Suchergebnisse

Occupational and sports medicine (OSM) education is poorly represented in Croatian university undergraduate medical curricula. Zagreb University medical students are required to take OSM classes for a week on their final year of studies. The classes are organised around team-based learning (TBL). Given that students who attend TBL classes have significantly higher exam scores than students who take lectures ex cathedra, the aim of this study was to assess students' knowledge and attitudes immediately after TBL OSM classes. This cross-sectional study included 162 final-year Zagreb University School of Medicine students taking TBL classes in OSM in the academic year of 2019/2020. They were recruited from 30 September 2019 to 4 March 2020. Participants filled in a 20-item questionnaire compiled by the authors and adapted to the Croatian legislation. Their answers demonstrated positive attitude toward OSM classes and negative attitude toward occupational medicine practice and OSM specialty. They showed moderate interest only for the job of sports physician. Even though they showed sufficient knowledge of OSM immediately after the course was completed, they were moderately satisfied with their knowledge. Our findings call for rethinking the practical aspects of teaching OSM classes in order to promote OSM practice among medical students or at least raise awareness about the importance of prevention of numerous work or sport-related disorders. ; Edukacija iz medicine rada i sporta (MRIS) slabo je zastupljena u kurikulima dodiplomskih studija medicine. Studenti medicine na Medicinskom fakultetu Sveučilišta u Zagrebu obvezni su pohađati nastavu iz MRIS-a tjedan dana na posljednjoj godini studija. Nastava je organizirana prema načinu poučavanja u grupi (PUG). Kako studenti koji iskuse PUG imaju bolje rezultate ispita i ocjene u odnosu na studente koji samo pohađaju predavanja, cilj ovog istraživanja bio je procijeniti znanje i stavove studenata odmah nakon nastave iz MRIS-a koja je zasnovana na PUG-u. U ovom presječnom istraživanju sudjelovala su 162 studenta završne godine studija medicine na Medicinskom fakultetu Sveučilišta u Zagrebu koji su iskusili PUG tijekom nastave iz MRIS-a u akademskoj godini 2019./2020. Bili su uključeni u istraživanje od 30. rujna 2019. do 4. ožujka 2020. Sudionici su ispunili upitnik s 20 čestica koji se odnosi na znanje i stavove studenata o MRIS-u. Autori su ga sastavili i prilagodili hrvatskom zakonodavstvu. Rezultati našega istraživanja pokazali su pozitivne stavove studenata prema nastavi iz MRIS-a i negativne stavove prema poslu u medicini rada i specijalizaciji iz MRIS-a. Studenti su pokazali osrednje zanimanje za posao u sportskoj medicini. Iako su pokazali dostatno znanje odmah nakon završetka kolegija, bili su umjereno zadovoljni svojim znanjem iz MRIS-a. Praktični aspekti strategije poučavanja na nastavi iz MRIS-a trebali bi se razmotriti u budućnosti kako bi se promicao rad u MRIS-u među studentima medicine rada i sporta ili barem podigla svijest o važnosti prevencije brojnih poremećaja koji su vezani uz rad ili sport.

Descritta da Marco Cesare Salbriggio a Fildoro suo Figlio . ; VD17-Nummer 2019 maschinell ergänzt ; Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Ital. 618 k

