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Društvene mreže mogu se definirati kao online mediji i sučelja osmišljena za povezivanje ljudi te olakšavanje interakcije i razmjene sadržaja među njima. Njihova važna specifičnost je stvaranje osobnih profila kojima se lakše ograničava vidljivost i dostupnost dijeljenih informacija. Razvoj društvenih mreža utječe na sve aspekte društva u cjelini, a zdravstveni djelatnici i zdravstvene institucije nisu izuzetak. Društvene mreže mogu se koristiti u osobne i profesionalne svrhe. Funkcioniraju po modelu dvosmjerne komunikacije te su vrlo dostupne, neformalne i javne. Potrebno je pretpostaviti da je sadržaj objavljen na društvenim mrežama u javnoj domeni i dostupan svima, bez obzira na postavke privatnosti – jednom kada se informacija objavi na internetu, vrlo teško ju je u potpunosti ukloniti. Rezultati istraživanja ukazuju na vrlo jasnu potrebu kontinuiranog praćenja i istraživanja društvenih mreža u nastajanju te kreiranju i ažuriranju smjernica. Nadalje, potrebno je poduzimanje određenih obrazovnih intervencija imajući u vidu specifičnosti svake zdravstvene profesije, a s obzirom na različit potencijal korištenja društvenih mreža. Smjernice su vrlo korisne kao upute u novim neistraženim područjima te područjima koja se vrlo dinamično mijenjaju, a društvene mreže upravo su takve. Smjernice su namijenjene savjetovanju i educiranju, a koriste se za preveniranje pogrešaka ili se mogu koristiti nakon što je pogreška učinjena u njihovom ispravljanju ili promišljanju. Zdravstveni djelatnici bi trebali prepoznati utjecaj i potencijal društvenih mreža te razmotriti kako ublažiti moguće rizike. Ove su smjernice izrađene kako bi educirale zdravstvene djelatnike te pružile okvir za donošenje odluka o optimalnom korištenju društvenih mreža za osobne i profesionalne svrhe. Smjernice su strukturirane u obliku izjava koje predlažu ili preporučuju specifično profesionalno ponašanje zdravstvenih djelatnika na društvenim mrežama. Namjera im je olakšati kontinuirani sustavni razvoj zdravstvene profesije te pomoći pri pružanju najkvalitetnije moguće skrbi.

UVOD Studenti medicinskih profesija učestali su korisnici društvenih mreža (DM). Cilj ovoga rada bio je istražiti učestalost i razloge zbog kojih studenti medicine Medicinskog fakulteta i dentalne medicine Stomatološkog fakulteta Sveučilišta u Zagrebu, polaznici jednosemestralnih izbornih/elektivnih predmeta, izmjenjuju postavke privatnosti svojih profila na DM te utjecaj edukacijske intervencije na promjenu postavki privatnosti profila na DM. MATERIJALI I METODE Istraživanje „pred-test post-test zatečenih grupa“ provedeno je korištenjem online upitnika na uzorku studenata medicine i dentalne medicine na početku i na kraju izvođenja nastave (T1 i T2). Upitnik je sadržavao instrument o postavkama privatnosti. Deskriptivna statistika i McNemar test provedeni su prilikom obrade podataka. REZULTATI Oba puta upitnik je ispunilo 53 studenata (16 studenata medicine i 37 studenata dentalne medicine). Od svih ispitanika, samo jedan nije koristio DM, te je 52 ušlo u finalni uzorak. Nakon odslušane nastave statistički značajno više studenata izmijenilo je postavke privatnosti na DM koju koriste, najviše u odnosu na one koji to nisu učinili ili ne znaju jesu li to učinili (T1 61, 5 % vs. T2 84, 6 %, p=.012). Od 32 studenta koji su odgovori pozitivno na pitanje o promjeni postavki, ne postoji statistički značajna razlika u razlozima promjene postavki privatnosti. Najčešće su studenti mijenjali postavke privatnosti zbog „zaštite osobnih podataka od nepoznatih osoba” te zbog “nepovjerenja u sigurnost početnih postavki privatnosti društvenih mreža”. Iako nema statistički značajne razlike , u česticama „zbog savjeta kolega i prijatelja“ (T1 15, 6 % vs. T2 28, 1 %, p=.289) i „rizika da bi njihov profil mogao vidjeti trenutni ili budući poslodavac“ (T1 21, 9 % vs. T2 43, 8 %, p=.289) vidi se porast nakon nastave. ZAKLJUČAK Edukacijska intervencija je imala statistički značaj utjecaj na aktivnost promjene postavki privatnosti profila na DM. Najzastupljeniji razlozi promjene bili su nepovjerenje u sigurnost početnih postavki te zaštita osobnih podataka od nepoznatih osoba. Zahvala: Ovo istraživanje dio je UIP 2017-05-2140 projekta Hrvatske zaklade za znanosti „Opasnosti i prednosti društvenih mreža: e-profesionalizam zdravstvenih djelatnika - SMePROF“

