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The Relationship Between Positive Youth Development and School Climate – Results of a Longitudinal Panel Study
No full textModel 5C nastoji objasniti kako interakcije adolescenata s
okolinom pridonose pozitivnom razvoju mladih, pri čemu su
indikatori pozitivnog razvoja kompetencije, samosvijest, karakter,
brižnost i povezanost. Dosadašnja presječna istraživanja poka-
zuju da pozitivna školska klima znatno predviđa snažniji razvoj
ovih indikatora, ali i da ovi indikatori predviđaju pozitivniju
školsku klimu. Ovim je longitudinalnim istraživanjem ispitana
povezanost modela 5C i školske klime te njihov međusobni
utjecaj kroz vrijeme. Rezultati pokazuju da pozitivna školska
klima pridonosi razvoju svih 5C indikatora, dok učenici s razvije-
nom odgovornosti i socijalnom svijesti te dobrim odnosima s
vršnjacima i nastavnicima pridonose boljoj školskoj klimi. Ovi
nalazi naglašavaju važnost poticanja suradnje i individualizira-
noga pristupa učenicima s različitim kompetencijama i akadem-
skim dostignućima.The 5C model seeks to explain how adolescents' interactions
with their environment contribute to positive youth
development, with the indicators of positive development
being competence, confidence, character, caring and
connection. Previous cross-sectional research has shown that
a positive school climate significantly predicts greater
development of these indicators, but also that these
indicators predict a more positive school climate. This
longitudinal study examined the relationship between the 5C
model and school climate and their mutual influence over
time. The results show that a positive school climate
contributes to the development of all 5C indicators, while
students with a developed sense of responsibility and social
awareness and good relationships with peers and teachers
contribute to a better school climate. These findings deepen
the understanding of the bidirectional links between the
school environment and adaptive developmental outcomes
and emphasise the importance of promoting cooperation
and an individualised approach for students with different
competencies and academic performance
Assessment of indoor air quality in a higher education institution: testing and analysis
No full textSuvremeni način života i rada podrazumijeva dugotrajan boravak u zatvorenim prostorima, osobito kod mlađe populacije koja značajan dio vremena provodi u obrazovnim ustanovama. Posljedično, kvaliteta zraka u unutarnjim prostorima postaje jedan od ključnih čimbenika u očuvanju zdravlja i održavanju kognitivne učinkovitosti. Kvaliteta zraka rezultat je složene interakcije mikrobioloških, kemijskih i fizikalnih parametara, a ne isključivo prisutnosti pojedinačnih onečišćujućih tvari. Povećan broj osoba u prostoru pridonosi porastu koncentracije mikroorganizama i plinova, dok fizikalni čimbenici poput temperature i relativne vlažnosti, utječu na njihovu disperziju i percepciju prostorne udobnosti. Glavni cilj ovog diplomskog rada bio je procijeniti kvalitetu zraka u zatvorenim prostorima visokoškolske ustanove analizom mikrobioloških (bakterije i plijesni), kemijskih (CO₂, O₂, CH₄) te fizikalnih parametara (temperatura, volumni udio vlage, atmosferski tlak), kao i ispitati međusobne povezanosti među tim parametrima. Uzorci zraka za analizu prikupljeni su unutar predavaonica tijekom nastave, pod jednakim uvjetima, dok su kontrolni uzorci uzeti ispred zgrade ustanove te u praznoj predavaonici s uključenim ventilacijskim sustavom. Mikrobiološko uzorkovanje provedeno je uređajem MAS-100 NT, a identifikacija izoliranih mikroorganizama izvršena je primjenom MALDI-TOF MS metode. Kemijske i fizikalne analize provedene su pomoću instrumenata Gasmet GT5000 Terra i Gas-Pro TK. Dobiveni rezultati su analizirani radi dobivanja uvida u opće stanje kvalitete zraka u ispitivanim prostorima. U uzorcima su identificirani rodovi plijesni (Penicillium, Cladosporium, Aspergillus, Rhizopus) te bakterija (Micrococcus, Staphylococcus, Acinetobacter, Bacillus, Paenibacillus, Peribacillus, Pseudomonas, Streptomyces), pri čemu je njihov ukupan broj bio unutar preporučenih međunarodnih graničnih vrijednosti. U većini prostorija zabilježene