La prevenzione delle fratture da fragilità nelle persone anziane è diventata una priorità dovuta al rilevante impatto sanitario, finanziario e sociale che comportano. Le strategie più appropriate per fare fronte a questo importante problema di salute pubblica sono ancora materia di discussione. Negli ultimi anni l'approccio tradizionale centrato quasi univocamente sulle terapie farmacologiche e sulla valutazione della densità minerale ossea (DMO) è cambiato alla luce del riconoscimento del ruolo di altri fattori di rischio per le fratture da fragilità che sono indipendenti della DMO e che possono essere di maggior rilievo in popolazioni anziane, nelle quali si verificano tre quarti di tutte le fratture da fragilità vertebrali e più di tre quarti delle fratture femorali. Tra i più importanti fattori DMO-indipendenti ricordiamo tra gli altri: a) il rischio di cadute, b) la sarcopenia, c) le alterazioni della mobilità e d) la perdita di peso. Il rapporto costo-efficacia di un approccio farmacologico per il trattamento dell'osteoporosi è in discussione. Alcuni farmaci hanno dimostrato una accertata efficacia nel ridurre il rischio di fratture in soggetti osteoporotici con T-score inferiore a -2.5 DS e fratture prevalenti, anche se i trials che hanno dimostrato tale efficacia non includevano solo persone anziane e spesso escludevano gli anziani più fragili. Nel Aprile 2016, l' "Interest Group on Falls and Fracture Prevention" della "European Union Geriatric Medicine Society (EUGMS)" insieme all'International Association of Gerontology and Geriatrics-European Region (IAGG-ER), all'Unione Europea dei Medici Specialisti (EUMS), all'International Osteoporosis Foundation, all'European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, hanno pubblicato uno statement che delinea la loro opinione sui punti principali nel (del?) dibattito in corso in relazione alla prevenzione primaria e secondaria delle cadute, alla diagnosi e il (al?) trattamento della fragilità ossea, e all'implementazione di servizi multidisciplinari ("Liasson Services") per la prevenzione delle cadute e delle fratture nelle persone anziane. Questo statement sostiene una strategia globale e suggerisce: 1) una migliore informazione sia per le persone anziane che per gli operatori sanitari per quanto riguarda lo stile di vita generale e misure mediche per ottimizzare la salute ossea e la prevenzione delle cadute; 2) un miglioramento delle conoscenze su screening e un'ottimizzazione della gestione delle persone anziane con fragilità ossea o ad alto rischio di cadere sia nelle cure primarie che nelle istituzioni; e 3) una forte collaborazione tra i "Fracture Liasson Services", i reparti di medicina geriatrica (Liasson Services di cadute e fratture) e le cure primarie. I decisori politici dovranno svolgere un ruolo importante nello sviluppo di programmi comunitari e istituzionali sulla prevenzione delle cadute, nello stabilire i "Liasson Services" di cadute e fratture e nel sviluppare percorsi adeguati per la prevenzione delle fratture che includano sia la valutazione che la gestione delle persone anziane che cadono frequentemente e l'ottimizzazione della gestione medica nelle persone con fragilità ossea.

In this essay the transfer of knowledge and experts between Vienna, Zagreb, inter-war China and the USSR will be analysed through the collaboration between two well-known interwar public health reformers, Aus- trian Julius Tandler and Croat Andrija Štampar. In the 1930s, they worked in China under the auspices of the League of Nations Health Organization and developed intensive cooperation in the field of public health. Based on the diary records of Andrija Štampar and the preserved archival correspondence, their personal and professional contacts were analysed. The main interest was the exchange of experiences and opinions, as well as their observations about the people and ideas they encountered and the situations in which they found themselves. This essay also tries to shed some light on the milieu in which the notions of public health and social medicine advanced, as well as the multiple external factors which influenced those developments. However, the opportunities for constructive work in the field of public health grew increasingly slim in the political constellation of the time. The League of Nations was losing its power and its health organisation followed suit. The local resistance to foreign influences in China was becoming progressively intense. The ever more severe unrest led the world into World War II and pushed the establishment of an international public health order to the margins for some time to come. However, what remained in memory was a flow of ideas and experiences which was formed in Central and Southeastern Europe and which subsequently tried to make their way far to the East and develop not only local but also general and international qualities. Many of these ideas became the basis for a new world-wide public health system that developed after World War II. ; U ovom su radu predstavljeni transfer znanja i stručnjaka između Beča, Zagreba, međuratne Kine i SSSR-a kroz suradnju dvaju poznatih međuratnih reformatora javnog zdravstva, Austrijanca Juliusa Tandlera i Hrvata Andrije Štampara. Ta su dva javnozdravstvena stručnjaka 1930-tih radili u Kini pod pokroviteljstvom Zdravstvene organizacije Lige naroda i razvijali intenzivnu suradnju u području javnog zdravstva i medicinske nastave. Na temelju dnevničkih zapisa Andrije Štampara i sačuvane arhivske korespondencije analizirani su njihovi osobni i profesionalni kontakti. Glavno zanimanje ovog rada se veže uz razmjenu njihovih iskustava i mišljenja, kao i njihova zapažanja o ljudima i idejama s kojima su se susreli te situacijama u kojima su se našli. Ovaj rad također pokušava osvijetliti milje u kojem su se javno zdravstvene i socijalno medicinske ideje razvijale kao i vanjske čimbenika, nevezane uz samu struku, koji su utjecali na njih. Krajem 30-tih godina 20. stoljeća prilike za konstruktivan rad na području javnog zdravstva postajale su sve slabije a pod utjecajem tadašnje političke konstelacije i gubita utjecaja Lige naroda. Lokalni otpor stranim utjecajima u Kini postajao je sve intenzivniji. Sve oštriji nemiri vodili su svijet u Drugi svjetski rat i gurnuli uspostavljanje međunarod- nog javnozdravstvenog poretka u posve drugi plan. Međutim, ono što je ostalo u naslijeđe je bio protok ideja i iskustava koji je zahvatio ne samo lokalno područje Srednje i Jugoistočne Europe već se proširio sve do područja Dalekog istoka. Mnoge od tih ideja postale su temelj novog svjetskog javnog zdravstvenog sustava koji se razvio nakon Drugog svjetskog rata.