Background As the use of social networking sites (SNSs) has greatly increased among health professionals, it is necessary to investigate their use of SNSs. The aim of this study was to identify the patterns of SNS use for contact with patients between medical doctors (MD) and doctors of dental medicine (DMD) in Croatia. Methods In collaboration with the Croatian Medical Chamber and the Croatian Chamber of Dental Medicine, a quantitative cross-sectional study was conducted on the use of SNSs and the attitudes of MDs and DMDs towards e-professionalism. Data were collected using online questionnaires. The data were analyzed using descriptive statistics. Results A total of 753 responses were processed, 507 (67,3%) MDs and 246 (32,7%) DMDs. DMDs were significantly more likely to visit patients or their family members’ profiles on SNSs (60,6% vs 33,3%, P < 0.001). The main reason for visiting a patient’s or family member’s profile is social communication, which is significantly more common among DMDs (46,3% vs 29,0%, P < 0.002). DMDs are significantly more likely to send friend requests from private SNS profiles to patients or their family members (15,0% DMDs vs 3,4% MDs, P < 0.001). Patients are much more likely to send friendship and connection requests on SNS to DMDs (91,1% DMDs vs 62,7% MDs, P < 0.001) who are also significantly more likely to accept these requests (76,8% DMDs vs 41,5% MDs, P < 0.001). MDs and DMDs would find the presence of e-professionalism guidelines useful (72,2% MDS vs 78,0% DMDs, P = 0.103). Conclusions The results show that DMDs are more open to communicating with patients via SNSs. Results showed a difference between MDs and DMDs in both directions - in sending requests to patients or their family members and in positive responses to their requests for connection. The findings point to the need to develop guidelines for health professionals regarding e-professionalism. Key messages • There are differences between MDs and DMDs toward communicating with patients using SNSs, DMDs being more open to the communication with patients. • There is a need to develop guidelines for health professionals on e-professionalism with emphasis regarding how to professionally communicate with patients on SNSs.

Healthcare workforce shortage is a worldwide problem (1). Workforce shortage may be defined as not having the right number of people with the right skills in the right place at the right time, to provide the right services to the right people (2). In this regard, the trends are worrisome, and the situation is getting worse. The consequences are also very consistent – limited care health services and limited quality of health care (1). In short, there is an imbalance between need and supply. The solution: as health care needs increase worldwide, the “production” of personnel must be increased! But is it really that simple? Are the problem and the solution so reciprocal and directly linked?

Uvod Društvene mreže (DM) zadiru u privatnost pojedinca i ostavljaju opasnost miješanja privatnog i profesionalnog. Održavanje postavka privatnosti profila te više profila pod raznim imenima omogućava višu razinu zaštite i privatnosti. Cilj ovog rada bio je istražiti razlike u vrsti profila doktora medicine (MD) i doktora dentalne medicine (DMD) na Facebooku i Instagramu. Materijali i metode Presječno istraživanje provedeno je korištenjem online upitnika na prigodnom neprobabilističkom uzorku svih MD i DMD članova Hrvatske liječničke komore i Hrvatske komore dentalne medicine. Deskriptivna statistika i hi kvadrat test provedeni su prilikom obrade podataka. Rezultati Uzorak se sastojao od 753 ispitanika (246 DMD i 507 MD) koji koriste barem jednu DM. Na obje DM i MD i DMD imali su predominantno samo jedan profil s pravim imenom (Facebook MD 84.9% vs. DMD 79%, Instagram MD 74.1% vs DMD 85%). Statistički značajna razlika između dvije skupine postoji na Facebooku gdje 17.6% DMD ima i privatan i profesionalan profil za razliku od 5.5% MD, te značajno više MD (9%) ima samo jedan profil pod drugačijim imenom za razliku od samo 2.5% DMD (x2=34.432, df=3, P

Family physicians are burdened with a great number of guidelines considering different conditions they treat. We analyzed opinions of family physicians on electronic tools which help managing chronic conditions and their influence on patient care by cardiovascular disease (CVD) prevention guideline availability, usage and adherence. A descriptive study was performed on a convenient sample of 417 (response rate 56.0%) Croatian family physicians. Data on physician characteristics and availability, usage and adherence to CVD prevention guidelines were analyzed. The χ2-test was used for comparisons. Significance was defined as p, Obiteljski liječnici su u radu opterećeni velikim brojem smjernica za različite bolesti. Analizirali smo njihovo mišljenje o elektroničkim alatima koji im pomažu u skrbi za bolesnike s kroničnim bolestima i njihovom utjecaju na dostupnost, uporabu i pridržavanje smjernica za prevenciju kardiovaskularnih bolesti (KVB). Provedeno je opisno istraživanje na uzorku od 417 (stopa odgovora 56,0%) hrvatskih obiteljskih liječnika. Analizirani su podaci o značajkama liječnika, dostupnosti, upotrebi i pridržavanju smjernica za prevenciju KVB. Za usporedbe je primijenjen χ2-test. Statistička značajnost je definirana kao p

Uvod: Privatni i profesionalni život isprepleću se na društvenim mrežama (DM). Pove ćanje vlastite i percepcije javnosti prema razini e-profesionalizma doktora dentalne me dicine (DMD) i medicine (MD), shvaćanje i kontrola privatnosti na DM je važna. Cilj ovog rada bio je istražiti stavove i postupke prema vlastitoj razini privatnosti na društve nim mrežama DMD i MD. Materijali i metode: Provedeno je presječno istraživanje korištenjem online upitnika na prigodnom uzorku svih liječnika MD i DMD u Hrvatskoj. Za obradu podataka korištena je deskriptivna statistika i hi kvadrat test. Rezultati: Od 1013 ukupno prikupljenih odgovora, u konačni uzorak ušlo je ukupno 753 ispitanika (246 DMD i 507 MD) koji koriste barem jednu DM. Facebook je DM u ko joj se obje skupine najbolje snalaze, dok za Instagram, YouTube, LinkedIn i Twitter posto je statistički značajne razlike između skupina. Obje skupine su najliberalnije u „prihvaća nju prijateljstava“ na LinkedIn-u. DMD su u toj kategoriji statistički značajno liberalniji od MD na LinkedInu i na Facebooku. Postavke privatnosti izmijenilo je 69, 9% DMD i 66, 9% MD, a najčešći razlog bio je „Zaštita mojih osobnih podataka od nepoznatih oso ba“ i „Nisam vjerovao u sigurnost početnih postavki privatnosti DM“. Statistički značaj no više MD je bilo zabrinuto zbog „Rizika da bi moj profil mogao vidjeti trenutni ili bu dući poslodavac“ (29, 2% vs 19, 8%, P=0, 028). Zabrinjavajuće je da u obje skupine nešto manje od trećine ispitanika nisu ili ne znaju jesu li promijenili osnovne postavke privat nosti na DM. Zaključak: DMD i MD pokazuju zabrinutost i spremnost za kontrolu vlastite privatnosti na DM. Potrebna je daljnja edukacija o načinima kontrole privatnosti na DMD.

