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Ovaj doktorski studij omogućio bi studentima potrebnu razinu znanja, vještina i stavova temeljenih na interdisciplinarnom pristupu u poimanju javnog zdravlja, što bi u konačnici moglo značajno pridonijeti istraživanju prevencije, promocije i zaštite zdravlja stanovništva u XXI. stoljeću.

Nova platforma Europass-a (https://europa.eu/europass/hr) od srpnja 2020. godine dostupna je kao besplatni online instrument za prikazivanje postignutih ishoda učenja, planiranje ili pripremu karijere u Europi, te služi kao potpora građanima Europske unije kako bi lakše prolazili kroz svoj profesionalni razvoj. Kroz platformu Europass-a korisnici mogu izraditi svoj profil, jednostavno pretraživati različite mogućnosti za učenje ili zapošljavanje diljem Europe, primati individualne prijedloge obrazovnih programa ili poslova koji odgovaraju njihovom profilu i interesima, izrađivati, uređivati i pohranjivati životopise, motivacijska pisma i prijave za posao, pohranjivati digitalne vjerodajnice, dijeliti svoj profil s poslodavcima, obrazovnim ustanovama ili karijernim savjetnicima, te koristiti brojne druge usluge. Od navedenih mogućnosti korištenja platforme Europass-a posebno se ističu Europske digitalne vjerodajnice za učenje (Europass Digital Credentials for learning, EDC), odnosno digitalne datoteke koje pojedincima dodjeljuje odgovarajuće obrazovne ustanova, primjerice sveučilišta, kako bi se potvrdio i pružio dokaz o postignutim ishodima učenja. Europske digitalne vjerodajnice za učenje mogu se koristiti za postignuća kroz sve oblike učenja, formalna, neformalna i informalna. Digitalne vjerodajnice imaju jednaku pravnu vrijednost kao potvrde, diplome i druge vjerodajnice u papirnatom obliku, a visokoškolskim ustanovama omogućuju besplatno i sigurno izdavanje. Platforma Europass-a omogućuje sigurnu pohranu i dijeljenje digitalnih vjerodajnica. Besplatnim i sigurnim sustavom Europskih digitalnih vjerodajnica za učenje upravlja Europska komisija. Ideja o uključivanju Sveučilišta u Splitu u procese razvoja i provedbe platforme za Europske digitalne vjerodajnice za učenje javila se u vrijeme jasnog interesa rektora, prof. dr. sc. Dragana Ljutića, i njegovih suradnika za jačanje internacionalizacije, relevantnosti i kvalitete studijskih programa i znanstvenih istraživanja. U suradnji s partnerskim sveučilištima Europskog sveučilišta mora (European University of the Seas, SEA-EU), razvijene su projektne aktivnosti za testiranje i provedbu za neformalna i informalna učenja, kao i za dodjelu diploma stečenih kroz sveučilišne preddiplomske, diplomske i poslijediplomske studije. Kroz aktivnosti Europskog sveučilišta mora, Europske digitalne vjerodajnice za učenje povezuju se s drugim europskim inicijativama u visokom obrazovanju, kao što su osiguravanje kvalitete i automatsko priznavanje visokoškolskih kvalifikacija i dijela studiranja. Prednosti Europskih digitalnih vjerodajnica za učenje proizlaze iz brzog i pouzdanog izdavanja diploma i drugih vjerodajnica, njihovog pregleda, pohrane i dijeljenja s poslodavcima i drugim pojedincima i institucijama. Glavna prednost za sva sveučilišta, pa tako i za Sveučilište u Splitu, povezana je s potencijalnim povezivanjem s mjerljivim pokazateljima provedbe osiguravanja kvalitete u Europskom prostoru visokog obrazovanja, tj. povezivanjem s Bazom podataka rezultata vanjskog osiguravanja kvalitete (DEQAR). Visokoškolskim ustanovama, posebno sveučilištima u okviru Europskih sveučilišta mora, Europske digitalne vjerodajnice za učenje donose niz prednosti koje se mogu koristiti za olakšavanje mobilnosti studenata, izgradnji fleksibilnijeg učenja usmjerenog na studente, poticanju cjeloživotnog učenja, stvaranju snažnijih veza s poduzetnicima i izgradnji boljih veza između obrazovanja, istraživanja i inovacija. Tijekom 2021. godine, Sveučilište u Splitu uspješno je dodijelilo nekoliko stotina pojedinačnih Europskih digitalnih vjerodajnica za sudjelovanja u nekoliko neformalnih i informalnih aktivnosti, čime je postalo prvo visokoškolsko učilište koje je uspješno koristilo platformu Europass-a za dodjelu Europskih digitalnih vjerodajnica za učenje., The new Europass platform (https://europa.eu/europass/en) is available as a free online tool from July 2020 for documenting learning outcomes, planning and career preparation in Europe, and serves to support the citizens of the European Union in managing their professional development. Through the Europass platform, users can create their own profile, easily search for different learning or employment opportunities across Europe, receive proposals for educational programmes or jobs that match their profile and interests, create, edit, and store CVs, cover letters and job applications, store digital credentials, share their profile with employers, educational institutions, or career counsellors, and use many other services. Among the mentioned possibilities of using the Europass platform, European digital learning credentials stand out (Europass Digital Credentials for learning, EDC), i.e., digital files assigned to individuals by appropriate educational institutions, such as universities, to validate and provide evidence of learning outcomes. Europass digital learning credentials can be used for achievements in all forms of learning, formal, non-formal and informal. Digital credentials have the same legal value as certificates, diplomas and other credentials in paper form, and allow higher education institutions to issue them free and securely. The Europass platform enables secure storage and sharing of digital credentials. The free and secure Europass Digital Learning Credentials system is managed by the European Commission. The idea of involving the University of Split in the processes of development and implementation of the platform for Europass digital learning credentials arose at a time of a strong interest of the Rector, prof. Dragan Ljutić, PhD, and his associates in strengthening the internationalization, relevance and quality of study programmes and scientific research. In collaboration with the partner universities of the European University of the Sea (European University of the Seas, SEA-EU) the project activities for testing and implementation for non-formal and informal learning have been developed, as well as for the award of diplomas obtained in university undergraduate, graduate, and postgraduate study programmes. Through the activities of the European University of the Sea, European digital learning credentials are linked to other European initiatives in higher education, such as quality assurance and automatic recognition of higher education qualifications and periods of study. The benefits of European digital learning credentials stem from the rapid and reliable issuing diplomas and other credentials, their review, storage and sharing with employers and other individuals and institutions. The main advantage for all universities, including the University of Split, is related to the potential association with measurable indicators of quality assurance implementation in the European Higher Education Area, i.e., connection with the External Quality Assurance Results Database (DEQAR). For higher education institutions, especially the European Maritime Universities, the Europass Digital Credentials for Learning bring many benefits that can be used to facilitate student mobility, build more flexible student-centred learning, foster lifelong learning, build stronger links with entrepreneurs, and build better links between education, research, and innovation. During 2021 the University of Split successfully issued several hundred Europass Digital Credentials to participants in several informal and informal activities, making it the first higher education institution to successfully use the Europass platform to issue Europass Digital Credentials for Learning.