Designed as a defensive system against the Ottoman Empire, the Austrian military border was doubled by a sanitary cordon, which served as a defense shield against epidemics. In order for this system to function adequately, the border patrol troops that served the House of Habsburg also needed protection against the diseases that threatened the empire. The present study brings into discussion the health problems that border guards from the Banat region experienced, a topic that remains largely unaddressed in the existing literature. By building on original archival research and the specialized work of the epoch, this article traces the main conditions, the means of tackling diseases, the remedies that were specifically local or those found within the European repertoire. It also sheds light on the support that the administrative apparatus offered to the troops, namely medical care in its material form (hospitals, quarantines, pharmacies, medicine, monetary assistance) and human form (the personnel hired at the borders: military doctors, surgeons, midwives, veterinarians). This article concludes that the entire correspondence from the center directed at the local authorities in Banat and vice versa reflects in a unique and subtle way the level of medical knowledge of the time. ; Zamišljena kao obrambeni sustav protiv Osmanskog Carstva, austrijska vojna granica ud-vostručena je sanitarnim kordonom koji je služio kao obrambeni štit od epidemija. Da bi taj sustav mogao odgovarajuće funkcionirati, granične ophodne trupe koje su služile Habsbur-govcima trebale su i zaštitu od bolesti koje su prijetile carstvu. U ovom se istraživanju ras- pravlja o zdravstvenim problemima s kojima su se suočili graničari iz Banata, što je tema o kojoj se u velikoj mjeri nije raspravljalo u postojećoj literaturi. Temeljeći se na istraživanjima originalnih arhiva i specijaliziranih radova epohe, članak prikazuje glavne okolnosti, sred-stva za suzbijanje bolesti, lijekove koji su bili specifično lokalni ili one pronađene u europskom okrilju. Također baca svjetlo na potporu koju je administrativni aparat pružao trupama, naime medicinsku skrb u njezinu materijalnom obliku (bolnice, karantene, ljekarne, lijekovi, novčana pomoć) i njezinu ljudskom obliku (osoblje angažirano na granicama: vojni liječnici, kirurzi, primalje, veterinari). Ovim istraživanjem zaključujemo da cjelokupna koresponden-cija iz centra usmjerena na lokalne vlasti u Banatu i obrnuto odražava na jedinstven i sup-tilan način razinu medicinskog znanja toga vremena.

