Suchergebnisse

Smjernice za kliničku praksu važan su dio medicinske prakse utemeljene na dokazima. Ovaj članak daje sažeti prikaz iskustva zemalja Europske unije u pravnoj regulaciji kliničkih smjernica, njihovom razvoju, kontroli kvalitete smjernica, primjeni i uporabi, te evaluaciji primjene smjernica. Iskustva zemalja s razvijenim sustavom kliničkih smjernica mogu biti korisna za daljnje podizanje kvalitete kliničkih smjernica u Hrvatskoj. ; Clinical practice guidelines are an important part of evidence-based clinical practice. This article presents a brief overview of the experiences in the European Union in legal regulation of clinical practical guidelines, their development, quality control, application and use, and evaluation of use. Experiences from countries with established system of clinical practice guidelines may be a useful step for the further development of quality practice guidelines in Croatia.

Aim: The aim of this study was to examine the moral foundations structure in the Croatian population, and to examine possible changes in moral foundation structure after a major political scandal in Croatia. Methods: We conducted an online survey using Moral Foundations Questionnaire and Key Social Issues Scale, which was distributed in two waves, in 2009 and 2014. Participants were invided from the Faculties of Humanities and Social Sciences at the universities in Zagreb and Split and asked to distribute the survey to colleagues and friends. Results: 3000 participants completed the survey in 2009, 1323 participants completed the survey in 2014. In both samples, most participants reported that they relied more on individual foundations of "Care/Harm" and "Fairness/Cheating", than on relational foundations of "Loyalty/Betrayal", "Authority/Subversion" or "Sanctity/Degradation", which are typically more valued by traditionally oriented or conservative individuals. Comparison of the two measurement time points indicated that scores on traditional foundations significantly decreased, while liberal values increased. These changes were triangulated and confirmed by the results on the Key Social Issues Scale. Conclusion: This is, to the best of our knowledge, the first study which analysed the changes in the moral foundations structure after a major political scandal, implicating that negative political events may decrease the expression of moral foundations related to the values which are nurtured by a political party involved in the scandal.

IntroductionDespite increased visibility of clinical trials through international trial registries, patients often remain uninformed of their existence, especially if they do not have access to adequate information about clinical research, including the language of the information. The aim of this study was to describe the context for transparency of clinical trials in Croatia in relation to countries in Central and Eastern Europe, and to assess how informed Croatian patients are about clinical trials and their accessibility. Materials and methodsWe assessed the transparency of clinical trials from the data available in the public domain. We also conducted an anonymous survey on a convenience sample of 257 patients visiting two family medicine offices or an oncology department in south Croatia, and members of national patients' associations. ResultsDespite legal provisions for transparency of clinical trials in Croatia, they are still not sufficiently visible in the public domain. Among countries from Central and Eastern Europe, Croatia has the fewest number of registered trials in the EU Clinical Trials Registry. 66% of the patients in the survey were aware of the existence of clinical trials but only 15% were informed about possibilities of participating in a trial. Although 58% of the respondents were willing to try new treatments, only 6% actually participated in a clinical trial. Only 2% of the respondents were aware of publicly available trial registries. ConclusionsOur study demonstrates that there is low transparency of clinical trials in Croatia, and that Croatian patients are not fully aware of clinical trials and the possibilities of participating in them, despite reported availability of Internet resources and good communication with their physicians. There is a need for active policy measures to increase the awareness of and access to clinical trials to patients in Croatia, particularly in their own language.

Acute crises, such as a war or a pandemic, are the ultimate tests for health care systems' resilience (temporary response to stress with change and adaptation) and antifragility (permanent benefit from change in response to stress). In this Health Policy paper, we analyse and discuss how the healthcare systems of two European countries – Bosnia and Herzegovina and Croatia – adapted to war as a man-made disaster, and how they adapted to COVID-19 pandemic twenty-five years later. These countries experienced full scale wars in recent history, which significantly changed their political and healthcare systems. This experience prepared the countries for the response to the pandemic, which coincided with two earthquakes in Croatia. We argue that healthcare systems in Croatia and Bosnia and Herzegovina are not only resilient but antifragile, and that they benefited from stressors they were exposed to. The antifragility of the two systems were primarily based on human effort – the strength, adaptability and resilience of health care professionals. We will look at lessons from the wars that were applied to the pandemic and discuss newly recognized opportunities and improvements.

The study aimed to examine whether the use of words related to different moral foundations can predict the perceived severity of research misconduct. We gave two groups of participants, undergraduate medical students, the same hypothetical scenarios of research misconduct cases containing words related to different aspects of morality, and asked them to assess how inappropriate the described behavior was. Students ranked the described behaviors differently by the inappropriateness of the behavior, but the group wording was not a significant predictor of appropriateness. The reasons for the ranking were not related to any standardized procedures for research integrity but were related to the moral assessment of the students, which was assessed using qualitative approach. The results of this study implicate that personal moral views are an important part in research integrity training.

To foster research integrity (RI), it is necessary to address the institutional and system-of-science factors that influence researchers' behavior. Consequently, research performing and research funding organizations (RPOs and RFOs) could develop comprehensive RI policies outlining the concrete steps they will take to foster RI. So far, there is no consensus on which topics are important to address in RI policies. Therefore, we conducted a three round Delphi survey study to explore which RI topics to address in institutional RI policies by seeking consensus from research policy experts and institutional leaders. A total of 68 RPO and 52 RFO experts, representing different disciplines, countries and genders, completed one, two or all rounds of the study. There was consensus among the experts on the importance of 12 RI topics for RPOs and 11 for RFOs. The topics that ranked highest for RPOs concerned education and training, supervision and mentoring, dealing with RI breaches, and supporting a responsible research process (e.g. through quality assurance). The highest ranked RFO topics concerned dealing with breaches of RI, conflicts of interest, and setting expectations on RPOs (e.g. about educating researchers about RI). Together with the research policy experts and institutional leaders, we developed a comprehensive overview of topics important for inclusion in the RI policies of RPOs and RFOs. The topics reflect preference for a preventative approach to RI, coupled with procedures for dealing with RI breaches. RPOs and RFOs should address each of these topics in order to support researchers in conducting responsible research.