The experience of pregnancy challenges a belief in control over one's health ; internal beliefs, the extent to which one's health is influenced by oneself, chance or fate and other people’s influence (powerful others). Belief that their health is related to their own behavior could increase their Quality of Life (QoL). This study gives insights from the Croatian Islands’ Birth Cohort Study (CRIBS) conducted on Adriatic island populations of Hvar and Brač and neighboring mainland area of the Split-Dalmatian County. The aims of the study were to investigate determinants of the QoL of pregnant women with focus on health locus of control as potential predictor of QoL domains. The sample consisted of 286 healthy pregnant women, age 18 or older, 18 to 28 weeks of gestation, enrolled into study from February 2016 to June 2018. Comprehensive study of maternal health assessed WHOQoL-bref (Physical QoL, Psychological QoL, Social relationships and Environmental health domain), Adult Hope Scale, Multidimensional Health Locus of Control scales (MHLC), Edinburgh Postnatal Depression Scale, the perceived stress appraisals and demographic questionnaire. Enrolment into the study and all scheduled visits were carried out at doctor's office where the pregnancy was routinely monitored and in the maternity unit in the University Hospital Center Split, Croatia. Inclusion criteria were 18 weeks or more of single pregnancy, not assisted with reproductive technology. Woman had significantly higher internal then external locus of control (p= .000) and then chance (p= .000). They believed that they are in control of their health, also that powerful other people (medical doctors) were responsible for their health in a more significant way then that their health is in control of chance or luck (p= .000). MHLC scale scores explained significant amount of the total variance on QoL in all four domains (3.5% to 4.7%). Together with other predictors, greatest variance was explained in Psychological health domain (42%) and the smallest in Physical health (25%). Differences in MHLC between women living at island and neighboring mainland were also found. Health outcomes left to chance lower Environmental health QoL (health accessibility and quality, opportunities for acquiring new information, etc.), especially in less connected areas as islands. With greater perception of all QoL domains but Physical, women believed more that powerful others are in control of their health outcomes, which could indicate that reliance on doctors and medical staff has an extraordinary importance in their lives. Understanding how health beliefs of women influence their QoL could have beneficial effects in establishing the best possible care standards and outcomes for women and newborns.

Introduction: Internet addiction is characterized by poorly controlled urges and behaviors toward Internet use that can result in psychosocial maladjustment and emotional problems, especially in young people. Sociodemographic factors and type of Internet activity can contribute to the individual differences in the levels of Internet addiction. To date, it is known that people who are initially free of mental health disturbances, but pathologically use the Internet, are at risk of developing psychopathological symptoms. Little is known about Internet addiction and its psychological consequences among people in middle and older age categories. Objectives: The aim of this study is to examine the prevalence of Internet addiction across different age groups and to examine the contribution of age, gender, educational level and predominant type of Internet activity to the degree of Internet addiction. The additionally aim is to examine the possibility of predicting psychological distress based on the degree of Internet addiction. Methods: The subjects are Internet users of both gender and in all age groups (N = 300) who are willing to participate in online research. The data have been collected through the Internet Addiction Test and General Health Questionnaire to examine addiction levels and current psychological status. Results: The results indicate higher levels of Internet addiction among younger participants who spend significantly longer on the Internet than the subjects in other age groups. Stepwise regression analysis has been conducted to determine whether it is possible to predict the levels of psychological distress based on the Internet addiction scores. Discussion: The novelty of this research is that the relationship between Internet addiction and its psychological consequences has been examined from a different age groups perspective instead only among young people. The findings have been discussed in the context of the present knowledge about Internet addiction.

Background: The trajectory of blood pressure (BP) in pregnancy is characterized by an early decrease and a late pregnancy increase. Aim: The aim of this study was to define trajectory of systolic (SBP) and diastolic (DBP) blood pressure in 308 pregnant participants in the CRIBS study and to analyse the association of BP with maternal pre-pregnancy BMI and newborns` anthropometry. Methods: Pregnant women included in the CRIBS study had no history of chronic diseases. The BP of CRIBS participants was measured at least once in each trimester. Maternal pre-pregnancy weight was self-reported. Z-scores were calculated for each newborn`s birth weight, length and head circumference using the WHOAnthro software. All deliveries were term births. The analyses were performed using SPSS 10.0 Results: Less than 2% of women had pregnancy- induced hypertension (SBP >140 mmHg and/or DBP >90 mmHg). BP changed through pregnancy: mean systolic BP of 113 mmHg in the 1st and in the 2nd trimester elevated to 116 mmHg in the 3rd trimester (p30 kg/m2) in all three trimesters were significantly higher than in pre-pregnancy underweight, normal weight or overweight women. Positive correlations were detected between maternal SBP in the 2nd trimester and z-scored birth weight, length and head circumference (R2=0.0205, R2=0.0240 and R2=0.0141, respectively) and between DBP in the 2nd trimester and z-scored weight and height (R2=0.0175 and R2=0.0251). No association between gestational age of newborns and maternal BP has been detected. Conclusion: Most of the CRIBS participants had BP within a normal range. The obesity pre-pregnancy was associated with higher BP in pregnancy and the BP in the 2nd trimester of pregnancy correlated with birth size.