su koncentracije CO₂ koje premašuju preporučene granice, uz istovremeno blago sniženje koncentracije O₂. Mikrobiološki, kemijski i fizikalni parametri pokazali su međusobnu povezanost te zajednički utječu na ukupnu kvalitetu zraka, zdravstvenu sigurnost i prostornu udobnost. Rezultati ukazuju na potrebu za kontinuiranim praćenjem zraka i optimizacijom ventilacije radi zaštite zdravlja i poboljšanja uvjeta boravka u obrazovnim ustanovama.The modern way of life and work involves prolonged stays in indoor environments, especially among younger populations who spend a significant amount of time in educational institutions. Consequently, indoor air quality becomes one of the key factors in preserving health and maintaining cognitive performance. Air quality is the result of a complex interaction between microbiological, chemical, and physical parameters, rather than the presence of individual pollutants alone. An increased number of occupants contributes to higher concentrations of microorganisms and gases, while physical factors such as temperature and relative humidity influence their dispersion and the perception of spatial comfort. The main objective of this thesis was to assess indoor air quality in a higher education facility by analyzing microbiological (bacteria and moulds), chemical (CO₂, O₂, CH₄), and physical parameters (temperature, moisture content, atmospheric pressure), and to investigate the interrelationships among these variables. Air samples for analysis were collected in lecture halls during classes under the same conditions, while control samples were taken outside the building and in an unoccupied lecture hall with an active ventilation system. Microbiological sampling was conducted using the MAS-100 NT device, and the identification of isolated microorganisms was performed using the MALDI-TOF MS method. Chemical and physical analyses were carried out using the Gasmet GT5000 Terra and Gas-Pro TK instruments. The obtained results were analyzed in order to gain insight into the overall air quality status in the examined indoor spaces. The samples revealed the presence of mold genera (Penicillium, Cladosporium, Aspergillus, Rhizopus) and bacterial genera (Micrococcus, Staphylococcus, Acinetobacter, Bacillus, Paenibacillus, Peribacillus, Pseudomonas, Streptomyces), with their total counts remaining within the recommended international threshold values. In most rooms, CO₂ concentrations exceeded the recommended limits, accompanied by a slight decrease in O₂ levels. Microbiological, chemical, and physical parameters were interrelated and collectively influenced overall air quality, health safety, and indoor comfort.The results highlight the need for continuous air monitoring and ventilation optimization to protect health and improve indoor conditions in educational institutions
Dietary Approaches to Managing Polycystic Ovary Syndrome
No full textPCOS is a multifactorial endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Women with PCOS have an increased risk of developing metabolic complications, including T2DM, dyslipidemia, obesity, and cardiovascular disease. Due to its complex pathogenesis, effective management requires a multidisciplinary and patient-centered approach, integrating lifestyle modifications and pharmacological therapies.
Dietary interventions play a central role in PCOS management, with evidence suggesting that the DASH diet, low-carbohydrate, and low GI diets improve metabolic and hormonal parameters. However, no single diet has been proven superior. Inositol supplementation has emerged as a potential alternative to metformin, demonstrating improvements in insulin sensitivity and ovulatory function with fewer side effects.
Despite the importance of lifestyle interventions, pharmacological management remains essential. COCPs are the first-line treatment for hyperandrogenism, metformin is widely used for metabolic disturbances, and GLP-1 receptor agonists are being investigated as a promising therapy for obe-sity in PCOS.
The gut microbiome has also gained attention in PCOS research, with probiotics and prebiotics showing potential metabolic benefits, though further studies are needed to confirm their clinical utility.
