Croatian Society Research Articles

Digital Health in Croatia: Key stakeholders’ perspective of societal and institutional readiness

Abstract Background According to the literature, digital health brings an innovative approach to healthcare and an inevitable transformation and disruption. The potential of digital technologies is far-reaching, from preventive medicine to addressing public health challenges. However, the implementation also significantly depends on the social & cultural context. Methods To research Croatia’s expectations, challenges, and readiness for implementing digital health, interviews were conducted with physicians, patients, hospital managers, policymakers, jurists, and engineers (n = 75). Following identifying key themes, a survey was conducted among Croatian medical students (n = 775) at the end of 2022. Results Key stakeholders believe implementation preparedness is demonstrated through institutional and societal readiness. Prominent characteristics of societal readiness include appropriate infrastructure and legal and financial frameworks. Societal readiness is assessed through digital and health literacy and existing social practices within Croatian society. Only 4.6% of medical students believe Croatia’s healthcare system is ready to implement digital technologies. They perceive the highest readiness regarding digital education (63.7%) and the digital literacy of physicians (60.9%) while negatively evaluating healthcare infrastructure, financial resources, and patient literacy. The results highlight numerous aspects that must be addressed for successful implementation, many of which have been neglected in previous periods. Conclusions The research identifies critical aspects of the social context and presents valuable implications for the digital health transformation. Key stakeholders assess that institutional and societal readiness is not at the level required for the sustainable implementation of digital health, thus necessitating specific actions, ranging from governmental bodies and international organisations to the health system, education system, and media. Key messages • It’s crucial to align digital health implementation with the social & cultural context and capabilities. • The prerequisites for successful implementation necessitate engagement across various societal domains beyond the healthcare system.

Laboratory medicine and sports: where are we now?

Laboratory medicine in sport and exercise has significantly developed during the last decades with the awareness that physical activity contributes to improved health status, and is present in monitoring both professional and recreational athletes. Training and competitions can modify concentrations of a variety of laboratory parameters, so the accurate laboratory data interpretation includes controlled and known preanalytical and analytical variables to prevent misleading interpretations. The paper represents a comprehensive summary of the lectures presented during the 35th Annual Symposium of the Croatian Society of Medical Biochemistry and Laboratory Medicine. It describes management of frequent sport injuries and sums up current knowledge of selected areas in laboratory medicine and sports including biological variation, changes in biochemical parameters and glycemic status. Additionally, the paper polemicizes sex hormone disorders in sports, encourages and comments research in recreational sports and laboratory medicine. In order to give the wider view, the connection of legal training protocols as well as monitoring prohibited substances in training is also considered through the eyes of laboratory medicine.

National recommendations of the Croatian Chamber of Medical Biochemists and Working group for Laboratory hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine: Management of samples with suspected EDTA-induced pseudothrombocytopenia.

Pseudothrombocytopenia (PTCP) is defined by the occurence of spouriously low platelet count as a consequence of in vitro platelet aggregation. It is a rare and benign artifact, not associated with any specific disorder or therapy, that becomes clinically relevant when it is not timely and reliably recognized. Thus, it may result in inappropriate clinical decisions (i.e. unnecessary further testing, misdiagnoses and potential patients' mismanagement) unavoidably compromising patient safety. The most common form of PTCP is caused by ethylenediaminetetraacetic acid (EDTA). Several approaches for the management of samples with EDTA-induced PTCP have been described in the literature. However, expert recommendations are scarce. The scope of these recommendations is to assist in achieving national harmonisation in laboratory management (i.e. detecting and reporting platelet counts) of samples with EDTA-induced PTCP. These minimal recommendations were prepared by the members of the joint working group of the Croatian Chamber of Medical Biochemists and Working group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine, and might be customized according to specific conditions (i.e. personnel and equipment) of each individual laboratory. These recommendations are primarily intended to all laboratory professionals involved in the management of samples with EDTA-induced PTCP, but also to other healthcare professionals involved in collecting samples and interpreting complete blood count results.