Predmet je ovoga rada razvoj zakonodavstva nadležnoga za regulativu lijekova u Banskoj Hrvatskoj u razdoblju Austro-Ugarske i na istom području kasnije, između dva svjetska rata, u okviru nove države (Kraljevstvo/Kraljevina SHS, odnosno Kraljevina Jugoslavija). Na početku vremenskoga razdoblja samo su ljekarne po propisima farmakopeje izrađivale službene lijekove. Na kraju promatranoga razdoblja to je područje imalo farmaceutsku industriju, sposobnu pratiti dosege svjetske farmaceutske industrije. Rad je napravljen s namjerom prikazati kako je zakonodavstvo pratilo novosti u farmaciji i farmaceutskoj industriji te kako je također proaktivno uvodilo i činilo obvezatnim nova praćenja svojstava lijekova. ; The variety of human diseases and necessity for curing them resulted in the appearance of medicines and medical treatments. Traditional or people's medicines had been applied in the old times. Rulers realized over time the importance of getting medicines and medical treatments codified. Pharmacies, being in charge for the production of medicines, existed from 13th century. The Habsburg Monarchy proclaimed the General Sanitary Order (Das Generalsanitätsnormativum) in 1770, codifying that physicians should visit pharmacies and control their work once a year. The pharmaceutical industry has taken over medicines production in the late 19th and the first half of the 20th century in Western Europe and North America, and new methods of medicines production has been occurring ever since.The Banal Croatia, which included today's Croatia without Međimurje, Baranja (Baranya), Istria and Dalmatia, had been relatively independent in the health policies in the period from 1869 to 1918, and passed the Law on Pharmacies in 1894. The Law stipulated the control of pharmacies rather than the control over the pharmaceutical industry. The traditional approach prevailed in healing of many different health issues at the times when modern medicines had not yet been developed. Pharmacists were barred from knowing the properties of medicines made by manufacturers, since manufacturers have kept ingredients and recipes of their sources of income secret. State was the only one privy to all of the properties of a medicine and such a medicine was usually known as "a secret remedy". The Banal Croatia witnessed the birth of a large-scale manufacturing of secret remedies by companies held by Adolphe Thierry de Chateauvieux and Eugen Viktor Feller.The interwar period saw the proliferation of the Croatian pharmaceutical industry. The Kingdom of Yugoslavia, in which the area of the Banal Croatia had been extended to Međimurje and Baranja, established the control of medicines made by the growing pharmaceutical industry. At first, the manufacturers were responsible for their products. In 1925 a state surveillance and control of medicines production and sale was established. It meant that the state had accepted the responsibility for the quality of medicines thereby making the state quality-proof assignments put on package inserts of medicines, as well as making the state registries and other documents regarding the medicines control. The Control of Biologics Act of 1930 made it clear that biological medicines are more important and that they treated efficiently the larger scope of health issues than chemical medicines had. The regulation related to the state control of medicines from the same year had been the biggest achievement of the interwar medicines state control. The regulation of medicines became an overall state affair, with the state comptrollers actively involved in the control of each and every batch of medicines. Banovina Hrvatska, which had included the former Banal Croatia, created the state institutes for production as well as control of medicines aimed at the centralization and co-ordination of production and control of medicines. The assessment of the properties of medicines improved as well, from the control of harmlessness to the controls of purity and potency. The control of efficiency was introduced later. The development of the production and regulation of medicines in the territory of Banal Croatia in the timeframe selected for this article moved in line with the development that occurred in the Western Europe and North America. When the Second World War broke out modern medicines regulation was already in existence.

La tesi si divide in due parti: nella prima si esamina l'esperienza etnografica condotta da M. Leiris durante la missione Dakar-Gibuti (1931-33) con riferimento alla studio della possessione a Gondar. Nella seconda parte si dà conto del lavoro sul terreno condotto dalla dottoranda nel Wollo a contatto con guaritori. Seguono appendici documentarie e iconografiche. ; The thesis is divided into two parts: the first examines the ethnographic experience led by M. Leiris during the Dakar-Djibouti mission (1931-33) with reference to the study of possession in Gondar. The second part gives an account of the fieldwork conducted by PhD student in Wollo in contact with healers. Iconographic and documentary appendices follow.

