2024-03-28T11:48:15Z
http://medlib.mef.hr/cgi/oai2
oai:medlib.mef.hr:5
2011-10-03T13:49:20Z
7374617475733D756E707562
7375626A656374733D5753:575331
74797065733D746865736973
http://medlib.mef.hr/5/
Utjecaj postojeće regionalizacije zdravstvene zaštite novorođenčadi na pomor novorođenčadi vrlo niske
porodne težine u dvogodišnjem razdoblju (1998-1999.)
u Republici Hrvatskoj [ Influence of present regionalization of neonatal health care on mortality of very low birth weight infants in a two-year period (1998-1999.) in Republic of Croatia ]
Filipović Grčić, Boris
WS 1-100 Reference Works. General Works
This is the first national study of survival of very-low-birth-weight (VLBW) infants to discharge from hospital in Republic of Croatia. In the period 1.1.1998.-31.12.1999., 672 VLBW infants were live-born, and they consisted 0.72% of all liveborns.
Among them, 663 had known outcome, and 51.9% of them survived to discharge from hospital. Out of 672 infants, 25.2% were born in maternities with level I. neonatal facilities, 13.5% in maternities with level II. neonatal facilities, and 61.3% in maternities with level III. neonatal facilities, respectively. The number of newborns which were born in maternities with level III. neonatal facilities is smaller than that in countries with regionalized perinatal care.
In further analysis the influence of risk factors to survival to discharge was investigated. Number of infants in this group was reduced to these who fulfilled the criteria (N=538). Average birth-weight was 1177.9 ± 227.3 g, average gestational age was 29.5 ± 2.9 completed weeks, and average CRIB score was 4.86.
Survival to discharge from hospital in this group was 61%, early neonatal mortality was 28.1%, and neonatal mortality was 36.1%. In investigated population of very low birth weight infants neonatal and postneonatal mortality is greater than in more developed countries.
CRIB score is shown to be better predictor of survival of these infants to discharge from hospital than birth weight and gestational age.
Analysis of standardized mortality ratio by CRIB score showed that survival to discharge was greatest in infants who were born in maternities with level III. neonatal facilities, than in infants who were born in maternities with level II. neonatal facilities, and lowest in infants who were born in maternities with level I. neonatal facilities. Ranking of different levels of neonatal facilities by survival obtained by crude mortality was the same as ranking obtained by standardized mortality ratio by CRIB score.
Overall 98 infants were transferred to neonatal facilities of higher organizational level in the first 36 hours of age. Outcomes of all infants were attributed to the levels of neonatal facilities where they were treated longer period from 12th to 72nd hours of life. Of 538 infants, 58 were treated in level I. neonatal facilities, 73 in level II. neonatal facilities, and 407 in level III. neonatal facilities, respectively.
Ranking of these patient subgroups and levels of neonatal facilities by survival obtained by crude mortality was different than ranking by survival obtained by standardized mortality ratio by CRIB score. Level III. neonatal facilities were found to be the best place for delivery, but also for the treatment of such infants. Level III. neonatal facilities also improved the survival for infants postnataly transferred from level I. and level II. neonatal facilities.
It can be concluded that is necessary, in the aim of increasing survival of these infants, to increase proportion of infants to be born in maternities with level III. neonatal facilities by forcing transportation "in utero". For those infants born in maternities with level I. and II., postnatal transportation should be forced toward level III. neonatal facilities.
Also, it can be suggested to collect the data for completing the CRIB score of such infants routinely, in attempt to compare the outcome between perinatal and neonatal facilities more fairly, taking into account the specificities of each patient caused by severity of initial disease.
2003-04-10
Thesis
NonPeerReviewed
application/pdf
en
http://medlib.mef.hr/5/1/Filipovic_Grcic__Boris.pdf
Filipović Grčić, Boris (2003) Utjecaj postojeće regionalizacije zdravstvene zaštite novorođenčadi na pomor novorođenčadi vrlo niske porodne težine u dvogodišnjem razdoblju (1998-1999.) u Republici Hrvatskoj [ Influence of present regionalization of neonatal health care on mortality of very low birth weight infants in a two-year period (1998-1999.) in Republic of Croatia ]. PhD thesis, Sveučilište u Zagrebu.
oai:medlib.mef.hr:1872
2013-03-15T09:28:26Z
7374617475733D756E707562
7375626A656374733D5753:5753343632
74797065733D746865736973
http://medlib.mef.hr/1872/
Povezanost usklađenosti roditelja u odgoju s emocionalnim i ponašajnim problemima adolescenata [The relationship between coparenting and adolescent emotional and behavioral problems]
Boričević Maršanić, Vlatka
WS 462-463 Adolescent Psychology. Adolescent Psychiatry
INTRODUCTION: The aim of this study was to examine the relationship between
coparenting and adolescent emotional and behavioral problems, and whether there were
differences according to adolescent gender. We also examined the relationship between
coparenting and overall family functioning, and parent-adolescent bonding. The predictive
value of coparenting, overall family functioning, and parent-adolescent bonding for
adolescent behavior problems was determined.
SUBJECTS AND METHODS: The study completed 241adolescents, 122 adolescents in the
clinical and 119 in the control group. Adolescents were aged 15 to 18 years. The clinical
group included adolescents referred to their first psychiatric interview at the psychiatric
Hospital for Children and Youth, Zagreb. The control group included adolescent who have
never been in psychiatric treatment in general practitioners' offices at he Helth Center Zagreb
– Zapad, Zagreb. Both biological parents of adolescents who were married, were also
included in the study. The participants filled in self-report questionnaires that assess the
quality of the coparenting relationship, overall faily functioning, parent-adolescent bonding
and adolescent emotional and behavioral problems.
RESULTS: Supportive coparenting was significantly lower in families with adolescents in
the clincal group than in the control group. Parents' characteristics had greater impact on
supportive coparenting than adolescents' characteristics. Supportive coparenting was
significantly higher in families with adolescents whose parents had higher level of education,
107
and lower in families with adolescents whose parents had a history of psychiatric illness. The
difference in supportive coparenting according to adolescent gender was not significant.
Supportive coparenting was significantly and negatively associated with male and female
adolescent emotional, behavioral and total problems, except for supportive coparenting
reported by fathers and emotional problems of male adolelscents. Supportive coparenting was
significantly and negatively associated with the number of problems in overall family
functioning, significantly and positively with parental care, and significantly and negatively
with maternal overprotection on the sample of female adolescents and paternal overprotection
on the total sample. The results of this study indicate significant differences in supoortive
coparenting according to the type of parent-adolescent bonding, such that with the increase in
supportive coparenting, the type of mother-adolescent bonding and father-adolescent bonding
improves.
Supportive coparenting predicted adolescent exteranlizing behavior problems, but not
internalizing problems.
CONCLUSION: Findings from this study underscore the role of coparenting for adolescent
externalizing behavior problems and the need to include the evaluation of this family
relationship in the initial assesment. Family interventions targeting the coparenting
relationship may be highly appropriate for families with adolescents referred for externalizing
symptoms.
2011-12-06
Thesis
NonPeerReviewed
application/pdf
en
http://medlib.mef.hr/1872/1/mar%C5%A1ani%C4%87.pdf
Boričević Maršanić, Vlatka (2011) Povezanost usklađenosti roditelja u odgoju s emocionalnim i ponašajnim problemima adolescenata [The relationship between coparenting and adolescent emotional and behavioral problems]. PhD thesis, Sveučilište u Zagrebu.