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Introduction For almost nine decades, the fortification of foods with vitamin D has been proven effective in preventing rickets. This study aims to build and economically evaluate a fortification model based on egg biofortification and milk (including yoghurt) fortification. Methods A cross-sectional study was carried out between 1. March and 31. May 2021. Three hundred and nineteen healthy women from the Central Slovenian region aged between 44 and 65 were recruited for the study, with 176 participants included in the final analysis. For the fortification model calculations, the vitamin D contents of unenriched milk (including yoghurt) and eggs were replaced by enriched foods containing vitamin D. The economic evaluation was done using available drug and food supplement prices. Fortification costs were calculated using vitamin D prices provided by suppliers. Results Mean vitamin D intake from food was 2.19±1.34 µg/d. With fortification Model 1 (enriched eggs), it would be: 6.49±4.45 µg/d, and with Model 2 (enriched eggs and milk): 10.53±6.49 µg/d. Without fortification, none of the participants would reach a daily vitamin D intake >10 µg. With fortification Model 1 (egg fortification), 15.3% would reach >10 µg and with Model 2 (egg and milk fortification) 46.2% would reach >10 µg. The economic comparison of the annual cost of 10 µg vitamin D/d/person was EUR 6.17 for prescription drugs, EUR 6.37 for food supplements, EUR 0.09 for direct milk fortification and EUR 0.12 for egg biofortification with vitamin D. Conclusions Egg and milk (including yoghurt) fortification could cost-effectively increase vitamin D intake in the Slovenian population of women between 44 and 65 by almost five-fold, and could significantly lower the prevalence of vitamin D deficiency. Additional research and changes to legislation are needed before this can be introduced.

Among physiotherapists, work-related musculoskeletal disorders (WMSDs) are the most common health problem. This study aimed to provide evidence for planning evidence-based health promotion programmes for ensuring and maintaining adequate physical fitness (PF) to decrease WMSDs among physiotherapists which would have started already during the study.A cross-sectional study involved the participation of a total of 100 physiotherapy students and 62 physiotherapists. Observed variables were prevalence of WMSDs in the last 12 months, lasting3 days during physiotherapeutic activities and five PF components: body composition, cardiorespiratory and muscle endurance, muscle strength, and flexibility. A chi-square test and binary logistic regression were used as the main analytical methods.Prevalence of WMSDs in physiotherapists was 63.9% (the most common locations: lower back, shoulders, neck), while in physiotherapy students it was 46.5% (the most common locations: lower back, neck, upper back) (p=0.031). Among the PF components, the results showed statistically significantly worse flexibility among students compared to physiotherapists (about two thirds of students had poor or very poor results of flexibility testing) (p=0.002) in comparison to physiotherapists. A statistically significant positive association between WMSDs and PF was observed only between knee pain and poor cardiorespiratory endurance (OR=4.03 with 95% CI 1.12-14.58; p=0.033).The study showed poor flexibility among students indicating that it is necessary to direct them to perform activities that will increase the extensibility of muscles. The awareness of this problem should be increased. A specific role should be played by staff involved in clinical practice.Pri fizioterapevtih so z delom povezane motnje mišično-skeletnega sistema (ZDPMSM) najpogostejša zdravstvena težava. Namen te študije je bil zagotoviti dokaze za razvoj z dokazi podprtih programov promocije zdravja za zagotavljanje in vzdrževanje ustrezne telesne pripravljenosti (TP) fizioterapevtov za zmanjšanje ZDPMSM z začetkom že v času študija.V presečni študiji je sodelovalo 100 študentov fizioterapije in 62 fizioterapevtov. Opazovane spremenljivke so bile prevalenca ZDPMSM v zadnjih 12 mesecih, ki so trajale3 dni med fizioterapevtskimi aktivnostmi in pet komponent TP: telesna sestava, srčno-dihalna vzdržljivost, mišična vzdržljivost, mišična moč in prožnost. Glavni analitični metodi sta bili test hi-kvadrat in binarna logistična regresija.Prevalenca ZDPMSM je bila v skupini fizioterapevtov 63,9-odstotna (najpogostejše lokacije: spodnji del hrbta, ramena, vrat), v skupini študentov fizioterapije pa 46,5-odstotna (najpogostejše lokacije: spodnji del hrbta, vrat, zgornji del hrbta) (p = 0,031). Med komponentami TP so rezultati pokazali statistično značilno slabšo fleksibilnost študentov v primerjavi s fizioterapevti (približno dve tretjini študentov je imelo slabe ali zelo slabe rezultate testiranja fleksibilnosti) v primerjavi s fizioterapevti (p = 0,002). Statistično značilna pozitivna povezanost med ZDPMSM in TP je bila zaznana le med bolečino v kolenu in slabo srčno-dihalno vzdržljivostjo (RO = 4,03 s 95-odstotnim IZ 1,12–14,58; p = 0,033).Študija je pokazala slabo fleksibilnost študentov, kar kaže, da jih je treba usmerjati v dejavnosti, ki bodo povečale raztegljivost mišic. Ozaveščenost o tem problemu je treba povečati. To posebno vlogo mora imeti osebje, vključeno v klinično prakso.