Uvod: Porastom korištenja društvenih mreža (DM) među općom populacijom postoji i porast u korištenju među nastavnicima u zdravstvu. Cilj ovog istraživanja bio je istražiti navike korištenja DM i razlike u stavovima o e- profesionalizmu među nastavnicima Medicinskog i Stomatološkog fakulteta. Materijali i metode: Provedeno je presječno istraživanje korištenjem online upitnika za nastavnike Medicinskog i Stomatološkog fakulteta Sveučilišta u Zagrebu u ak. god. 2018./2019. Za obradu podataka korištena je deskriptivna statistika. Rezultati: U završni uzorak ušlo je 93 odgovora: 68 s Medicinskog (RR 13.6%) i 25 sa Stomatološkog fakulteta (RR 10.8%) Facebook je najšire korišten (82.2%) a na drugom mjestu LinkedIn (77.4%). Instagram je statistički značajno češće korišten od nastavnika Stomatološkog (64% stom vs. 39.7% med, P=0.037) a Twitter od nastavnika Medicinskog (23.5% med vs. 4% stom, P=0.035) fakulteta. YouTube (65.6%) je najčešće korišten u edukacijske svrhe. Većina nastavnika oba fakulteta ne bi prihvatilo (88.2%) niti bi poslalo (97.8%) zahtjev za prijateljstvo pacijentu. Percepcija neprofesionalnog ponašanja na značajno se razlikovala u stavovima prema postavljanju slika pacijenata (97.1% med vs 80% stom P= 0.006), dok su obje skupina neprofesionalnim smatrali postavljanjem povjerljivih informacija (94.6%), kriminalnih aktivnosti (90.3%), korištenje alkohola (82.8%) i droge (89.2%) te eksplicitni seksualni sadržaj (88.2%). Većina nastavnika (84.8%) smatra dobrodošlim postojanje smjernica o e- profesionalizmu na DM. Zaključak: Facebook i LinkedIn najčešće su korištene DM. Nastavnici Medicinskog fakulteta osjetljiviji su na postavljanje fotografija pacijenata. Potrebno je razviti smjernice o e-profesionalizmu na DM.

Eksponencijalnim razvojem društvenih mreţa znaĉajan dio privatne i profesionalne komunikacije premješta se iz klasiĉnih medija u elektroniĉki format. Profesionalno ponašanje pri korištenju društvenih mreţa odnosno „e-profesionalizam― postaje vaţan element u svakodnevnoj komunikaciji. Djelatnici fakulteta biomedicinskog podruĉja, a osobito medicine i stomatologije u svojoj komunikaciji s kolegama, studentima kao i u interakciji s pacijentima susreću se s izazovima balansiranja osobnih i profesionalnih stavova.

Osiguranje adekvatnog i održivog broja radnika u zdravstvu, sa odgovarajućim znanjima i vještinama, ključno je pitanje zdravstvene politike širom svijeta. Cilj disertacije je razviti model za simulaciju dinamike upućivanja na specijalističko usavršavanje doktora medicine u Republici Hrvatskoj te sustavnim ispitivanjem različitih scenarija procijeniti optimalnu strategiju kojom se osigurava stabilna opskrba specijalistima različitih specijalnosti i korigira procjep između ponude i potražnje. Za izradu simulacijskog modela i za izvođenje simulacijskih eksperimenata korišten je programski paket Stella Architect v1.9.1 s grafičkim sučeljem za izradu i simulaciju modela metodom sistemske dinamike. Promjene u broju liječnika i njihovoj dobnoj raspodjeli projicirane su u kontekstu očekivanih budućih promjena hrvatske populacije pod različitim scenarijima koji pokrivaju razdoblje od 2020. do 2035. godine. Razvijen je višedijelni model dinamike sustava kojim su obuhvaćene sve faze školovanja i rada liječnika specijalista, od upisa na studij medicine preko specijalističkog usavršavanja i radnog vijeka u zdravstvenom sustavu (ili nekom drugom sustavu koji zapošljava doktore medicine) do odlaska u mirovinu. Sustavno ispitivanje različitih scenarija pokazuje da je sadašnja ukupna upisna kvota na studij medicine u Republici Hrvatskoj od 590 studenata godišnje dovoljna za zadovoljenje potreba za liječnicima u budućem razdoblju do 2035. godine., Ensuring an adequate and sustainable number of health workers, with appropriate knowledge and skills, is a key health policy issue worldwide. The aim of this thesis was to develop a model for simulating the dynamics of referral to specialist training of medical doctors in the Republic of Croatia and systematically examine different scenarios to assess the optimal strategy to ensure a stable supply of specialists in various specialties and correct the gap between supply and demand. Stella Architect v1.9.1 software package with a graphical interface for creating and simulating models using the system dynamics method was used to create a simulation model and to perform simulation experiments. Changes in the number of physicians and their age distribution are projected in the context of expected future changes in the Croatian population under different scenarios covering the period from 2020 to 2035. A multi-part model of system dynamics has been developed, covering all phases of education and work of specialist physicians, from enrolment in medical studies through specialist training and working life in the health system (or another system that employs physicians) to retirement. The results of simulation modelling of different scenarios indicate that the current total enrolment quota for the study of medicine in the Republic of Croatia of 590 students per year is sufficient to meet the needs for medical doctors in the future until 2035.