The purpose of this paper is to examine the political dimension of the relationship between the doctor and the patient, and the therapeutic dimension of the relationship between the politician and the citizen in Plato's philosophy. The purpose of the study is to show that the liaison between medicine and politics in the Platonic doctrine is not extrinsic, as if it were two disciplines analogous but of a different nature. We believe, on the contrary, that the relationship between the two sciences is substantial, by virtue of the political and therapeutic dimensions that both sciences essentially share. This affinity is possible as a result of the particular constitution of their object of study; the epistemological structure of the two sciences and the specific use of the persuasive discourse that both arts adopt to achieve their results. In order to examine our hypothesis we will investigate some passages from the Politicus, the Timaeus and the Laws.

[The European Directive 2001/20/EC on clinical trials in Italy]The European Directive 2001/20/EC legally ensured the implementation of the principles of good clinical practice in clinical trials on medicinal products in Europe. The Directive establishes, specific provisions regarding clinical trials conduction in all Member States, including multicenter trials on human subject involving medicinal products and harmonizes the practice of Independent Ethics Committees (IEC) and administrative provisions. In Italy, the European Directive was implemented by the Legislative Decree 211/2003 that considers three subsequent phases in the activation procedure of multicenter clinical trials: first, the clinical trial application submission to the IEC of both the coordinating and the participating centres as well as the administrative agreement submission to the Competent Authority of participating centres; second, the issuance of the "single" opinion by the IEC of the coordinating centre and, in case of positive opinion, the acceptance or refusal by the IEC of each participating centre; third, in case of acceptance, the trial contracts signature between the coordinating and each participating centre. Moreover, the European Directive defines the time required for issuing of opinion by the IEC. However, the high variability of documentation "centre-specific" required by independent ethics committee (IEC) plays a critical role in the time required for activation of participating centres of multicenter clinical trials. The harmonization of IECs practice in Italy and the reduction of the total number of IECs are the first step to facilitate multicenter clinical trials. Similar efforts should be made to standardize administrative procedures concerning the approval of clinical trials.

Mode of access: Internet. ; Colofón. ; Marca tip. en port. ; Frisos y cap. orn. ; Apostillas y reclamos ; Frontispicio calc. ; Sign.: []4, [cruz]6, 2[cruz]4, A-Z6, Aa-Rr6, Ss-Tt4, a-c4.

[Law is jurisprudence: "there is no certainty of tomorrow". Comment to: judgment of the Court of Milan, July 17th 2014]Today, more and more evidence is perfected a peculiar creation process of law: law is jurisprudence!The judgment of the Court of Milan, here under review, sets out a direction completely contrasting with the well-established theory of liability of "social contact" in the health sector.The point at issue? The same for some time, now: the Decree Balduzzi revived the responsibility model in force before the landmark ruling in 1999, or only represented a failure of the Legislator?The jurisprudential debate arises from the interpretation of Article 3 of Law 189 of November 8, 2012, the conversion of D.L. September 13, 2012 n. 158, the notorius "Decree Balduzzi".The Court of Milan promotes the interpretation that the second part of Article 3 of Law n. 189/2012, would change the "living law", making a choice in line with the purpose of containing the costs of compensation of public health and to remedy the phenomenon of so-called "defensive medicine", "throwing to the nettles" the usability in practice of the theory of social contact.The position taken by the Court of Milan cannot be shared: the reference to art. 2043 of the Civil Code must be interpreted as a failure of the Legislator, too worried about reducing health care costs. We must therefore continue to apply the model of liability of art. 1218 of the Civil Code, and then the theory of social contact. Anyway: posterity will judge!