With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients.In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value.Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002).Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management.Z namenom izboljšati personalizirano zdravljenje bolnikov, ki prejemajo kemoterapijo, je bil cilj naše raziskave oceniti stopnjo povezanosti med izbranimi kazalniki kakovosti življenja (QoL) ter kliničnimi in slikovnimi kazalniki srčnega statusa v kontekstu zaznave poslabšanja QoL teh bolnikov.V kohortni klinični študiji v Hamburgu smo od avgusta 2017 do oktobra 2020 59 bolnikom z rakom, starim 18–80 let, pred kemoterapijo in več kontrolnimi pregledi, napravili oceno QoL z vprašalnikoma EQ-5D in SF-36, hitro z deformacijo miokarda kodirano (fast-SENC) magnetnoresonančno slikanje srca (CMR), konvencionalno CMR, ultrazvočni pregled srca ter klinični pregled z določitvijo biomarkerjev. Podatke smo analizirali z analizo preživetja. Upad za več kot 5 % v vrednosti posameznega opazovanega kazalnika QoL je bil izbran kot opazovani dogodek. Razdelitev bolnikov v skupine je bila definirana glede na pojav kardiotoksičnosti po njeni klinični definiciji, postavitev indikacije za zdravljenje z zdravili za zaščito srčne mišice ter na osnovi poslabšanja vrednosti posameznega opazovanega slikovnega kazalnika za več kot 5 % ob zadnjem kontrolnem pregledu v primerjavi z njegovo vrednostjo pred pričetkom kemoterapije.Med kliničnimi kazalniki srčnega statusa je postavitev indikacije za zdravljenje z zdravili za zaščito srčne mišice pokazala statistično dobro povezanost s kazalniki QoL (EQ-5Dp = 0,028; SF-36 telesna komponenta p = 0,016; SF-36 mentalna komponenta p = 0,012). Med slikovnimi kazalniki je bila MyoHealth ocena segmentne krčljivosti miokarda edina, ki je pokazala konsistentno dobro povezanost s kazalniki QoL (EQ-5D p = 0,005; SF-36 telesna komponenta p = 0,056; SF-36 mentalna komponenta p = 0,002).Uveljavljeni fast-SENC kazalniki CMR so se pokazali za sposobne izpostaviti bolnike z zmanjšano QoL, ki potrebujejo pogostejšo/optimalnejšo obravnavo.

The aim of our study was to chronologically analyse various public health measures of fluoride use in caries prevention.We systematically searched the PubMed database on the preventive role of fluorides in public health, published from 1984 to 2014. The search process was divided into four steps, where inclusion and exclusion criteria were defined. Qualitative methodology was used for the article analysis. In the research process, the described forms of F use, diversity of the described F agents, and the observed population group were analysed.In our systematic review, 40 relevant reviews were revealed. Fluorides have been used in many different forms, but only a few studies showed their significant role in public health. Water fluoridation was the most important public health measure. In the recent decades, the number of studies on topical fluorides is constantly rising. The most extensively described topical forms of fluorides are professionally applied fluoride agents and fluoride toothpaste for home-use. The use of fluoride containing toothpaste in caries prevention is a safe and successful public health measure (PHM) if their use is widespread, and it is recommended for all. The results on other topical forms of fluorides are insufficient to be suggested as an important PHM.The role of fluorides in public health prevention has changed in accordance with the knowledge about the fluoride cariostatic mechanism. Previously the most important pre-eruptive effect of fluorides was supplemented by the post eruptive effect. Abundant evidence exists to show the effectiveness of systemic and topical fluorides.Namen naše raziskave je bil kronološko analizirati različne načine javnozdravstvene uporabe fluoridov pri preventivi kariesa.Sistematično smo pregledali pregledne članke v bibliografski bazi PubMed, ki so bili objavljeni v obdobju od leta 1984 do leta 2014. Iskalni proces je potekal v štirih fazah, v katerih smo določili vključitvene in izključitvene kriterije za določitev člankovza končno analizo. Za analizo člankovsmo uporabili kvalitativno metodologijo. V procesu analiziranja smo se osredotočili na razlicne oblike in načine uporabe fluoridov, jih opisali ter opredelili uporabo fluoridov in pomen za populacijo, v kateri so bili uporabljeni.V našem sistematičnem pregledu smo analizirali 40 preglednih člankov. Opisane so številne oblike uporabe fluoridov, vendar le nekatere raziskave poudarjajo javnozdravstveni pomen. Fluoridiranje pitne vode je najpomembnejši javnozdravstveni ukrep. Povecalo se je število raziskav, ki proučujejo topikalne fluoride. Največ raziskav opisuje profesionalne pripravke s fluoridi in kreme za zobe s fluoridi za domačo uporabo. Uporaba kreme za zobe s fluoridi je varen in uspešen javnozdravstveni ukrep v preventivi kariesa, zato ga priporočamo za celotno populacijo. Rezultati o drugih oblikah topikalnih fluoridov so nezadostni, zato jih ni mogoče označiti kot pomembne javnozdravstvene ukrepe.Vloga fluoridov se je spremenila v skladu z znanjem o njihovem delovanju. V preteklosti najpomembnejšemu preeruptivnemu delovanju se je pridružilo razumevanje o posteruptivnem učinku fluoridov. Obstajajo jasni dokazi o učinkovitosti tako sistemskih kot topikalnih fluoridov.