Smjernice za poticanje razvoja e-profesionalizma tijekom studija medicine i dentalne medicine rezultat su dvogodišnjeg rada na uspostavnom istraživačkom projektu Hrvatske zaklade za znanost Opasnosti i prednosti društvenih mreža: e- profesionalizam zdravstvenih djelatnika (SMePROF projekt). Smjernice predstavljaju prvi dokument na hrvatskom jeziku koji nudi preporuke profesionalnog ponašanja zdravstvenim djelatnicima, konkretno studentima medicine i dentalne medicine, ali i ostalima koji koriste društvene mreže.

We report a qualitative analysis of higher education biomedical informatics (BMI) teachers' opinions on the needs for BMI workforce and employment opportunities in the Croatian health care system. Needs were perceived as considerable ; however this was not coupled with adequate employment opportunities. Barriers were identified to correcting this imbalance, including the failure of the health care system planners to recognise BMI experts as an important part of the workforce and lack of adequate educational opportunities.

Gluten is the complex of water-insoluble proteins, gliadin (prolamin) and glutenin (glutelin) fraction from wheat, rye, and barley. Because of its properties (water binding and viscosity yielding) is widely used food additive. Gliadin is very important in the context of coeliac disease (CD), non-coeliac gluten sensitivity (NCGS), gluten ataxia (GA) and dermatitis herpetiformis (DH). CD is characterized by villus atrophy of the small intestinal mucosa caused by the interaction of the gliadin and the mucosa of the small intestine in susceptible persons as an immune disorder. NCGS presents patients whose symptoms have disappeared with gluten withdrawal who do not have typical CD antibodies and do not suffer from lesions in the duodenal mucosa. GA occurs later in life with or without enteropathy and is associated with cerebellum affection by CD antibodies causing clinical features of gait and limb ataxia, ocular signs of cerebellar dysfunction. DH is uncommon cutaneous eruption associated with gluten sensitivity it is diagnosed after biopsy by immunofluorescence of granular or speckled IgA deposits in an area of perilesional skin. The gluten-free diet leads to complete regression of symptoms in all this entities. Despite the fact that self-reported gluten sensitivity (GS) is increasing over the past years there is no scientific evidence of benefits of gluten withdrawal in gluten non associated diseases. Researches show that the public perception of gluten is causing increase in the number of people who erroneously believe they are sensitive to it.

U svakodnevnom radu obiteljskog liječnika, depresija je česta i još uvijek nedovoljno prepoznata bolest. Cilj ovoga rada je pregledom literature istražiti značajke prepoznavanja (dijagnosticiranja) i liječenja depresije u bolesnika s kroničnom tjelesnom bolešću (KTB) u ordinaciji obiteljskoga liječnika. Pretraživana je baza podataka PubMed, a kriterijima uključivanja udovoljavali su radovi pisani na hrvatskom ili engleskom jeziku, objavljeni između 2000. i 2018. godine. Postupnim sužavanjem pretraživane tematike definirane su 93 publikacije. Uočeno je da simptomi depresije mogu biti maskirani simptomima KTB. Povećan broj posjeta bolesnika s KTB obiteljskom liječniku prepoznaje se kao čimbenik koji je unaprijedio prepoznavanje simptoma depresije. Publikacije koje su sadržajem analizirale liječenje depresije ukazuju na potrebu da se, uz farmakološko liječenje antidepresivima, trebaju provoditi i učinkovite psihoterapijske tehnike. Prepoznavanje i liječenje depresije veliki je izazov za zdravstveni sustav današnjice, ali i veliki izazov u svakodnevnom radu obiteljskih liječnika., Depression is a common disease in a family physician's daily work but is still not sufficiently recognized. The aim of this paper is to examine the characteristics of diagnosis and treatment of depressed patients without chronic physical disease (CPD) compared to those with depression and one or more CPDs. The PubMed database was searched. The inclusion criteria met the articles written in Croatian or English, published between 2000 and 2018. By gradual filtration of the searched topics, 93 publications were selected. It was found that symptoms of depression can be masked by the symptoms of CPD. An increased number of visits to family physician was recognized as a factor that improved the recognition of depression. Publications that analyzed the treatment of depression indicate the need for effective psychotherapy techniques along the pharmacological treatment with antidepressants. Recognizing and treating depression is a major burden to today's healthcare system and a major challenge in the family physician's daily work.

European Union (EU) has defi ned the process and norms of nursing education. The aim of this project is to describe the nursing education in Croatia and compare it with education of nurses in the United Kingdom (UK) as a cradle of modern nursing, and in Slovenia as a transition country. As a source of data we used Directive 2005/36/EC and Directive 2013/55/EU, and also laws, regulations and documents from the mentioned countries which are related to nursing education. Nursing education in Croatia is carried out through high school education and also at the university level. Slovenian education of medical nurses starts after twelve years of general education and it is carried out at the level of college education. In the UK education is being carried out at the college level after twelve years of general education, and the possibility of acceptance into nursing involves professional qualifications at a similar academic level and courses of higher education. Experience in nursing education in the UK and Slovenia can be useful in the improving of nursing education in Croatia.