The main goal of this study was to test the association of pre-pregnancy body mass index (BMI) and fasting glucose level in pregnancy on birth size of newborns. The sample consisted of 177 healthy pregnant woman and their newborns from the islands (Hvar and Brač) and the mainland (Split- Dalmatian County) who are participants in the Croatian Islands Birth cohort Study (CRIBS). Anthropometric variables (body weight, height and waist circumference) were measured according to the International Biological Program. Peripheral blood of pregnant women was taken between 22nd and 26th week of gestation, and fasting glucose values >5.1 mmol/L were considered elevated. Statistical analyses were done by SPSS10.0 for Windows. There was a significant positive correlation between pre-pregnancy BMI and fasting glucose levels during pregnancy as well as between pre- pregnancy BMI and birth weight, length, and head circumference of the newborns. Hyperglycemic women gave birth to significantly heavier newborn girls then normoglycemic women (p

The aim of this study was to investigate the relationship between pre-pregnancy body mass index (BMI) and fasting blood glucose level in pregnancy on the anthropometry of newborns. The sample consisted of 171 healthy pregnant women and their newborns from the Croatian Islands' Birth Cohort Study. Peripheral blood of pregnant women was taken in the second trimester and fasting glucose values >5.1 mmol/l were considered elevated. Anthropometric variables (body weight, height and waist circumference) were measured according to the International Biological Program. Pre- pregnancy BMI and fasting glucose levels during pregnancy were significantly positively correlated (p

The intrauterine environment affects fetal growth and development. Healthy women with no history of chronic diseases, who concieved naturally and had singleton pregnancies have been participating in the CRoatian Islands` Birth Cohort Study (CRIBS), an ongoing project in the Eastern Adriatic, Croatia, aiming to assess the prevalence of risk factors for the Metabolic Syndrom. Fasting blood lipids (tot- Chol, Trig, HDL-Chol and LDL-Chol), glucose and homocysteine levels were determined in 94 pregnant women (taken between 22th and 26th week of gestation). We investigated their association with possible predisposing factors (age, gestational age, level of education, obesity and smoking status), newborns` anthropometric measures (weight, lenght and head circumference) and with adverse pregnancy outcomes (pre-eclampsia, preterm birth, small/large for gestational age). Among the blood lipids, the largest divergence was found in triglyceride levels (mean 4.2±1.1, range 0.9-11), with elevated values (>1.7 mmol/L) present in >75% of the examinees. Smokers, in comparison to non-smokers, had significantly lower HDL-Chol levels and women older than 30 years had significantly higher tot-Chol than younger ones. Women with higher mean glucose levels (but within the normal range) gave birth to children with significantly higher weight- at-birth z-standardized according to WHO, and women with low homocysteine levels (

In the identification process of historical figures, and especially in cases of Saint’s bodies or mummified remains, any method that includes physical encroachment or sampling is often not allowed. In these cases, one of the few remaining possibilities is the application of nondestructive radiographical and anthropological methods. However, although there have been a few attempts of such analyses, no systematic standard methodology has been developed until now. In this study, we developed a methodological approach that was used to test the authenticity of the alleged body of Saint Paul the Confessor. Upon imaging the remains on MSCT and post-processing, the images were analyzed by an interdisciplinary team in order to explore the contents beneath the biding media (e.g. the remains) and to obtain osetobiographical data for comparison with historical biological data. Obtained results coincided to a large extent: ancestry, sex, age, appearance, occupation and social status. Although the methodological approach proved to be appropriate in this case, due to the discrepancy in the amount of data identity could not be fully confirmed. Nonetheless, the hypothesis that the remains do not belong to St. Paul was rejected, whilst the second one, that of positive identification, showed to be highly positive.

Concentration of lipoprotein (a), Lp(a), an important part of the clinical biomarker profile for atherosclerosis, in blood plasma varies both between and among populations. The elevated Lp(a) level in pregnancy were recognized as a risk factor for thrombosis and/or pre-eclampsia, but the referent values for uneventful pregnancies are yet undefined. The objective of this study was to test the association of fasting Lp(a) levels, taken between 22nd and 26th week of gestation, with possible predisposing factors (older age, smoking status, physical inactivity, hypertension, gestational diabetes), pregnancy outcomes (preterm birth, small/normal/large for gestational age) and newborns` anthropometric measures in 113 women (age range 19.8-41.7 yrs, mean 30.6±4.6 yrs) from the CRoatian Islands` Birth Cohort Study (CRIBS). In these women, with no history of chronic disease prior to pregnancy, Lp(a) leves varied largely, from 1.0 mg/dl to 127.3 mg/dl (median 13.1 mg/dl), but most of the women (88.5%) had Lp(a) 35 yrs), smoking statuts (both current and ex-smokers) and hypertension in predicting Lp(a)≥50 mg/dL (p=0.017, Cox & Snell R2=0.162, Nagelkerke R2=0.333). Nor logistic, neither linear regression models used for the estimation of adjusted associations between Lp(a) and birth weight, length and head circumference, all z- standardized according to WHO, showed significant associations. In the CRIBS sample, elevated Lp(a) levels were not found to be a predictive biomarker for the pregnancy outcome and neonatal size.

Homocysteine is an amino acid involved in several key metabolic processes. In the general population hyperhomocysteinaemia is an indicator of vascular disease, while in normal pregnancy homocysteine blood levels falls. The objective of this study was to examine associations of homocisteine in pregnant women with possible predisposing factors (older age, smoking status, physical inactivity, hypertension), pregnancy outcomes (preterm birth, small/normal/large for gestational age) and newborns` anthropometry (measures z- standardized according to WHO). Fasting homocisteine concentration, taken between 22nd and 26th week of gestation, were determined in 116 women, participants in the CRoatian Islands` Birth Cohort Study (CRIBS). Homocisteine below than referent range (3.4- 20.4 µmol/L) was determined in 19 women (16.4%) while its concentration in others was within the referent range. None of the investigated predisposing factors was significantly associated with predicting homocisteine level, nor were pregnancy outcomes. Newborns of mothers with homocisteine

The prevalence of Metabolic Syndrome (MetS) on Eastern Adriatic islands is higher than in neighboring mainland area. The CRoatian Islands` Birth Cohort Study (CRIBS) is an ongoing 3-year-project with an aim to assess the prevalence of known risk factors for MetS. The CRIBS sample consists of pregnant women from Dalmatian islands Brač and Hvar and nearby coastal town Split and its surroundings, who had no history of chronic diseases (particularly MetS), who conceived naturally and had singleton pregnancies, and their newborns. We tested the association of possible predisposing factors for MetS (age, smoking, prepregnancy BMI, fasting blood biochemical parameters) and newborns` anthropometric measures. In this preliminary sample (n=131, age range 19.8-41.7 yrs, mean 30.6±4.6 yrs), 28.3% of women reported smoking in pregnancy and 22.2% reported being exposed to passive smoking. 17.9% of all the women were overweight and 4.7% were obese. In comparison to underweight women (