Monuments in the City of Zagreb as a Reflection of Croatian Society in Space and Time

This paper presents a sociological analysis of the monumental heritage of the City of Zagreb. Monuments are understood and described as „carriers of symbols” through which the ruling elites in a certain time and space endeavor to shape public opinion. A special focus has been given to the analysis of the temporal and spatial dimensions of monument management. The spatial dimension refers to the characteristics of a particular monument and the broader context of the space, that is, the environment in which it was placed. The temporal dimension refers to the management of monumental heritage by the ruling elites, which change in the process of elite circulation. The process of elite circulation is accompanied with efforts for imposing a historical narrative, which is necessarily a selective process in which certain parts of the collective memory are forgotten and others highlighted. Finally, this paper offers a temporal, that is, historical, context of the installation and meaning of the monumental heritage in the City of Zagreb, both for the people of Zagreb and for the entire Croatian nation.

Guidelines for evaluation and treatment of gastroesophageal reflux disease in children – Recommendations of the Croatian Society for Pediatric Gastroenterology, Hepatology and Nutrition of the Croatian Medical Association

Guidelines for evaluation and treatment of gastroesophageal reflux disease in children – Recommendations of the Croatian Society for Pediatric Gastroenterology, Hepatology and Nutrition of the Croatian Medical Association

Transforming anger into resilience: The Zagreb Pride LGBTIQ NGO and stigmatized youth in Croatia

After an intensive marriage referendum campaign in 2013, organized by the ‘In the Name of Family’ organisation (Cro. U ime obitelji), the definition of marriage as a union between a man and a woman was included in the Croatian constitution. At the time of the campaign, the participants in this research were young people, most of whom were in elementary or secondary school. Considering most of them had not come out to their immediate social circle, they were particularly vulnerable because of the visibility that was imposed on them.This article will introduce the results of ethnographic research on the Zagreb Pride LGBTIQ non-governmental organisation, as part of which we conducted 31 semi-structured interviews with former and (at the time) current members of the organisation. We focused on three different issues: 1. How the marriage referendum campaign affected young LGBTQ individuals and their social engagement; 2. Why they saw their identity as an expression of political activism; 3. How they transformed their initial negative feelings into resilience and political activism.The results show that the marriage referendum campaign had a significant impact on young LGBTQ people, transforming their initial feelings of anger and fear into resilience. Considering the political and social context in Croatian society at the time, our participants noted that they thought about their coming out as a political act. Consequently, this inspired them to further mobilise and take part in political activism.

ESHRE guideline: number of embryos to transfer during IVF/ICSI†.

ESHRE guideline: number of embryos to transfer during IVF/ICSI†.

The Principle of Solidarity and Fraternity/Brotherhood in Socialist Yugoslavia in the Light of the Catholic Social Teaching

The paper is divided into two parts. The first part explains the concept of solidarity and fraternity on a theoretical level, especially in the light of Catholic social teaching. The second part analyzes the principles of solidarity and fraternity in Croatian society during the National Federal Republic of Yugoslavia and the Socialist Federal Republic of Yugoslavia. In addition to solving the national question under a specific aspect of brotherhood, this term was understood in the spirit of the communist ideology of brotherhood and unity of the Yugoslav peoples, and the ideology of solidarity was present predominantly in the form of self-governing socialism. The paper, therefore, shows how socialist Yugoslavia had many characteristics of a totalitarian system defined by communist ideology.

NA PUTU PREMA RODNOJ RAVNOPRAVNOSTI ŽENA U HRVATSKOM DRUŠTVU

After more than half a century since the beginning of a global movement for women’s rights, humanity still has a long way to go before achieving true gender equality. Currently, achieving equality of women and men is an important political and strategic goal at the global and European levels, as well as in the Republic of Croatia. This paper aims to provide a brief overview of the historical development of women’s rights in global and national contexts, to analyse the legislative and institutional framework of protection of women’s rights to equality and non-discrimination in the Republic of Croatia, and to present current data on the equality index of women and men in the Republic of Croatia based on international measurements. In conclusion, the current status of women on the way to achieving gender equality in Croatian society will be reviewed critically.