[Patient safety in the hospital setting and the professional responsibilities of top managers] The authors underline the evolution of legislation concerning the creation of Hospital Companies and the reasons for the implementation of clinical risk management activities, then analyse the responsibilities involving the top figures of the top hospital management. In particular, the authors highlight the obligation and responsibilities of the strategic apex of a Hospital Company and show that, sometimes, the technical consultants – who express a medical-legal advice – underestimate the responsibility of these figures.It is a management responsibility that determines the obvious and inevitable consequences on those who work in contact with the patient and who bear the obligations and responsibilities.In some cases, the responsibility of the top figures is indisputable and obvious, but there is no awareness about the possibility of the top management involvement within the assessment evaluation.

[Patient safety in the hospital setting and the professional responsibilities of top managers] The authors underline the evolution of legislation concerning the creation of Hospital Companies and the reasons for the implementation of clinical risk management activities, then analyse the responsibilities involving the top figures of the top hospital management. In particular, the authors highlight the obligation and responsibilities of the strategic apex of a Hospital Company and show that, sometimes, the technical consultants – who express a medical-legal advice – underestimate the responsibility of these figures.It is a management responsibility that determines the obvious and inevitable consequences on those who work in contact with the patient and who bear the obligations and responsibilities.In some cases, the responsibility of the top figures is indisputable and obvious, but there is no awareness about the possibility of the top management involvement within the assessment evaluation.

[The workplace injury and work-related illness in the changing world of work. Legal obligations of the family doctor]This article describes functions and tasks of INAIL (the Italian insurance institutefor workplace injury and work related illness), given the changes in the world ofwork with its relevant legislation. In addition, the article explains the mission ofINAIL, in the prevention, insurance and rehabilitation.The main concepts that characterize the work injury and occupational disease aredefined. Then the legal obligations of family doctors in the treatment of injuriesand work related illnesses are highlighted.

Il contributo indaga la relazione tra gli ambiti retorico e medico nei dialoghi platonici attraverso la funzione di mito come 'rimedio utile'. Per Platone il mito è una via di mezzo tra verità e menzogna, salute e malattia, giustizia e ingiustizia, bene e male, e può avere una funzione educativa e terapeutica nella città ideale solo dopo una selezione 'chirurgica' dei contenuti tipici della poesia tradizionale. Inoltre, Platone critica anche la retorica e la medicina tradizionali: mentre la persuasione retorica è finalizzata unicamente a sé stessa, la medicina ippocratica non può costituire la più alta techne in quanto, contrariamente alla filosofia, concerne solo il soma e non la psyche. Il nesso retorica-medicina si complica ulteriormente se si considera la rifondazione di una 'sana mitologia', come mostra il mito della 'nobile menzogna', che costituisce un rimedio politico necessario per preservare la salute cittadina, mirando a persuadere i pazienti – governanti e cittadini – di una loro comune discendenza e dell'assegnazione di ruoli differenti nella polis. Tuttavia, nel XX secolo questa complessa intersezione tra retorica e medicina ha alimentato mistificazioni e fraintendimenti delle intenzioni platoniche, come dimostrano Popper e il dibattito conseguitone. ; The paper aims to investigate the relationship between rhetorical and medical fields in Plato's dialogues through the lens of myth as a 'useful remedy'. For Plato myth is a middle way between truth and lie, as well as health and disease, justice and injustice, good and evil. In this way, it can have both an educational and a therapeutic function in the ideal city only after a 'surgical' selection of the typical contents of traditional poetry. Plato also criticizes traditional rhetoric and medicine: while rhetorical persuasion is aimed only at itself, Hippocratic medicine is unqualified to be the highest techne because it deals only with the body and not with the soul, unlike philosophy. The rhetoric-medicine link gets more complicated considering the refoundation of a healthy mythology, as the myth of 'noble lie' shows. The noble lie constitutes a necessary political remedy to preserve city health and aims to persuade rulers and citizens (regarded as patients) to have a common ancestry and different tasks to be undertaken within the city. However, in the last century, this complex intersection between rhetoric and medicine gave rise to mystifications and misunderstandings of Plato's intentions, as Popper and the following debate demonstrates.