The remains of the body of St. Paul - archbishop of Constantinople are kept in a church of the St. Blasius in Vodnjan among other relics and numerous valuable artifacts. According to historical data, St. Paul was born in Thessalonica at the end of the 3rd century and died around 350 AD. The historical records also state that in the time around his death he was tortured with hunger and thirst in a dungeon, and when found alive after six days, strangled to death. To ensure a minimum revolt, his warders spread rumors that he had died of disease. In 2009, his body was examined in Clinical Hospital Center Split, Croatia using Multi Slice Computed Tomography (MSCT). The study was conducted to determine the state of preservation of the remains, to reveal if the body was mummified, and if so, if the mummification was natural or artificial. Afterwards, images were examined in order to obtain basic anthropological data, i.e. to construct osteobiography that could eventually be compared with historical records about St. Paul. The analysis of images revealed that the body is not mummified. Skeletal remains were well preserved, but the bones were not in their anatomical position. Anthropological results reviled that there are no anthropological indicators that could rule out that remains belong to St. Paul, but an amount of specific data was not enough to be used for the identity confirmation.

Obrazovanje zdravstvenih radnika u Republici Hrvatskoj kroz različita povijesna razdoblja uglavnom je pratilo trendove obrazovanja zdravstvenih radnika u okruženju, posebice po ugledu na zemlje zapadne Europe. To obrazovanje, ovisno o pojedinoj profesiji, seže različito u povijest. Za neka zanimanja primjerice radiološke tehnologe i medicinsko laboratorijsku dijagnostiku oko jednog stoljeća, a obrisi početaka obrazovanja nekih drugih zdravstvenih radnika (medicinske sestre npr.) sežu i više stoljeća unazad. Zajedničko svima je da su se ova zanimanja kroz povijest razvijala postupno i dugotrajno, manje ili više uspješno slijedeći potrebe društva kao i trenutne tehnološke, razvojne i organizacijske mogućnosti. U današnje vrijeme u svim europskim zemljama zdravstvena zanimanja regulirana su zakonom. U Hrvatskoj zakonom regulirane profesije su: medicina, stomatologija, farmacija, sestrinstvo, fizioterapija i primaljstvo, kao i radiološka tehnologija, radna terapija, medicinsko-laboratorijska dijagnostika te sanitarno inženjerstvo. Trenutna edukacija zdravstvenih djelatnika u Hrvatskoj je pretežno tradicionalna, neadekvatna i nedovoljno usklađena s trenutnim obrazovnim trendovima, kao i sa zahtjevima i direktivama Europske komisije. Ovaj hrvatski model obrazovanja zdravstvenih radnika na sveučilišnoj razini slijedi preporuke navedene u Hrvatskom kvalifikacijskom okviru: temeljene na ishodima učenja i kompetencijama, poticanju mobilnosti studenata i nastavnika, uz očekivano osiguranje kvalitete. Hrvatski model visokog obrazovanja zdravstvenih radnika osigurava prepoznatljivost studijskih programa, mobilnost, ishode učenja, osiguranje kvalitete i pouzdanosti koje traže pojedine kvalifikacije, sukladno europskim i hrvatskim kvalifikacijskim okvirima koji konačno vode prema standardu (registru) zanimanja.

Purpose: The objective of this study was to present our experience with CT perfusion (CTP) compared to noncontrast CT (NCCT) in early diagnosis of acute ischemic stroke at University Hospital Split and to determine the value of these diagnostic procedures in assesment of adequate thrombolytic therapy. Methods and materials: 87 consecutive patients with acute ischaemic stroke within 3 hours of onset of symptoms underwent Stroke protocol that included NCCT, CTP and MSCTA (MSCT Sensation 16 Siemens, Germany). We used 200 ml of nonionic intravenous contrast media iopamidol 370 at an injection rate of 10, 0 ml/s. Patients with confirmed presence of an ischemic penumbra recieved thrombolytic therapy (Alteplase). Results: Ischemic stroke was confirmed in 78, 1% patients who were admitted with stroke symptoms to our emergency department. CTP was significantly superior to NCCT in depicting ischemic stroke (41 patients diagnosed with NCCT, in comparison to 68 with CTP, p= 0, 008). In 27 cases with negative NCCT there were signs of ischemic stroke on CTP, and 16 of patients with significant penumbra received thrombolytic therapy. NCCT sensitivity (taking CTP as the reference method) was 60, 3%. The accuracy of this method was 69%. Negative predictive value of NCCT in comparison to CTP was 41%. Conclusion: CTP is a sensitive tool for identifying early signs of ischemia and it should be done regulary in patients presenting with acute ischemic stroke symptoms. It is crucial in determining whether the thrombolysis is appropriate by estimating ischemic penumbra and infarct core.

Web izdanje udžbenika Osnove radiologije za primalje je prvo takvo nastavno štivo, kako na sveučilišnom Odjelu za zdravstvene studije sveučilišta u Splitu, tako i Hrvatskoj biomedicinskoj znanosti i zdravstvu općenito. Rukopis se sastoji od 10 poglavlja koja nakon uvodnih napomena, sveučilišne prvostupnike Primaljstva upoznaje s vrstama zračenja koja se koriste u Radiologiji, njihovim svojstvima, mogućim štetnim učincima čak i kod opravdane primjene, te mogućnostima zaštite i sprječavanja štetnih djelovanja zračenja. Studenti/ce se upoznaju s rentgenskom anatomijom urogenitalnog sustava i temeljnim metodama radiološke dijagnostike urogenitalnog sustava, kao i specifičnim zadaćama prvostupnika Primaljstva u svezi radiološke obrade bolesnica, trudnica i novorođenčadi, što je i glavna zadaća ovog udžbenika. Na kraju je popis recentne literature koju studenti mogu koristiti po vlastitoj želji radi proširenja svojih spoznaja o mogućnostima i vrijednosti radiološke dijagnostike urogenitalnog sustava…