(KAZNENO)PRAVNI POLOŽAJ DJETETA U SUKOBU SA ZAKONOM U REPUBLICI HRVATSKOJ: TEMELJNI OBRISI

The contemporary society has long recognized the child’s special position in the legal and judicial systems. Given that law is a reflection of societal understandings, such developments are the result of increased awareness of the need to adjust the law to the child at the normative and institutional levels, as well as the child’s unique protection within the legal (judicial) system. This is (must be) especially true in the repressive part of that system, i.e. criminal and misdemeanor law. The phrase “child in conflict with the law” appears in the more recent development of juvenile criminal law, so we will use it here as well. Therefore, in this paper, we provide an overview of the normative foundations and perspectives of the position of children in criminal and misdemeanor law, both at the supranational level (in terms of standards and impact on changes) and at the national level (in terms of the state and needs of Croatian society). The paper also discusses the position of the child as a victim of a criminal offense.

Memory of Communist Crimes in Croatia and the Influence of the European Culture of Remembrance

Abstract Dealing with various aspects of 20th century history still poses a significant challenge to Croatian society. This also includes dealing with the socialist period. In the last fifteen years, propelled by the Eastern enlargement (2004, 2007), the EU has developed a common European memory of the totalitarian and authoritarian regimes of the 20th century, including communism. This article analyzes the impact of a common European culture of remembrance on Croatian commemorative culture, especially remembrance of communist crimes. The analysis will include the political discourse of selected mnemonic actors and commemorative practices. In 2011, the Croatian Parliament passed a law to commemorate the European Day of Remembrance of Victims of All Totalitarian and Authoritarian Regimes every August 23. However, the article argues that a shared European memory had only limited success on Croatian debates and conflicting narratives on communist crimes and the socialist period. The main reason is the dominantly antagonistic mode of remembering and representing of the communist period in Croatia.

Political Modernization and Democratization in Croatia

Abstract This article deals with Croatian democratization as the most important process of its political modernization and identifies the main facilitating and inhibiting factors and their influence on its outcomes. The analysis is carried out at the sociostructural, institutional-political and sociocultural levels, while the outcomes of democratization are evaluated in relation to the features of a consolidated (substantive) democracy and the basic features of political modernization. It is shown that the specific sociostructural and sociocultural features – modeled by contingent factors – had a decisive influence on the context, processes and actors of democratization and its outcomes. It turns out that elite-driven democratization in such a specific context produced further limited modernization. Despite the normative-institutional consolidation and stability of democracy, incomplete sociostructural modernization and sociocultural adaptation, as well as democratic deficits, indicate that the political modernization of Croatian society and the state is still an open process.

Point of care testing in Croatia: a survey of the Working group for point of care testing of the Croatian society of medical biochemistry and laboratory medicine.

The aim of this study was to investigate attitudes and routine procedures in point of care testing (POCT) among non-laboratory and laboratory healthcare professionals in Croatia. The Working Group (WG) for POCT of the Croatian society of medical biochemistry and laboratory medicine has designed two anonymous surveys for laboratory staff and non-laboratory staff with a total of 44 questions/statements on POCT (27 questions for non-laboratory staff and 17 for laboratory staff). Surveys were sent to 184 medical biochemistry laboratory (MBL) managers, the Croatian medical chamber and the Croatian chamber of nurses. The survey was disseminated using the online survey platform SurveyMonkey. A total of 112 non-laboratory healthcare professionals and 50 laboratories participated in the survey, which represents a response rate of 0.25% for non-laboratory professionals and 27% for MBLs. The majority of non-laboratory staff stated that POCT enables better medical care for the patient (90/112) and that the implementation of new POCT devices should be the responsibility of a POCT team comprising laboratory and clinical healthcare professionals. The great majority of responding MBLs (42/50) acknowledge that POCT is necessary for better patient care, and also realize that validation of POCT devices and comparison to the central laboratory is necessary before implementation (49/50). The majority of participants consider POCT as a medical tool that enables better patient care but there is still a lack of communication between laboratory and clinical staff. The study identified some critical spots that will help to create national guidelines to ensure high patient safety when using POCT devices.

Renal Denervation in the Treatment of Resistant Hypertension and Difficult-to-Control Hypertension - Consensus Document of the Croatian Hypertension League - Croatian Society of Hypertension, Croatian Cardiac Society, Croatian Endovascular Initiative, Croatian Society for Diabetes and Metabolic Diseases, Croatian Renal Association, and Croatian Society of Family Physicians of the Croatian Medical Association.