Despite advancements, heterogeneity in PCOS phenotypes, study designs, and small sample sizes limit the generalizability of findings. Future research should focus on long-term dietary interven-tions, particularly their real-life applicability and sustainability. Overall, a patient-centered, multidisciplinary approach is essential to optimize treatment strategies and improve the quality of life for women affected by PCOS
The impact of biological interventions on health-related quality of life in adults with Crohn's disease: a systematic review with meta-analysis
No full textBackground: Health-related quality of life (HRQoL) is one of the main issues in Crohn's disease (CD). We systematically assessed the effects of a biological treatment on HRQoL in adults with CD. Methods: We searched MEDLINE, EMBASE, and CENTRAL from inception to 26 Jul 2024 for randomised controlled trials (RCTs) investigating the effects of the biological agents approved for CD on HRQoL-related outcomes. Changes in IBDQ (Inflammatory Bowel Disease Questonnaire), SF-36 (The 36-Item Short Form Survey) and EQ-5D scores were evaluated using random-effects meta-analyses to determine if they met a clinically meaningful improvement (CMI). Cochrane's Risk of Bias tool 2 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were applied to assess the quality and certainty of findings. PROSPERO registration: CRD42024573408. Findings: Twenty-six RCTs involving 9013 participants were included in analysis. A clinically meaningful IBDQ score improvement was observed for infliximab (mean difference (MD) of 16.09 (95% CI: −0.13 to 32.31; 4 studies; 1162 participants, very low-certainty evidence)) and upadacitinib (MD 20.65, 95% CI 7.04–34.25; I2 = 42.8%, P = 0.17; 3 studies; 1523 participants; high-certainty evidence). No significant IBDQ improvement was observed for adalimumab, certolizumab pegol, ustekinumab, or natalizumab compared to placebo (low-to high-certainty evidence). Due to considerable heterogeneity, data on vedolizumab and risankizumab could not be pooled. Interpretation: Methodological issues in HRQoL measurement, including the need for larger sample sizes, standardized reporting, and uniform participant characteristics, contribute to the low methodological quality of current evidence on the impact of biological agents on HRQoL in CD. There is a large unmet need to investigate the association between clinical outcomes and HRQoL outcomes more thoroughly
The role of non-invasive diagnostic procedures in diagnosing and assessing the risk of coronary heart disease
No full textKronični koronarni sindrom (CCS) jedan je od glavnih uzroka morbiditeta i mortaliteta u svijetu, s velikim socioekonomskim značajem. CCS se može prezentirati nizom kliničkih manifestacija ili sindroma koji nastaju zbog strukturnih i/ili funkcionalnih promjena povezanih s kroničnim bolestima koronarnih arterija i/ili mikrocirkulacije. S obzirom na trenutačno razumijevanje složenih patofizioloških mehanizama koji vode razvoju CCS-a, u kliničkoj se praksi upotrebljavaju dva temeljna neinvazivna dijagnostička modaliteta: anatomski (koronarna kompjutorizirana tomografska angiografija - CCTA) i funkcionalni (stres ehokardiografija – SE, magnetska rezonanca srca – CMR, jednofotonska emisijska kompjutorizirana tomografija – SPECT, pozitornska emisijska tomografija –PET). Funkcionalne neinvazivne dijagnostičke metode omogućuju procjenu protoka krvi kroz koronarne arterije, uočavanje poremećaja perfuzije miokarda, evaluaciju poremećaja kontraktilnosti miokarda te procjenu prisutnosti eventualnih ožiljnih promjena u miokardu. S druge strane, anatomsko oslikavanje putem CCTA može procijeniti težinu koronarne stenoze, kao i sastav i morfologiju plaka, identificirajući značajke visokorizičnog plaka te pružajući dodatne informacije o ukupnom kardiovaskularnom opterećenju. Ovakva sveobuhvatna procjena omogućuje rano postavljanje dijagnoze CCS-a, određivanje prostorne distribucije ishemije prema zahvaćenim koronarnim segmentima te identifikaciju pacijenata s povišenim rizikom za nepovoljne kliničke ishode, koji bi potencijalno mogli imati korist od invazivnih intervencija poput revaskularizacije.Chronic coronary syndrome (CCS) is one of the leading causes of morbidity and mortality worldwide, with significant socioeconomic impact. CCS can present with a variety of clinical manifestations or syndromes that result from structural and/or functional changes associated with chronic coronary artery disease and/or microcirculation