Higher Education Network for Radiography in Europe (HENRE), organizacija financirana od Europske komisije u svrhu usklađivanja obrazovanja radioloških tehnologa u zemljama Europske unije u svom dokumentu "Tuning Template for Radiography in Europe", navodi kako je radiografska profesija regulirana Direktivom 2005/36/EU, te preporučuje visoko obrazovanje radioloških tehnologa na tri razine: preddiplomska razina (bachelor level), diplomska razina (master’s level) i poslijediplomska razina (doctoral level). Predloženi sustav obrazovanja radioloških tehnologa identičan je onome kakav je u prihvaćenom Hrvatskom modelu sveučilišnog obrazovanja zdravstvenih radnika. Drugim riječima, njihov zaključak o potrebama i načinu usklađivanja visokog obrazovanja radioloških tehnologa u zemljama Europske unije u potpunosti je sukladan visokom obrazovanju radioloških tehnologa na SOZS-u. Gotovo istovjetan je i program obrazovanja radioloških tehnologa u SAD-u. Naime, u SAD-u je 2005. godine Joint Review Committee on Education in Radiologic Technology's (JRCERT) postavio zahtjev da voditelji i predavači studija radioloških tehnologija i slikovnih metoda do 2009. godine trebaju završiti Master's degree razinu obrazovanja (informacije su dostupne na web stranici www.rt- image.com/0912JRCERT). Ovaj zahtjev doveo je do otvaranja nekoliko studijskih programa na visokim učilištima u SAD-u, a među prvima je prepoznao potrebu i razvio program Thomas Jefferson University u Philadelphiji. Program se temelji na shemi studija 3 + 2 godine, gdje je uvjet za upis diplomskog magistarskog studija završetak baccalaureate degree u trajanju od tri godine i najmanje jedne godine rada u području radioloških tehnologija. Studijski program Master's degree na navedenom visokom učilištu pruža edukacijski i upravljački pravac obrazovanja. Nakon završetka studija studenti će imati kompetencije i vještine potrebne za samostalni rad na poslovima iz područja radiološke tehnologije u zdravstvenom sustavu, kao i neophodne kliničke vještine, te temeljne vještine komuniciranja s pacijentima, njihovim obiteljima i drugim članovima zdravstvenih timova. Osim toga, imat će definirane profesionalne i akademske stavove. Ovladati će vještinama upravljanja procesima u tijeku osiguravanja zdravstvene skrbi i drugim različitim procesima u zdravstvu. Također će imati i temeljna znanja i vještine u provođenju, kontroli, stručnom vrednovanju, te osiguranju i unaprjeđenju procesa kvalitete u segmentima radiološke tehnologije kao dijela zdravstvenog sustava. Imati će i izgrađene stavove o nužnosti cjeloživotnog učenja i usavršavanja, te prenošenja znanja na druge zdravstvene djelatnike.

Brojna zanimanja zdravstvenih usmjerenja su vrlo zahtjevna i specifična te zahtijevaju visoku kvalitetu izvođenja teorijske i praktične nastave. Visoku kvalitetu obrazovanja zdravstvenih radnika mogu osigurati samo nastavnici i stručnjaci koji posjeduju znanja, vještine i kompetencije iz područja obrazovanja određenog zdravstvenog obrazovnog profila. Da bi postigli taj cilj nužno je uspostaviti cjelovitu vertikalu unutar sveučilišnog obrazovanja za različita zdravstvena zanimanja. Hrvatski model sveučilišnog obrazovanja zdravstvenih radnika osigurat će provođenje svih postupaka koji se predviđaju Hrvatskim kvalifikacijskim okvirom u postizanju prihvatljive transparentnosti, pristupanju studijskim programima, prohodnosti, stjecanju svih ishoda učenja, te izgrađivanju kvalitete i pouzdanosti stečenih kvalifikacija. Sveučilišni zdravstveni studiji odvijaju se u tri ciklusa: prvi (bachelor degree), drugi (master degree) i treći (doctor degree) stupanj/ciklus. Prvi stupanj sveučilišnog obrazovanja zdravstvenih radnika (preddiplomska sveučilišna razina, engl. bachelor degree) traje tri godine, drugi stupanj sveučilišnog obrazovanja (diplomska sveučilišna razina, engl. master degree) traje dvije godine, a treća - poslijediplomska sveučilišna razina (poslijediplomski sveučilišni studij, engl. doctor degree) traje tri godine. Broj sati nastave je određen prema postulatima Bolonjskog procesa i Direktive 36/2005 EU razmjerno broju ECTS bodova. Prvi stupanj (engl. bachelor degree) ima 4.600 sati, drugi (engl. master degree) 3.000 i treći (engl. doctor degree) 4.500 sati, s naglaskom na znatnom većem udjelu vježbovnih sati (praktične nastave i individualnog rada). Implementacijom usklađenih sveučilišnih studijskih programa na razini Republike Hrvatske te ugovorima o stručno znanstvenoj i nastavnoj suradnji sa sličnim ili istim fakultetima u Republici Hrvatskoj, regiji i Europi, omogućena je horizontalna i vertikalna pokretljivost studenata i nastavnika na svim razinama obrazovanja sveučilišnih zdravstvenih studija.

By noninvasive and nondestructive virtual autopsy techniques of forensic analysis we studied the anatomical and pathological changes of four mummified bodies from the Church of St. Blać (St. Blaise) in Vodnjan (Istria, Croatia). We analyzed the images obtained by multi-slice computed tomography (MSCT) of bodies using Osirix software, which allows the three-dimensional examination of the interior of the body. As the bodies of St. Nicolosa Bursa and St. Ivan Olini were mummified, all soft tissue data were negative due to lack of water inside them. The remains of internal organs, muscles and ligaments were preserved. The body of St. Ivan Olini revealed the spina bifida occulta on the sacrum as well as a clubfoot. Images of the remains of St. Leon Bembo and St. Paul did not show any soft tissue. The remains of their bones were attached to metal and wooden handles, covered with fabric and filled with the material that is assumed to be cotton. Forensic teams from University Department for Forensic Sciences and Forensic Science Centre “Ivan VuËetiĘ” performed anthropological analysis and photographically documented 670 relics (bones) for their catalogue and individualization. We will present the most important findings of MSCT imaging and anthropological analysis of the relics as well as the significance of their catalogue, preservation and presentation.