Introduction: Social networks are defined as web sites and applications that allow users to create, share, comment on content and present platforms that enable social networking. With the emergence of digital media and social networks, the term e- professionalism of physicians is defined as attitudes and behaviours that reflect the traditional paradigms of professionalism of health professionals manifested through digital media. Methods: Aim of this presentation is to explore the impact of social networks on e-professionalism of healthcare professionals in the Republic of Croatia. We’ll present the impact of social networks on e-professionalism from the prospective of a specialist in psychiatry, and compare it with the prospective from a different healthcare professional, dentist. Results and discussion: Digital media influence a wide range of medical professional behaviour, and present both dangers and challenges to opportunities. The opportunities are: 1) the use of social networks as a tool to improve information sharing ; 2) the presence of doctors in area with inadequate health care ; 3) the process of life-long learning is supported by social networks ; 4) mentoring student activities on social networks. The most common limitations are insufficient reliability, questionable quality of information, lack of privacy and confidentiality, inadequate use of social networks for communicating with patients and social networks may be an obstacle to realizing "real" contact with a healthcare worker.

U posljednjih nekoliko desetljeća kronične nezarazne bolesti (KNB) prepoznate su kao jedan od glavnih uzroka smrti u gotovo svim zemljama svijeta. U Republici Hrvatskoj, zemlji srednjoeuorpskog kulturnog kruga koja je prošla fazu „demografske tranzicije“, KNB također predstavljaju vodeći uzrok smrti. Vođena idejom preventivnog djelovanja i smanjenja razine rizičnih čimbenika prema temeljnim postulatima velikana hrvatske i svjetske medicine Andrije Štampara, skupina studenata medicine i mladih liječnika je 12. siječnja 2009. godine u prostorima Medicinskog fakulteta Sveučilišta u Zagrebu osnovala Udrugu narodnog zdravlja „Andrija Štampar“. Ustrajni rad doveo je do realizacije projekata prepoznatih na lokalnoj, regionalnoj i međunarodnoj razini od kojih je najznačajniji troetapni Stručno-edukacijski simpozij „Štamparovi dani“ koji se sastoji od javnozdravstvene akcije mjerenja krvnog tlaka i glukoze u krvi građanima Požeštine, programa prevencije međuvršnjačkog nasilja „Budi cool, ne budi bully“ te međunarodnog simpozija Zdravi stilovi života kojemu je glavni cilj trajna edukacija i stručno usavršavanje članova Udruge. Važno je istaknuti i projekte poput programa Zdravlje svima, Obilježavanje svjetskog dana moždanog udara, Kava bez šlaga, Provedi zdravi dan, CROatian Student Summit – CROSS te Inicijalnu programsku suradnju s Nacionalnom zakladom za razvoj civilnoga društva. Kao i do sada, članovi Udruge će i u budućnosti težiti ustrajnom provođenju javnozdravstvenih akcija i kvalitetnih projekata, uključivanju entuzijasta u rad i širenju ideja zdravih stilova života., Chronic non-communicable diseases (CND) have been recognized as one of the major causes of death in almost every country in the world, in recent decades.. In the Republic of Croatia, the country of the Middle East cultural circle that has passed the "demographic transition", the CND is also the leading cause of death. Guided by the idea of preventive action and the reduction of risk factors for CND according to the basic postulates of the great Croatian doctor, Andrija Štampar, a group of medical students and young doctors, founded the Association of People’s Health Andrija Štampar on January 12th, 2009 at the School of Medicine, University of Zagreb. The ongoing work has led to the realization of projects recognized at the local, regional and international level, the most important of which is the three-day Profesional-educational symposium "Štamparovi dani", which consists of blood pressure and glucose measurements for the citizens of Požega County, the preventive program of violence among schoolchildren "Be cool, do not be bully "and the international symposium Healthy Lifestyles whose main goal is continuous education for the members of the Association. It is also important to highlight projects such as Health for All, Coffee without Cream, Spend a Healthy Day, CROatian Student Summit - CROSS and Initial Program Cooperation with the National Foundation for Civil Society Development. As before, members of the Association will continue organizing public health activities and quality projects, including enthusiasts in the work and spreading the ideas of healthy lifestyles.

Lack of experts with complementary competences in the field of information technology as well as medicine and health care has been recognised as an important obstacle to successful computerisation of the health care system. Using a questionnaire survey, we aimed to describe the current educational landscape of biomedical informatics in Croatia, focussing on teachers' profiles and attitudes about existing educational opportunities in the field. Our findings show that Croatian institutions of higher education should better recognise the need for education in biomedical informatics. Dedicated programs need to be established and teacher force strengthened. Joint efforts of existing teachers-institutionalised through a working group focussing on education within the Croatian Society for Medical Informatics, for which strong support exists-might contribute to recognition of the field and improvement of educational opportunities.