disorders. Based on the current understanding of the complex pathophysiological mechanisms leading to the development of CCS, two fundamental non-invasive diagnostic modalities are used in clinical practice. These include anatomical imaging (coronary computed tomography angiography – CCTA) and functional imaging (stress echocardiography – SE, cardiac magnetic resonance – CMR, single-photon emission computed tomography – SPECT, positron emission tomography – PET). Functional non-invasive diagnostic methods enable the assessment of blood flow through the coronary arteries, the detection of myocardial perfusion abnormalities, evaluation of myocardial contractility disorders, and the identification of potential myocardial scarring. On the other hand, anatomical imaging using CCTA can evaluate the severity of coronary stenosis, as well as the structure and morphology of plaques, identifying features of high-risk plaques and providing additional information on the overall cardiovascular risk. This comprehensive assessment enables early diagnosis of CCS, determination of the spatial distribution of ischemia according to the affected coronary segments, and identification of patients at increased risk for adverse clinical outcomes, who may benefit from invasive interventions such as revascularization
How to recognise a seriously ill child
No full textInfekcije, osobito one respiratornog sustava, predstavljaju najčešće bolesti u dječjoj dobi. Premda su u većini slučajeva blagog i samolimitirajućeg tijeka, pojedini uzročnici mogu dovesti do ozbiljnih kliničkih stanja, osobito ako se bolest ne prepozna pravovremeno i ne započne odgovarajuće liječenje. Teško bolesno dijete prepoznaje se temeljem niza nespecifičnih, ali klinički značajnih simptoma i znakova koji se identificiraju pažljivim uzimanjem anamneze i sustavnim fizikalnim pregledom. U kliničkoj praksi ključnu ulogu ima primjena ABCDE protokola, koji omogućuje brzo prepoznavanje i inicijalno zbrinjavanje vitalno ugroženog djeteta. Ovaj pristup uključuje sustavnu procjenu prohodnosti dišnoga puta, disanja, cirkulacije, neurološkog statusa i tjelesne izloženosti, redoslijedom koji omogućuje identifikaciju i liječenje najopasnijih stanja u najkraćem mogućem vremenu. Upozoravajući klinički znakovi koji ukazuju na teško bolesno dijete uključuju letargiju, odbijanje hrane, promjene boje kože s mogućim petehijama, hipotoniju, razdražljivost, visokofrekventan ili neuobičajen plač, tahipneju ili bradipneju, nepravilne obrasce disanja, poremećaje ritma i cirkulacije, produljeno kapilarno punjenje, promjene u svijesti i veličini zjenica.Infections, particularly those affecting the respiratory system, represent the most common illnesses in childhood. Although these diseases are typically mild and self-limiting, certain pathogens can lead to severe clinical conditions, especially if not recognized promptly and appropriately treated. A critically ill child is identified based on a range of nonspecific yet clinically significant symptoms and signs, which must be assessed through careful medical history taking and thorough physical examination. In clinical practice, the ABCDE approach plays a crucial role, as it enables the rapid identification and initial management of life-threatening conditions in children. This protocol involves systematic assessment of the airway, breathing, circulation, neurological status, and exposure, in a sequence that allows clinicians to detect and treat the most urgent conditions in the shortest time possible. Warning clinical signs that indicate a critically ill child include lethargy, refusal to eat, skin color changes with possible petechiae, hypotonia, irritability, high-pitched or abnormal crying, tachypnea or bradypnea, abnormal breathing patterns, rhythm and circulatory disturbances, prolonged capillary refill time, changes in consciousness and pupil size, and hypoglycemia
Translation and Adaptation of the Survey of Organizational Research Climate to the Croatian Context