The Croatian model of university education for health professionals

UVOD: Mikrokalcifikati otkriveni na mamografskoj snimci mogu biti jedini dijagnostički znak malignih promjena u dojci. Prema BI‐RADS klasifikaciji mikrokalcifikati umjereno suspektni i vrlo suspektni za maligni proces klasificirani su u skupine 4 i 5. Vjerojatnost da su mikrokalcifikati iz BIRADS skupine 4 maligni, kreće se u rasponu od 2 do 95%, a za BI‐RADS 5 mikrokalcifikate vjerojatnost je preko 95% te su iz tog razloga dijagnostičke smjernice za ove kategorije biopsijske procedure. Ipak, jedan dio autora zaključuju da MR dojki, nakon prethodno učinjene mamografije, u određenim slučajevima može promijeniti indikaciju i za biopsijske procedure. CILJ ISTRAŽIVANJA: Cilj ovog istraživanja jest istražiti osjetljivost i specifičnost magnetske rezonance dojki u dijagnostici mamografskih mikrokalcifikata suspektnih za maligni proces. METODE ISTRAŽIVANJA: Istraživanje je obuhvatilo 20 žena s mamografski suspektnim mikrokalcifikatima koji predstavljaju indikaciju za daljnju dijagnostičku obradu (biopsijske procedure). Sve su ispitanice upućene na pregled dojki magnetskom rezonancom, nakon koje je slijedila minimalno invazivna biopsija mamografskih mikrokalcifikata (stereotaksijska vakuum asistirana biopsija pod kontrolom mamografa. Prema dosadašnjim rezultatima 2 DCIS‐a nisu bila prepoznata primjenom MR‐a, odnosno nisu pokazala bojenje (imbibiciju) paramagnetskim intravenskim kontrastnim sredstvom, dok su 4 benigne promjene pokazale bojenje paramagnetskim kontrastnim sredstvom te su bile proglašene pozitivnim MR nalazom. U tri slučaja otkrivenih invazivnih karcinoma dojke (IDC‐a), MR nalaz je bio pozitivan. ZAKLJUČAK: Prema dosadašnjim našim rezultatima osjetljivost pregleda dojki magnetskom rezonancom u dijagnostici IDC‐a, DCIS‐a i lezija visokog rizika nije dovoljno pouzdana da zamijeni biopsijske procedure u slučaju suspektnih mikrokalcifikata.

Zbog povećane složenosti zdravstvene skrbi izobrazba djelatnika u zdravstvenim strukama: sestrinstvu, primaljstvu, fizioterapiji, radiološkoj tehnologiji i medicinskoj laboratorijskoj dijagnostici, promaknuta je na sveučilišnu razinu preddiplomskog, diplomskog i poslijediplomskog obrazovanja. U Hrvatskoj je 1997. godine sestrinstvo uvršteno u područje biomedicine i zdravstva, polje kliničkih medicinskih znanosti. Hrvatska i Bosna i Hercegovina već se uvele prva dva stupnja obrazovanja za zdravstvene struke, ali se pojavljuje jaka potreba za trećim (doktorskim studijem u trajanju od tri godine i sa 180 bodova ECTS). Uključuje usvajanje napredne zdravstvene prakse temeljene na dokazima i stjecanje sposobnosti neovisnog istraživanja i kritičke analize. Doktorska diploma iz područja zdravstvenih znanosti nužna je za akademsku karijeru nastavnika na fakultetima zdravstvenih studija. No, s time se poslenici ne će odvojiti od bolesnika i postati administrativni službenici, već će i dalje najveći dio posla obavljati uz bolesnike.

Rezultati mamografskog probira raka dojke u Županiji Splitsko - Dalmatinskoj

Vakum asistirana biopsija mikrokalcifikata dojke:dijagnostička pouzdanost u analizi nemalignih promjena

28. studenog 2009 godine u KBC - u Split, u suradnji Kliničkog zavoda za patologiju, sudsku medicinu i citologiju i Kliničkog zavoda za dijagnostičku i intervencijsku radiologiju, četiri sveta tijela dopremljena su iz crkve sv. Blaža u Vodnjanu i snimljena MSCT (multislice computed tomography) uređajem. Tehnika snimanja ovim uređajem odabrana je zbog njene nedestruktivnosti i neinvazivnosti. Slikovni je materijal analiziran pomoću programa Osirix, koji omogućuje 3D pregled svih struktura unutar tijela. Tehnikama virtualne obdukcije analizirane su anatomske i patološke promjene svih tjelesnih struktura. Tim s Kliničkog zavoda za patologiju, sudsku medicinu i citologiju, zajedno s Centrom za forenzična ispitivanja, istraživanja i vještačenja „Ivan Vučetić“ antropološki je analizirao i izradio foto - elaborat za 774 relikvije. Rad će prezentirati najvažnije rezultate analize slikovnog materijala dobivenog MSCT uređajem, kao i antropološkom analizom relikvija. Također će se osvrnuti na važnost znanstvene obrade relikvija, njihovu katalogizaciju, zaštitu i prezentaciju.

RATIONALE: Lung function measures are heritable traits that predict population morbidity and mortality and are essential for the diagnosis of chronic obstructive pulmonary disease (COPD). Variations in many genes have been reported to affect these traits, but attempts at replication have provided conflicting results. Recently, we undertook a meta-analysis of Genome Wide Association Study (GWAS) results for lung function measures in 20, 288 individuals from the general population (the SpiroMeta consortium). OBJECTIVES: To comprehensively analyse previously reported genetic associations with lung function measures, and to investigate whether single nucleotide polymorphisms (SNPs) in these genomic regions are associated with lung function in a large population sample. METHODS: We analysed association for SNPs tagging 130 genes and 48 intergenic regions (+/-10 kb), after conducting a systematic review of the literature in the PubMed database for genetic association studies reporting lung function associations. RESULTS: The analysis included 16, 936 genotyped and imputed SNPs. No loci showed overall significant association for FEV(1) or FEV(1)/FVC traits using a carefully defined significance threshold of 1.3×10(-5). The most significant loci associated with FEV(1) include SNPs tagging MACROD2 (P = 6.81×10(-5)), CNTN5 (P = 4.37×10(-4)), and TRPV4 (P = 1.58×10(-3)). Among ever-smokers, SERPINA1 showed the most significant association with FEV(1) (P = 8.41×10(-5)), followed by PDE4D (P = 1.22×10(-4)). The strongest association with FEV(1)/FVC ratio was observed with ABCC1 (P = 4.38×10(-4)), and ESR1 (P = 5.42×10(-4)) among ever-smokers. CONCLUSIONS: Polymorphisms spanning previously associated lung function genes did not show strong evidence for association with lung function measures in the SpiroMeta consortium population. Common SERPINA1 polymorphisms may affect FEV(1) among smokers in the general population.