Aim: The aim of our study was to assess the temporal association between the number of consultations in the primary health care unit due to respiratory diseases in children and the level of particular matter of 10 micrometres in diameter (PM10) pollution in the Zasavje region. Methods: A time-trend ecological study was carried out for the period between 1 January 2006 and 31 December 2011. The daily number of first consultations for respiratory diseases among children in the Zasavje region was observed as the outcome. Poisson regression analysis was used to investigate the association between the observed outcome and the daily PM10 concentrations, adjusted to other covariates. Results: The results showed that the daily number of first consultations were highly significantly associated with the daily concentrations of PM10 in the Zagorje (p Conclusions: It can be concluded that evidence of association between the daily PM10 concentration and the daily number of first consultations for respiratory diseases among children exists, indicating that there is still a need for public health activities in the sense of reduction of harmful environmental factors in the region. Additionally, on the basis of these results, it can be assumed that with some improvements linkage of existing health and environmental data in Slovenia in general could be feasible in identifying a grounded need for future public health action.

Izvleček Izhodišča: Bolnišnice predstavljajo kompleksno notranje okolje, v katerem so bolniki, zaposleni in obiskovalci izpostavljeni številnim dejavnikom tveganja za zdravje. Raziskav, ki bi obravnavale več dejavnikov tveganja hkrati, je danes malo. Ne izhajajo iz povezave med uporabniki, stavbo in sistemi. Namen metaanalize je prepoznati fizikalne, biološke in kemične dejavnike tveganja za zdravje v bolnišničnem okolju ter izdelati izhodišča za pripravo priporočil za njihovo preprečevanje in obvladovanje. Pri tem bomo upoštevali uporabnike ter življenjski cikel stavbe in sistemov. Metode: Opravili smo metaanalizo raziskav na področju fizikalnih, bioloških in kemičnih dejavnikov tveganj za zdravje v bolnišničnem okolju. Zajeli smo dve bibliografski bazi (Pub Med in Science Direct). V analizo je bilo vključenih 634 virov literature, ki so bili objavljeni med letoma 1934 in 2012. Izhodišča za pripravo priporočil smo izdelali po nadgrajeni metodi inženirskega načrtovanja. Rezultati: Na podlagi izsledkov metaanalize smo pripravili izhodišča za pripravo priporočil, ki vključujejo sistematične ukrepe, specifične za bolnišnično okolje. Preprečevanje fizikalnih dejavnikov tveganja za zdravje vključuje ukrepe s področja zakonodaje, načrtovanja stavbe in sistemov ter usposabljanja zaposlenih. Najpomembnejši ukrepi s področja bioloških in kemičnih dejavnikov tveganja za zdravje so: preprečevanje in obvladovanje poti prenosa povzročiteljev bolezni ter nadzor kemičnih onesnaževal v notranjem in zunanjem zraku. Zaključki: Metaanaliza predstavlja nov pristop k preprečevanju in obvladovanju fizikalnih, bioloških in kemičnih dejavnikov tveganja za zdravje v kompleksnem bolnišničnem okolju - od načrtovanja stavbe do njene uporabe in vzdrževanja. Učinkovitost stavbe in sistemov se doseže s celostnim upoštevanjem značilnosti uporabnikov, bolnišničnega okolja in rabe energije. Uporabljen pristop je tudi pogoj za načrtovanje stavb in sistemov; je temelj uspešnih prenov.