No full textAn organizational climate based on research integrity is one of the key goals of contemporary universities and scientific organizations. Survey of Organizational Research Climate is widely tested and used instrument for measuring organizational climate based on research integrity developed in the USA; however, its successful use in different cultures and environments requires translation and adaptation. This study aims to translate and adapt Survey of Organizational Research Climate to the social, legal, and cultural context of Croatia in a three-phase process. First, we translated the survey into Croatian using a double-blind forward and backward translation method. Next, we conducted a content validity assessment in which experts examined whether all relevant aspects of the research integrity climate were successfully translated and adapted to the Croatian context. Finally, a face validity assessment was performed to evaluate the comprehensibility of the survey among typical representatives of the academic population in Croatia. Croatian version of the Survey of Organizational Research Climate survey will enable successful monitoring and evaluation of organizational climate in Croatian educational institution with internationally comparable results
Intolerance towards obesity in medical environments: perspectives of patients and healthcare professionals
No full textDebljina predstavlja rastući zdravstveni problem praćen učestalom stigmatizacijom unutar društva, pa tako i u zdravstvenom sustavu. Ovaj pregledni rad analizira pojavu netolerancije prema osobama s pretilošću iz dvostruke perspektive: one pacijenata i one zdravstvenih djelatnika. Prikazana je suvremena definicija pretilosti, epidemiološki podaci o njezinoj prevalenciji globalno i u Hrvatskoj te ključni biološki, psihološki i okolišni čimbenici rizika. S pacijentove strane, razmotrena su iskustva stigmatizacije: od suptilnih predrasuda do konkretnih prepreka u skrbi, poput nedostatka prilagođene medicinske opreme, što sve može dovesti do izbjegavanja zdravstvene skrbi, osjećaja srama, narušenog povjerenja u liječnike i lošijih ishoda liječenja. Iz perspektive zdravstvenih profesionalaca, analizirani su nesvjesni negativni stavovi prema pacijentima s pretilošću, njihove moguće posljedice na kvalitetu skrbi te etičke dileme koje proizlaze iz diskriminacije kao što su kršenje načela pravednosti i autonomije. Rad ističe da ukorijenjena stigma otežava odnos liječnik-pacijent i dovodi do niza psiholoških posljedica za pacijente poput internalizirane stigme. U završnom dijelu rada predložene su strateške mjere za smanjenje stigme: edukacija zdravstvenih kadrova uključujući uvođenje tema o stigmi u kurikulume, razvoj nacionalnih smjernica koje naglašavaju individualizirani i nediskriminatorni pristup pacijentima s pretilošću, prilagodba infrastrukture te odgovorna javna komunikacija i medijsko izvještavanje. Snažnijom osviještenošću i sustavnim intervencijama može se ublažiti negativan utjecaj stigme i unaprijediti kvaliteta skrbi za osobe s pretilošću.Obesity is an increasing public health issue that is frequently accompanied by stigma, including within healthcare settings. This review thesis examines weight-related intolerance towards individuals with obesity from two perspectives – that of patients and that of healthcare professionals. It presents current definitions of obesity, epidemiological data on its prevalence globally and in Croatia, and the key biological, psychological, and environmental risk factors. From the patient perspective, the thesis discusses experiences of weight stigma: from subtle biases to tangible barriers in care such as lack of adequately sized medical equipment, all of which can lead to patients avoiding healthcare, feeling shame, losing trust in providers, and experiencing worse health outcomes. From the healthcare professional perspective, the thesis analyzes implicit negative attitudes toward patients with obesity, their potential impact on the quality of care, and the ethical dilemmas arising from discriminatory behavior such as violations of the principles of justice and autonomy. The findings highlight that deeply rooted stigma impairs the doctor-patient relationship and causes various psychological consequences for patients including internalized stigma and low self-esteem. In its final part, the thesis proposes strategic measures to reduce weight stigma: better education of healthcare staff including introducing training on stigma and bias into curricula, development of national guidelines emphasizing individualized and non-discriminatory care for patients with obesity, adaptation of healthcare infrastructure, and more responsible public communication and media reporting. Through greater awareness and systematic interventions, the negative effects of weight stigma can be mitigated and the quality of care for individuals with obesity can be improved
Clinic, Ambulatory and Home Blood Pressure Monitoring for Metabolic Syndrome: Time to Change the Definition?