The aim of this cross-sectional retrospective study was to compare the accuracy of three radiographic methods for age estimation using orthopantomogram radiographs (OPGs) from developing children. OPGs of 2652 children (1214 boys and 1438 girls, aged 5.22–14.92 years) with 1474 children from Croatia and 1178 children from Bosnia and Herzegovina were examined and seven mandibular teeth from left side of mandible were assessed using Cameriere’s method by measurement of open apices in teeth, mineralization stages of four different teeth from right side of jaws using Haavikko’s adopted method based on Finnish children and Demirjian's mineralization stages of seven teeth from left side of mandible for Willems’ method with updated scoring based on Belgian children. The mean difference(±SD) in years between dental and chronological age (DA-CA) was calculated for each method. Results show that the most accurate method was by Cameriere (boys -0.08 ± 0.71, girls -0.03 ± 0.70 years), Haavikko’s method underestimated age more (boys -0.09 ± 0.80, girls -0.34 ± 0.75 years), while Willems’ method overestimated age (boys 0.51 ± 0.79, girls 0.28 ± 0.83 years). According to the analysis of variance, no statistically significant differences were found in results of DA-CA between children from Croatia and Bosnia and Herzegovina for each method. No statistically significant difference of DA-CA was found between boys and girls for Cameriere’s method, for Haavikko and Willems method there were statistically significant differences between genders. Statistically significant differences were found in results of DA-CA among different age groups for each method. Published results could be used in clinical, forensic and anthropological purposes when sample of children was used from specified countries.

Dental age estimation in children plays an important role in forensic dentistry. The most wide used method for age estimation developed by Demirjian in 1973 on French-Canadian sample generally overestimates dental age in many population. Chaillet's international maturity scores were formed to obtain a predicted age with more confidence when ethnical origin was not available. The aim of this study is to evaluate the accuracy of Chaillet's international scores for the dental age assessment in Croatian children. Methods: panoramic radiographs of 1475 children, 805 girls and 670 boys, from 4.79 to 14.92 years, were assessed using Chaillet's international maturity tables and curves. The dental age was compared to the chronological age through a paired t-test for both genders separately. Mean overestimation using Chaillet's international maturity scores were 0.19±0.77 year for girls (P

Senat Sveučilišta u Splitu je prihvatio inicijativu Fakultetskog vijeća Medicinskog fakulteta te na 41. sjednici Senata, održanoj 1. ožujka 2010. godine je usvojio „Strateški plan osnivanja novih sveučilišnih preddiplomskih, sveučilišnih diplomskih, sveučilišnih integriranih, stručnih i specijalističkih diplomskih stručnih studija Sveučilišta u Splitu“. U tom strateškom dokumentu za znanstveno područje Biomedicina i zdravstvo predviđeno je osnivanje preddiplomskih i diplomskih sveučilišnih zdravstvenih studija nakon akademske 2010./2011., odnosno početak za akademsku 2011./2012. godinu. U elaborate se ističe da se pokretanjem Fakulteta zdravstvenih studija na Sveučilištu u Splitu po prvi put u Republici Hrvatskoj, po načelima Hrvatskog modela sveučilišnog obrazovanja zdravstvenih radnika, sveučilišni i stručni studiji usklađuju s onima u europskom obrazovnom sustavu prema zahtjevima Bolonjske deklaracije i Europskim kvalifikacijskim okvirom.

The objective of this study was to compare noncontrast computed tomography (NCCT) and computed tomography perfusion (CTP) in early diagnosis of acute ischemic stroke and to define influence of these diagnostic procedures on early outcome of thrombolytic therapy (TLTH). The study included 45 patients, 35 patients submitted to NCCT and CTP and 10 patients who underwent only NCCT, before CTP was introduced. Based on the National Institute of Health Stroke Scale (NIHSS) score we compared early outcome of patients who received TLTH after NCCT only (group 1) with the early outcome of patients who received TLTH following NCCT and CTP (group 2). Statistically significant difference was found in acute stroke diagnosing between CTP and NCCT (p=0.002). There were no statistically significant differences in TLTH early outcome between group 1 and group 2. In conclusion, CTP should be done regulary in patients presenting with acute ischemic stroke symptoms. More research needs to be done in defining exact influence of CTP implementation on the TLTH outcome.

Results of our analysis show as that breast reconstruction become a standard part of the care of female patients with breast cancer. We will analyse the factors that are important for the primary or secondary breast reconstruction after mastectomy, and also take a closer look on the most recent scientific advances on breast reconstruction and on the protocols regarding them. The breast is the most common site of cancer in Croatia women. Breast cancer is the first leading cause of cancer death among women today. The incidence of female breast cancer in Croatia estimates that approximately 2.200 news cases of female breast will be diagnosed every year. We retrospectively analysed data of 101 female patients undergoing reconstructive surgery for breast reconstruction after mastectomy at Division of Plastic Surgery and Burns, University Hospital Center Split and University Clinic of Plastic and Reconstructive Surgery, Innsbruck, Austria, between 1998 and 2008. For the purpose of outcome assessment, we performed the tree different type of questionnaire: (1) Personal/medical profile (Table 1), (2) Aesthetic assessment (Table 2), and (3) Psychosocial assessment (Table 3). The occurrence of main complications during breast reconstruction (partial necrosis of flap, hernia of donor site, pulmonary embolism, deep venous thrombosis, infection rate, hemathoma and seroma formation, and extrusion of expander/implant) during hospitalisation and follow up period until 6 post operatively were analysed with respect to use different type of reconstructive methods for breast reconstruction. The difference in complication between patients groups was evaluated by c2-test. The level of significance was set up at p=0.05. Mann-Whitney test was used to compare the time from mastectomy to breast reconstruction, due to asymmetrical data distribution. The three main variables of this study were to identify significant risk factors, asses the aesthetic outcome, and patient satisfaction with performed different methods for breast reconstruction (LD flap with or without tissue expander and implant, pedicle and free TRAM flaps, and expander /implants only. These variables determined the current guidelines for early and late breast reconstruction after mastectomy such as patient data, age and own decision, relation ship between reconstruction and radiotherapy, and chemotherapy, and finally about breast preserving operation. The result should confirm that breast reconstruction after mastectomy is justified, especially in young women, as well as how essential is team work involved in breast cancer operation and breast reconstruction after mastectomy.