Suvremeni stil života od ljudi sve češće zahtijeva zanemarivanje osnovnih zdravstvenih potreba u svrhu bržeg napredovanja na radnom mjestu, zadovoljavanja potreba socijalne okoline te podmirivanja svih onih obaveza koje nam moderno društvo sa sobom donosi. Brojne negativne strane modernih životnih stilova narušavaju zdravlje, a to su prije svega nezdrava i neuravnotežena prehrana, pretjeran unos soli, nedovoljan odmor i san, nedostatna tjelesna aktivnost, pušenje, pretjerana konzumacija alkohola te prekomjerna izloženost stresu. Vođena navedenim problemima, skupina studenata medicine i mladih liječnika 2009. godine okupila se u Udruzi narodnog zdravlja „Andrija Štampar“ s ciljem promocije javnozdravstvenih težnji i načela Andrije Štampara, posebice onoga koje govori kako je glavno mjesto liječničkog djelovanja tamo gdje ljudi žive, a ne ordinacija. Iste godine Udruga je započela s organizacijom Stručno-edukacijskog simpozija „Štamparovi dani“ koji se tijekom devet godina prometnuo u nezaobilazan događaj koji iz godine u godinu posjećuju brojni stručnjaci, mladi liječnici te studenti iz Republike Hrvatske i inozemstva s idejom razmjene javnozdravstvenih misli, kontinuirane stručne izobrazbe i promocije zdravlja i zdravih stilova života. „Štamparove dane“ i rad Udruge su do sada prepoznale i podržale brojne relevantne institucije, a u budućnosti se očekuju i brojne druge suradnje koje će za cilj imati povratak temeljnim javnozdravstvenim postulatima te promociju zdravlja i zdravih stilova života., The modern lifestyle often requires neglecting basic health needs for the purpose of faster progress in the workplace, meeting the needs of the social environment, and fulfilling the obligations that the modern society carries with it. Many negative aspects of modern lifestyles impair health, especially unhealthy and unbalanced diet, excessive salt intake, insufficient rest and sleep, lack of physical activity, smoking, excessive alcohol consumption and excessive exposure to stress. Guided by these problems, a group of medical students and young doctors gathered in the Association of People’s Health Andrija Štampar back in 2009, in order to promote public health aspirations and principles of Andrija Štampar, especially the one that says that the most important places of medical activity are places where people live, not offices. That same year, the Association started to organize the Professional-educational Symposium “Štamparovi dani” that turned into an unavoidable annual event which has already been visited by many experts, young physicians and students from all over the Croatia and abroad with the idea of sharing their public health thinking, practising continuous professional education, health promotion and healthy lifestyles. “Štampar days” and the work of the Association have so far been recognized and supported by number of relevant institutions. Many other collaborations are expected in the future, especially those which will aim to return to basic postulates of public health, health promotion, and healthy lifestyles.

The paper reviews experiences and accomplishments in application of system dynamics modeling in education, training and research projects at the Andrija Štampar School of Public Health, a branch of the Zagreb University School of Medicine, Croatia. A number of simulation models developed over the past 40 years are briefly described with regard to real problems concerned, objectives and modeling methods and techniques used. Many of them have been developed as the individual students' projects as a part of their graduation, MSc or PhD theses and subsequently published in journals or conference proceedings. Some of them were later used in teaching and simulation training. System dynamics modeling proved to be not only powerful method for research and decision making but also a useful tool in medical and nursing education enabling better understanding of dynamic systems' behavior.

With the emergence of social media and social networks, the term e-professionalism of physicians is defined as attitudes and behaviors that reflect the traditional paradigms of professionalism of health professionals manifested through social media. Some health institutions and medical universities have developed guidelines for students, teachers and physicians regarding the use of social media and social networks, since there is unquestionable fact that nowadays everyone is using social media. Social media guidelines and policies are based on pre-existing guidelines about the concept of health professionalism, which have been developed for decades and adopted according to ethical principles, enabling to make decisions about what is right and what is wrong or what will we decide. Even though these ethical principles in its fundamental basis are still applicable today, they are not specific enough to guide psychiatrists in this brave new social world that is overwhelmed with technology and instant availability. Aim of this presentation is to explore the impact of social networks on e-professionalism from the prospective of a specialist in psychiatry. Social media influence a wide range of medical professional behaviour, and present both dangers and challenges to opportunities. The opportunities are: 1) the use of social networks as a tool to improve information sharing ; 2) the presence of psychiatrists in area with inadequate health care ; 3) the process of life-long learning is supported by social networks ; 4) mentoring student activities on social networks. The most common limitations are insufficient reliability, questionable quality of information, lack of privacy and confidentiality and inadequate use of social networks for communicating with patients

Sažetak. Europska unija (EU) definirala je procese i norme obrazovanja medicinskih sestara. Cilj je ovog rada opisati njihovo obrazovanje u Hrvatskoj i usporediti ga s obrazovanjem medicinskih sestara u Ujedinjenom Kraljevstvu (UK) kao kolijevci modernog sestrinstva te Sloveniji kao tranzicijskoj zemlji. Kao izvor podataka upotrijebljeni su Direktiva 2005/36/EZ i Direktiva 2013/55/EU te zakoni, pravilnici i dokumenti navedenih zemalja koji su vezani uz obrazovanje medicinskih sestara. Medicinske sestre u Hrvatskoj obrazuju se u srednjoškolskome strukovnom obrazovanju te obrazovanju na visokoškolskoj razini. Obrazovanje medicinskih sestara u Sloveniji započinje nakon dvanaest godina općeg obrazovanja i održava se na razini stručnih studija. U UK obrazovanje se provodi na sveučilišnoj razini nakon dvanaest godina općeg obrazovanja, a mogućnost za ulazak u sestrinstvo uključuje strukovne kvalifikacije na sličnoj akademskoj razini te tečajeve visokog obrazovanja. Iskustva u obrazovanju medicinskih sestara u UK i Sloveniji mogu biti korisna u procesu unapređenja obrazovanja medicinskih sestara u Hrvatskoj., Summary. European Union (EU) has defined the process and norms of nursing education. The aim of this project is to describe the nursing education in Croatia and compare it with education of nurses in the United Kingdom (UK) as a cradle of modern nursing, and in Slovenia as a transition country. As a source of data we used Directive 2005/36/EC and Directive 2013/55/EU, and also laws, regulations and documents from the mentioned countries which are related to nursing education. Nursing education in Croatia is carried out through high school education and also at the university level. Slovenian education of medical nurses starts after twelve years of general education and it is carried out at the level of college education. In the UK education is being carried out at the college level after twelve years of general education, and the possibility of acceptance into nursing involves professional qualifications at a similar academic level and courses of higher education. Experience in nursing education in the UK and Slovenia can be useful in the improving of nursing education in Croatia.

