood pressure was detected in 532 (26.60%) subjects that were divided into three groups according to the level of hypertension: mild, moderate and severe hypertension. Study results showed that there were no statistically significant age or sex differences according to the levels of asymptomatic hypertension, or between the urban and rural populations of the Posušje community.

Medical teachers are well prepared for their clinical roles but not all of them have been trained for their teaching roles. Therefore, staff/faculty development has become an increasingly important component of medical education and the majority of programmes focus on the medical teacher. Several models of medical teachers' training with the aim to improve faculty members’ knowledge and skills relevant to their institutional and faculty position are widely available, ranging from the learning from self-experience, peer learning, learning from mistakes and successes, shorter or longer courses or workshops, fellowships, integrated longitudinal programmes, to postgraduate courses lasting one or two years, peers and medical teachers themselves. Since 2000, the Croatian Association for Medical Education in collaboration with the Department of Educational Technology, has organized one-week courses for junior teachers entitled “The Art of Medical Education”. This paper is describing the main characteristics of this Croatian training model for medical teachers (aims, working format and main contents) as well as strengths and weaknesses.

Arterijska hipertenzija je vode i čimbenik rizika smrtnosti. Cilj rada je utvrditi stopu otkrivene asimptomatske hipertenzije me u slučajno odabranim uzorkom pučanstva na podru ju općine Posušje u odnosu na stupanj (blagi, srednji i teški) hipertenzije i u odnosu na čimbenike rizika. Analizirani čimbenici rizika su: konzumacija zasićenih masnih kiselina, alkohola, duhanskih proizvoda i crne kave. Asimptomatska hipertenzija otkrivena je u 532 od ukupno 2000 osoba ili 26,60% ispitanih. U tih je osoba utvrđena statistički značajno veća konzumacija zasićenih masnih kiselina, alkohola, duhanskih proizvoda i crne kave u odnosu na ostale ispitanike, Arterial hypertension is the leading mortality risk factor. The aim of the study was to assess the rate of asymptomatic hypertension detected in a randomly selected population sample in Posušje Municipality according to the grade of hypertension (mild, moderate or severe) and risk factors. The following risk factors were analyzed: intake of saturated fatty acids, alcohol, tobacco products and black coffee. Asymptomatic hypertension was detected in 532 of 2000 (26.60%) subjects included in the study. In comparison to the rest of the study sample, these 532 subjects reported a statistically signiicantly higher consumption of saturated fatty acids, alcohol, tobacco products and black coffee

Prospektivnom studijom rađenom 2009. godine pokušalo se utvrditi prevalenciju asimptomatske hipertenzije i utjecaj tjelesne aktivnosti na novootkrivene hipertenzije među slučajno odabranim uzorkom pučanstva na području općine Posušje. Ukupno je bilo 2000 spitanika kojima se mjerio arterijski tlak, te su oni ukoliko je tlak bio povišen, razvrstani u tri stupnja: blagu, srednju ili tešku asimptomatsku hipertenziju. Ona je otkrivena u 532 osobe ili 26,6% ispitanih. Statistički značajna razlika uočena je kod ispitanika koji su u svoje slobodno vrijeme bili tjelesno aktivni, jer se kod njih rjeđe dijagnosticirala asimptomatska hipertenzija., The prospective study carried out in 2009 tried to establish the prevalence of asymptomatic hypertension and the influence of physical activity on newly discovered hypertensions among randomly chosen examples of inhabitants in Posušje municipality area. A total of 2,000 examinees had their blood pressure measured, and if high blood pressure was established, they were divided into three groups: low, medium and high asymptomatic hypertension. It was found in 532 people or 26.6% of examinees. A statistically significant difference was seen in examinees that were physically active in their spare time, for asymptomatic hypertension was not diagnosed with these examinees.

U razdiblju od 1992-1996. godine organizirano je 50 kineziološko- rekrativnih treninga i natjecanja u kojima su sudjelovala 566 ( 23, 03%) od ukupno 2457 ranjenika Domovinskog rata tada stacionarno liječenih u Kliničkoj bolnici Dubrava.