To examine the associations between marital status, place of residence, self-reported health status, quality of life, and physical activity among older adults during the COVID-19 pandemic. This cross-sectional study enrolled 962 participants aged 65 and older, surveyed between March 2020 and May 2023. Respondents were categorized according to marital status (married/living with a partner, single, divorced, widowed) and place of residence (own home vs nursing home). Standardized instruments were used: the Short Form Health Survey-36 for health status, the Personal Well-being Index for quality of life, and the Croatian short version of the International Physical Activity Questionnaire. Respondents who were married or living with a partner reported significantly higher levels of physical activity, better physical and mental health, and greater life satisfaction than single, divorced, or widowed respondents (P<0.001). Community-dwelling respondents scored significantly higher on most health and quality-of-life indicators than nursing home residents, except for perceived future security. Marital status and living arrangements significantly affected the self-perceived health, physical activity, and quality of life of older adults during the COVID-19 pandemic. The results emphasize the importance of social support and residential context in promoting healthy aging.

To compare the accuracy, scientific adequacy, and clarity of responses provided by ChatGPT-4o and Gemini to frequently asked patients' questions about warfarin use. Forty patients' questions were posed to ChatGPT and Gemini using the zero-shot method. Four cardiovascular surgeons evaluated the responses for adequacy, scientific accuracy, and clarity on a 5-point Likert scale. The first and second set of data evaluations were separated by seven days to minimize any memory effect. The experts were blinded to the type of LLM that created the response. ChatGPT responses were significantly shorter (187.3±47.6 vs 291.4±98.1 words; P<0.001) but scientifically more adequate (4.38±0.30 vs 4.17±0.35; P=0.004). Gemini scored higher in terms of clarity (4.69±0.24 vs 4.48±0.33; P<0.001). The two models did not significantly differ in terms of accuracy (P = 0.606). Both LLMs provide reliable and understandable information for warfarin counseling. While ChatGPT provides dense and scientifically detailed responses, Gemini excels in clarity and user-friendly communication. However, expert supervision and appropriate clinical guidance are critical for safe and comprehensive guidance.

AimTo assess health care professionals’ knowledge and opinions regarding extracorporeal membrane oxygenation (ECMO) use, training, standards, and resource availability.MethodsThis cross-sectional study employed an online self-administered survey to evaluate health care professionals' knowledge and opinions concerning ECMO procedures. The survey consisted of multiple-choice and open-ended questions inquiring about demographics, ECMO practices, training and certification experiences, ECMO use during the COVID-19 pandemic, and obstacles to ECMO implementation.ResultsThe study enrolled 89 health care professionals from 12 countries. The respondents were most frequently from Kazakhstan (67.4%), Turkey (5.6%), Croatia (5.6%), and Ukraine (5.6%). Notably, 61.8% of respondents supported ECMO procedures performed by certified specialists. The respondents believed that the main ECMO indications were respiratory failure (83.1%), cardiopulmonary failure (69.6%), heart and lung transplantation (64.1%), and cardiogenic shock (58.4%). Major obstacles to ECMO implementation were reported to be high costs (53.9%), inadequately qualified staff (52.8% for physicians, 41.6% for nurses), and restricted availability of ECMO devices (42.7%).ConclusionThe findings emphasize the need for standardized training, wider availability of ECMO standards, and efforts to address resource-related barriers to ECMO access. Our results primarily reflect practices in Kazakhstan and should be interpreted in light of the study's restricted geographical coverage.

AimTo evaluate the feasibility, participation rate, diagnostic pathway performance, and early detection outcomes of the first year of the Croatian pilot prostate cancer screening program (CROState) implemented in Zagreb.MethodsThis prospective pilot program invited men aged 55-69 years without a prior prostate cancer diagnosis or prostate-specific antigen (PSA) testing in the past 12 months. Recruitment was conducted by general practitioners. Men with PSA>4 ng/mL underwent repeat testing, and if PSA was elevated again, they were referred to one of two university hospitals for further evaluation. The diagnostic pathway included multiparametric magnetic resonance imaging, urological examination, and transperineal fusion biopsy when indicated. All confirmed cancer cases were reviewed by a multidisciplinary team.ResultsA total of 5251 men were invited to the program, of whom 4930 (93.9%) participated in PSA testing. Elevated PSA was detected in 419 (8.5%). Only 157 (37.5%) men completed repeat PSA testing, and 123 men were referred for hospital evaluation. Eighty-eight patients completed advanced diagnostics, with 83 undergoing magnetic resonance imaging. Forty-two men proceeded to biopsy, of whom 27 had positive results (64.3%). Most cancers were clinically significant; only two men fulfilled criteria for active surveillance. The main challenge was incomplete adherence to repeat PSA testing.ConclusionThe CROState pilot demonstrated high initial participation and high detection rate of prostate cancer, with a few clinically insignificant tumors, when combining PSA testing with advanced imaging and targeted biopsy. Limited compliance with repeat PSA testing must be addressed before wider national implementation.

AimTo examine the relationship between pain conceptualization and treatment outcomes in patients with chronic nonspecific low back pain (CNSLBP) undergoing physiotherapy, and to explore the influence of educational attainment on pain conceptualization.MethodsThis prospective observational study enrolled 84 adults (mean age ≈50 years) receiving exercise-based physiotherapy for CNSLBP in an outpatient setting. Outcome measures included pain intensity (Numeric Pain Rating Scale), disability (Roland-Morris Disability Questionnaire), and health-related quality of life (EQ-5D-5L index and EQ-VAS), assessed before and after treatment. Pain conceptualization was measured with the Croatian version of the Concept of Pain Inventory for Adults (COPI-Adult).ResultsSignificant post-treatment improvements were observed in pain (−2.41), disability (−5.27), EQ-5D-5L index (+0.128), and EQ-VAS (+13.79) (all P < 0.001). Higher COPI-Adult scores were weakly and negatively correlated with pain (r = −0.273, P = 0.012) and disability (r = −0.259, P = 0.018), and positively with HRQoL (EQ-5D-5L: r = 0.295; EQ-VAS: r = 0.323). However, pain conceptualization did not significantly moderate the magnitude of outcome changes (all interaction effects P > 0.005). Participants with higher education scored significantly higher on COPI-Adult (P = 0.014; d = 0.55).ConclusionsWhile pain conceptualization is associated with post-treatment pain, disability, and HRQoL outcomes, it does not predict the degree of improvement after physiotherapy. Educational attainment influences pain conceptualization, which indicates a need for tailored communication strategies in rehabilitation. The Croatian COPI-Adult is a reliable tool for assessing patients' concepts of pain within CNSLBP care.

AimTo evaluate whether adding a medical assistant (MA) during team substitutions improves workload, access to care, preventive activities, and staff-reported working conditions in Zagreb family medicine practices.MethodsThis case-control study involved 60 family medicine practices: 30 with an integrated MA during summer vacation team substitutions and 30 controls. Patient contacts, task distribution, and health care professionals' feedback were assessed. The MAs involved were medical or nursing students in their final years, who undertook non-medical tasks under supervision by health care staff.ResultsTeams with an MA demonstrated a significant 10.55% increase in total patient contacts, responded to significantly more patient emails and phone calls, and performed significantly more preventive and chronic disease panels. Furthermore, MAs in these teams resolved up to 39% of consultations without the need for patients to directly contact health personnel. Healthcare professionals in these teams reported improved job satisfaction, reduced work-related stress, and better overall working conditions than the control group.ConclusionIntegrating an MA during team substitutions is a promising strategy for enhancing operational efficiency and improving health care standards in family medicine practices. MAs have the potential to address administrative challenges and promote patient-centered care.