Development of a model for simulation of the needed number of specialists of different specialties in the Republic of Croatia by the year 2035 based on the expected changes in size and age structure of population and experts' estimates of the needs. The model will be implemented in the form of a computer program based on the estimated most potent predictors. The developed model will be used as a tool for the simulation of different scenarios for specialist education combined with other factors like migration flows, changes in retirement age and skill mixing in order to compare different possibilities and options for the renewal of the Croatian healthcare personnel. Results will enable the development of recommendations for decision making and the adoption of a rational plan of referral to specialist training. Indirectly, developed model will be useful for needs assessment and simulation and planning of workforce renewal of other health professionals and for other countries.

Udruga narodnog zdravlja Andrija Štampar u suradnji s partnerima Zagrebačkim institutom za kulturu zdravlja, Udrugom za neuropsihijatriju te Društvom za prevenciju moždanog udara pokrenula je projekt „Zdravlje svima“. Projekt je prepoznat od strane Ministarstva zdravlja Republike Hrvatske te je na natječaju za udruge bio među najbolje ocijenjenima i stoga je njegovo provođenje financijski potpomognut od strane Ministarstva zdravlja. „Zdravlje svima“ je projekt koji je prožet mišlju kako se pojedinca i pacijenta ne smije promatrati isključivo kroz prizmu bolesti te ga se na istu simplificirati, već da svaka osoba treba biti promatrana u jedinstvu svog fizičkog, psihičkog, socijalnog i duhovnog stanja. Projekt ima za cilj promovirati zdravlje provedbom aktivnosti osmišljenih prema načelima dr. Andrije Štampara koji je zagovarao djelovanje struke među populacijom, a ne samo u zdravstvenim ustanovama. Anketiranjem stanovništva mladi liječnici i studenti medicine stječu praktična znanja koja u svojem budućem radu prenose na generacije mladih liječnika te osviješćuju pacijente o potrebi razvijanja kulture zdravlja. Provodeći edukativno-promotivne aktivnosti među općom populacijom promiču se zdravi stilovi života i važnost zdravlja i prevencije bolesti. Ciljevi koji se postižu provedbom projekta su praćenje i ocjena zdravstvenog stanja i kvalitete života stanovništva, identifikacija zdravstvenih problema i opasnosti za zdravlje stanovništva, promicanje zdravih stilova življenja i sprečavanje i suzbijanje rizičnih čimbenika bolesti, smanjenje socijalnih nejednakosti u zdravlju i promocija zdravlja. Važnost promicanja zdravlja nije samo zadatak nacionalnih i lokalnih zdravstvenih politika, ustanova i djelatnika već i organizacija civilnog društva u kojima stručnjaci nesebično prenose svoja znanja i kroz aktivnosti ovoga projekta educiraju javnost i osnažuju kapacitete za provedbu i nekih budućih programa i projekata promocije i očuvanja zdravlja., Association of People's Health Andrija Štampar has launched the project "Health for all" which is recognized by the Ministry of Health of the Republic of Croatia and was among the best rated. Project is imbued with the idea that the person should not be seen solely through the prism of the disease and simplify to it, but that each person should be observed in the unity of his physical, mental, social and spiritual condition. According to the principles of Andrija Štampar, professionals should perform among the population not only in health care institutions. Educational and promotional activities among the general population to promote healthy lifestyles and the importance of health and disease prevention are also the goals. The objectives are identification of health problems and dangers to public health, promoting healthy lifestyles and preventing and combating disease risk factors, reduction of social inequalities in health care and health promotion. The importance of health promotion is not just the task of national and local health policies, institutions, professionals, but also of civil society organizations to strengthen the capacity to implement and some future programs and projects to promote and preserve health.

A major activity of Association is professional and educational symposium „Stampar days“ which consists of three parts and makes an unique component with appointed goal of prevention of cardiovascular diseases with public health campaign. One component presents active involvement of educated members of Asscociation that have been taken short version of Croatian health survey (HSA) questionnaire has been used in the door to door survey during which they have been measured blood pressure and glucose level in blood of population in rural area of town Pleternica. Assesement of differences in morbidity, socioeconomic and behavioral characteristics of are also have been investigated. Within 4 years survey has taken in south eastern and south western rural parts of Pleternica and also in north eastern part. Data that were collected in Brodski Drenovac, birthplace of Andrija Stampar, one of the founders of the World health organization are processed. Results are similar those published by Milosevic et al 2003. Although alcohol consumption is higher (29, 58 units of pure alcohol) than recommended by WHO (21 units), it is almost than double lower than Croatian average in alcohol per capita consumption. No double effect for cardiovascular disease risk for men that drinks and don’t drink alcohol has been noted, but higher incidence of hypertension and hyperlipidaemia is noted in women that drinks alcohol. When tobacco smokers and non smokers data were processed results have shown that tobacco smokers have slightly more common cardiovascular diseases, and suprisingly tobacco smoking is almost than double higher than Croatian average. Although this is small sample it is representative percentage of habitants in Brodski Drenovac and therefore this results could be starting point for next preventive activities and surveys of Association