No full textBackground and Objectives: Metabolic syndrome (MetS) is considered a global epidemic, and its diagnosis is crucial, allowing early intervention and management. The main aim of this study was to examine any possible blood pressure (BP) differences based on office and out-of-office measurements in patients with and without MetS, and to investigate if any of these measurements correlated better with MetS. The secondary aim was to investigate any possible cardiovascular risk differences. Materials and Methods: The study population consisted of individuals attending the outpatient hypertension clinic. Office and out-of-office BP measurements were recorded in all of the patients, as well as different cardiovascular risk scores and echocardiography. MetS was defined according to ACC/AHA criteria. Results: A total of 282 (39.9% men) individuals (56.8 ± 15.8 years) were analyzed; 60.8% of them had MetS. The patients with MetS had a significantly higher systolic BP (SBP) in all of the BP measurements, higher ASCVD risk (22% vs. 12%), Framingham risk scores (11.8% vs. 6.9%), a significantly higher prevalence of LVH (49.2% vs. 22.7%) and early vascular aging (54.8% vs. 27.4%) compared with the patients without MetS (p < 0.05 for all). In a univariate analysis, MetS was significantly correlated with the average 24h SBP, daytime and nighttime ambulatory SBP, office SBP, and home SBP in the morning (p < 0.05). No significant differences were observed for any of the DBP measurements. Finally, 50.5% of the MetS patients had sustained hypertension, 15.2% masked hypertension, and 11.5% white-coat hypertension based on ABPM, and these values were 45.1%, 19.3%, and 13.6%, respectively, based on HBPM. Furthermore, most of the MetS patients had non-dipping hypertension (56.4%). Conclusions: The present findings highlight the importance of out-of-office BP measurements in the diagnosis of MetS, since both a high office and out-of-office SBP were significant features of the syndrome (whereas this was not the case with DBP). This is further supported by the increased prevalence of different hypertension phenotypes observed in the MetS patients. Higher ASCVD risk scores and LVH and EVA prevalence were also related to MetS, thus strongly supporting the necessity for early detection and treatment
Association between the COX-2 rs689466 polymorphism and antipsychotic treatment: Impact on HDL cholesterol changes in clozapine-treated psychosis patients
No full textSeveral studies have shown antipsychotic effects of the selective cyclooxygenase-2 (COX-2) inhibitor celecoxib as an add-on treatment to antipsychotic treatment. The functional rs689466 (A/G) polymorphism in the gene encoding COX-2 (also known as the prostaglandin-endoperoxide synthase 2 gene) has been correlated with schizophrenia risk and the niacin skin flush response among chronic patients under antipsychotic treatment. Here, we investigated whether this polymorphism was associated with antipsychotic treatment in a group of total psychosis patients (N = 186), as well as a subgroup of patients treated with clozapine (N = 74). Antipsychotic-naïve first-episode patients and non-adherent chronic psychosis patients were genotyped by polymerase chain reaction/restriction fragment length polymorphism analysis. At baseline and after 8 weeks of treatment with various antipsychotic medications, we assessed the patients’ Positive and Negative Syndrome Scale (PANSS) scores, factors, and metabolic syndrome-related parameters, including fasting plasma lipid and glucose levels and body mass index. In the total patient group, the COX-2 polymorphism was not associated with PANSS psychopathology scores or metabolic parameters. However, in the subgroup of patients treated with clozapine, the COX-2 polymorphism was associated with changes in plasma HDL cholesterol. Specifically, compared to patients homozygous for the A allele, the subgroup of patients treated with clozapine and positive for the G allele (i.e., GG or AG genotype) exhibited significantly higher increases in HDL cholesterol levels. The COX-2 polymorphism had a moderate effect size but made a relatively weak contribution to variations in the HDL cholesterol level (∼9.6 %)