Hrvatsko katoličko liječničko društvo podružnica Split organiziralo je predavanje na temu "Radiološke metode i trudnoća"

Pulmonary function measures are heritable traits that predict morbidity and mortality and define chronic obstructive pulmonary disease (COPD). We tested genome-wide association with forced expiratory volume in 1 s (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) in the SpiroMeta consortium (n = 20, 288 individuals of European ancestry). We conducted a meta-analysis of top signals with data from direct genotyping (n ≤ 32, 184 additional individuals) and in silico summary association data from the CHARGE Consortium (n = 21, 209) and the Health 2000 survey (n ≤ 883). We confirmed the reported locus at 4q31 and identified associations with FEV1 or FEV1/FVC and common variants at five additional loci: 2q35 in TNS1 (P = 1.11 × 10−12), 4q24 in GSTCD (2.18 × 10−23), 5q33 in HTR4 (P = 4.29 × 10−9), 6p21 in AGER (P = 3.07 × 10−15) and 15q23 in THSD4 (P = 7.24 × 10−15). mRNA analyses showed expression of TNS1, GSTCD, AGER, HTR4 and THSD4 in human lung tissue. These associations offer mechanistic insight into pulmonary function regulation and indicate potential targets for interventions to alleviate respiratory disease.

Painful shoulder in patients on chronic haemodialyis is most often associated with dialysis arthropathy or accumulation of deposits containing modified fibrils of b2- microglobuline especially in bones and joints due to insufficient elimination during the therapy. The aim of this study is to investigate whether there is connection between painful shoulder and plasma level of b2- microglobuline and to corroborate that with morphologic parameters found in proved amyloidosis. It has to be emphasized that even other causes may contribute the development of painful shoulder. Real time sonography and conventional plain radiographs of the 108 shoulders were performed in 54 patients receiving chronic haemodialysis as a treatment of terminal renal failure (without previous history of rheumatoid arthritis), 27 symptomatic with persistent pain and stiffness in both shoulders and lasting for more than 6 weeks and restriction of movements in various degree and 27 asymptomatic. Plasma level of b2- microglobuline, CRP and uric acid were taken periodically as routine procedure during a one year prospective trial, as well as plasma level of calcium, phosphor and alkaline phosphatase. Plasmatic level of b2-microglobuline is strongly connected with painful shoulder in dialyzed patients, as well as CRP as sign of acute inflammation. That is proved by morphologic parameters associated with histological proved amyloidosis in patients on long term dialysis, more then 10 years.

Rezultati mamografskog probira raka dojke u Splitsko-dalmatinskoj županiji

Aim: To identify genetic variants underlying six anthropometric traits: body height, body weight, body mass index, brachial circumference, waist circumference, and hip circumference, using a genome-wide association study. Methods: The study was carried out in the isolated population of the island of Korcula, Croatia, with 898 adult examinees who participated in the larger DNA-based genetic epidemiological study in 2007. Anthropometric measurements followed standard internationally accepted procedures. Examinees were genotyped using HumanHap 370CNV chip by Illumina, with a genome-wide scan containing 316730 single nucleotide polymorphisms (SNP). Results: A total of 11 SNPs were associated with the investigated traits at the level of P

To identify genetic variants underlying biochemical traits--total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, uric acid, albumin, and fibrinogen, in a genome-wide association study in an isolated population where rare variants of larger effect may be more easily identified.

This is the first follow-up of the national report submitted at the Third ORPHEUS 2007 Conference: European PhD Programmes in Clinical Medicine, on the state of PhD programmes in Croatia. In Helsinki, we presented the effects of the first two conferences, especially of the Zagreb Declaration, on the PhD studies in the field of biomedicine and health in Croatia. Analysing the past we found that in the last decade, to our disappointment, 75% of theses did not result in any published paper. After this two ORPHEUS conferences and the agreements settled at two symposium in the Croatian Academy of Science and Arts, all four medical schools in Croatia accepted the Zagreb Declaration recommendations, making it impossible to obtain a PhD degree without having scientific papers published. The data from Zagreb Medical School presented for the first time in the text show that above criteria led to a certain decrease in the total number of PhD thesis , but rising trend is evident in the number of thesis based on the previously published three scientific papers in internationally recognised journals. However, because of the interest of PhD candidates in the PhD programmes was higher than the availability of component mentors, etc., a number of young people are not able to complete the thesis according to the new, more rigorous criteria. At the same time, demand for PhD thesis according to the new, more rigorous criteria. At the same time, the demand for PhD holders and new faculty has increased because the "old baby boom generation" is stepping down and there are not enough established young leaders to take their place. Consequently, the schools are burdened with the growing responsibility of balancing between the demands of increasing the quality of PhD thesis and vigorous faculty renewal expected in the coming years.

Akutni moždani poremećaji zahtijevaju pravodobno utvrđivanje točne dijagnoze. Kliničko-neurološka procjena temeljna je vodilja u obradi bolesnika. Ispitivali smo osjetljivost i specifičnost kliničke procjene bolesnika s akutnim moždanim zbivanjem. Usporedili smo kliničku procjenu vrste akutne bolesti mozga s konačnom dijagnozom utvrđenom neuroradiološkom obradom, kompjuteriziranom tomografijom (CT). Utvrdili smo statistički značajnu korelaciju kliničke procjene bolesnika i CT-a mozga u oboljelih s ishemijskim moždanim udarom. U oboljelih s hemoragijskim moždanim udarom i tumorima mozga utvrdili smo statistički značajno slabiju osjetljivost i specifičnost kliničko eurološke procjene. Klinička procjena možde dati lažno pozitivne i lažno negativne nalaze za hemoragijske moždane udare i tumore mozga. Navedeno upućuje da je Ct mozga neophodna dijagnostička metoda koja upotpunjuje kliničku procjenu akutnih moždanih zbivanja.

Prikazani su rani rezultati organizacije mamografskog probira raka dojke u Republici Hrvatskoj, s osobitim naglaskom na rezultate u Splitsko-dalmatinskoj županiji.

Prikazani su rezultati mamografskog probira raka dojke, s posebnim osvrtom na interopserverske razlike pojedinih radiologa s obzirom na iskustvo.