Introduction: Technology is increasingly used to promote physical activity (PA) and reduce sedentary behaviour in the general population, but the possibility of using it to support PA in chronic pain (CP) patients is still sparse. CP is a global health concern affecting fifth of the global population, with immense adverse impact on all aspects of a patient’s life. PA is crucial for improving quality of life of CP patients. However, long-term PA goals widely depend on pain perception, actual or anticipated pain exacerbation, and lack of confidence when doing PA. This study aims to determine effectiveness, motivating opportunities and limitations of Fitbit 2 fitness bands used to measure PA and sleep pattern in CP patients enrolled in the 4-week CP management programme. Participants and Methods: Out of 42 CP patients who completed the programme, the analysis was performed on the data for 41 patients (one patient had no data). We compared PA and sleep pattern of CP patients between the intervention (0-4 weeks) and follow-up (4-8 weeks). Wrist band collected the following data: number of days of the activity measured, average time of activity per day, average steps per day, average deep sleep time per day, average time spent awake per day, number of wakening per day. These data were correlated to patients’ anthropometric measurements. Full protocol is available in the Clinical Trials Registry (NCT 03837080). Results: The number of steps and average time of activity per day increased, as well as deep sleep time per day but without reaching statistical significance. However, we observed several advantages: patients are getting active role in their CP management which is self- motivating, encourages goal-setting, competition and social support within the CP group, and in clinical/research setting bands provide better, continuous oversight of patient’s PA and sleeping patterns which are very useful for behavioural change and individualized educational strategies. Still, wrist bands have several disadvantages. Firstly, they require a mobile app and some knowledge of how to use a smart phone (patients’ mean age is 55.6 ± 12.5 years). Sudden malfunction of the band (2 out of 16) and/or the software (2 out of 16). Also, various obstacles on an individual basis (i.e., demographics, psychosocial factors, lack of motivation) might be a reason not in favour of the band. In addition, we found significant improvement in waist circumference and waist-to-hip ratio and waist-to-height ratio were found in CP patients with longer deep sleep time. These results confirm the role of sleep on state of nourishment and metabolic risks. Conclusion: Fitness bands were found to be suitable for the promotion of PA in CP patients, but restrictions apply, mainly due to required IT literacy.

Atherosclerotic cardiovascular disease (CVD) remains the leading cause of death for people of most racial/ethnic groups. As long as obesity and type 2 diabetes rates continue to grow, so will the burden of CVDs. The ideal CV health is observed through seven domains: blood pressure, physical activity, cholesterol, diet, weight, smoking, and blood glucose. In other words, CVDs should be observed as a complex entity that requires a team-based approach for primary as well as secondary prevention. Diet represents pillar for every treatment focused on CV health. Patients with risk factors have better outcomes when they receive patient-centered care by a multidisciplinary team vs usual care. This approach is especially effective for the control of hypertension. All diet-centered techniques related to glucose-lowering effect (energy restrictions, establishing regular meal patterns, promoting nutrient-dense foods, etc.), along with lifestyle modifications focused on physical activity are especially effective in type 2 diabetics. While research evidence continuously emphasize superiority of the Mediterranean diet, more evidence, especially in children show that the Mediterranean diet is at the verge of existence. Benefits of polyunsaturated fatty acids (especially from extra virgin olive oil and fish), low-fat dairy, green leafy vegetables and wholegrains on CV health are well documented. Still, the effect goes well beyond the diet and we underline that it is the Mediterranean lifestyle that works. But the question is whether we can copy this lifestyle, adapt it slightly to our way of life? Or, in the light of the global sustainability movement, maybe we should start looking whether our own, traditional dietary patterns have beneficial traits for CV health too.

2016. je godine procijenjeno kako je broj djece i adolescenata s prekomjernom tjelesnom masom (ptm) i debljinom (deb) u zadnjih 40 godina porastao čak 10 puta. Mladi koji pate od prekomjerne tjelesne mase i debljine češće obolijevaju od psihičkih poteškoća. Neke studije su pokazale povezanost između konduktivnog poremećaja i debljine, no druge studije ne pokazuju takav rezultat. Cilj je ovog sustavnog pregleda i meta-analize bio proučiti povezanost konduktivnog poremećaja s ptm i deb među djecom i adolescentima. Sustavno je pretraživanje literature provedeno 31. listopada 2019. u bazama: MEDLINE preko OVID-a, PsycINFO i PsycARTICLES preko EBSCOhost, SCOPUS i OpenGrey. Uključene su 43presječne i kohortne studije iz bilo koje države ukoliko sadrže podatak o omjeru šansi (OR) za kon-duktivni poremećaj među ptm i/ili deb djecom i/ili adolescentima, ili iz kojih se ti podaci mogu iz-računati, studije u kojima su korišteni validirani psihijatrijski testovi te one u kojima ispitanici imaju trenutnu dijagnozu konduktivnog poremećaja. Kriteriji za isključenje su bili: studije provedene na klin-ičkim uzorcima ispitanika, ispitanicimastarijim od 21 godinu te ispitanicima koji imaju morbidnu debljinu. Ekstrakciju podataka uključenih studija vršila su dva istraživača neovisno (DN i JM) prema unaprijed pripremljenom obrascu. Podaci su analizirani pomoću programa Comprehensive Meta-analy-sis. Statistička heterogenost među studijama je procijenjena pomoću I2 testa i Cochran Q statističkog testa. Podaci su analizirani prema modelu slučajnih učinaka. Ukupno 10 studija je uključeno u meta-analizu, koje su sadržavale podatke o 73 903 ispitanika.Postoji statistički značajna povezanost između ptm i deb u djece i adolescenata i konduktivnog poremećaja (OR 1.34 [95% CI, 1.16-1.54]). Meta-analitički rezultati pokazuju postojanje značajne varijacije u veličinama učinaka među studijama (Q=79.75 ; df=8 ; I2=89.97). Postoji značajna razlika u veličinama učinaka među djevojčicama u odnosu na dječake (Q=10.94 ; df=1 ; p