Renal denervation (RDN) as a method of treating arterial hypertension (AH) was introduced in Croatia in 2012. A multidisciplinary team and a network of hospitals that diagnose and treat patients with severe forms of AH were established, and a very strict diagnostic-treatment algorithm was prepared. At monthly meetings patients with truly resistant hypertension who were candidates for RDN were discussed. According to the 2021 ESH position statement and 2023 ESH guidelines, RDN is considered an alternative and additional, not a competitive method of treating patients with various forms of AH which must be performed by following a structured procedure and the patient's preference should be considered. In view of the changes in the global scientific community, the Croatian Hypertension League brings this consensus document on RDN conducted with radiofrequency-based catheter, the only currently available method in Croatia. In this document, exclusion and inclusion criteria are shown, as well as three groups of patients in whom RDN could be considered. The new diagnostic-treatment algorithm is prepared and follow-up procedure is explained. In Croatia, RDN is reimbursed by the national insurance company, thus pharmacoeconomic analyses is also shown. Criteria required by an individual centre to be approved of RDN are listed, and plans for prospective research on RDN in Croatia, including the Croatian registry for RDN, are discussed.

The Socioeconomic Position of National Minorities with a Special Emphasis on Slovenes in Croatia over the Past Thirty Years

Abstract The article presents the situation of members of the Slovene community in Croatia, focusing on selected aspects of their socioeconomic participation (inclusion) in Croatian society. This topic has not been thoroughly studied yet, firstly due to the low interest of researchers in the position and activities of members of the Slovene community in Croatia, and secondly due to a continuous lack of data on the socioeconomic participation of members of not only the Slovene community but of all minorities in Croatia in general. Based on the analysis of data mainly collected from Croatian official reports, the situation of members of the Slovene minority in Croatia is presented mainly in relation to the exercise of their rights to education and employment.

Health literacy, religiosity, and political identification as predictors of vaccination conspiracy beliefs: a test of the deficit and contextual models

The primary focus of this paper is to investigate the influence of science literacy, particularly health literacy, on vaccine-specific conspiracy beliefs, within the broader context of vaccine hesitancy. The authors tested deficit (scientific literacy shapes science attitudes) and contextual models (contextual variables exert direct influence and influence the connection between literacy and science attitudes) in a survey research study (N = 729) in Croatia. The analytical approach included structural equation modeling with vaccination conspiracy beliefs as the outcome variable and health literacy, religiosity, and political identification as predictors. The results showed that lower health literacy and higher religiosity were related to higher vaccination conspiracy beliefs, which was not the case for political identification. In addition, the moderating effect of religiosity on the relationship between health literacy and conspiracy beliefs was confirmed. In contrast, the moderating effect of political identification was not confirmed, thus partially confirming the stronger version of the contextual model. The authors comparatively discuss the results by evoking specific socio-political characteristics of Croatian society as well as the reactions of political and religious organizations to the COVID-19 pandemic.

Structural-interactional Determinants of Patriotism in Croatian Society

Domoljublje je pojam koji ne karakterizira terminološko već živopisno određenje. To znači da se u razmatranju pojma domoljublje ne valja zadovoljiti definicijom već načinima na koje ljudi percipiraju domoljublje u okvirima svakodnevnog života. U hrvatskom je društvu domoljublje česta tema u javnom prostoru i stoga ovaj rad analizira veze između povjerenja u različite skupine institucija i percepcije domoljublja. Razlog proučavanja odnosa opisane veze može se pronaći u teorijskom razmatranju domoljublja kao specifičnog za interakcijsku sferu, a koja je pod utjecajem strukturalnih silnica društva pa se i sama percepcija domoljublja reflektira kroz odnos pojedinaca prema pojedinim institucijama. Podaci su dobiveni pomoću metode anketnog istraživanja na neprobabilističkom uzorku, a sama analiza je napravljena faktorskom analizom i strukturalnim modeliranjem. Pomoću faktorske analize su dobivene dvije dimenzije za percepciju domoljublja, a koje su nazvane »pozitivna percepcija« i »negativna percepcija domoljublja«; te dvije dimenzije za povjerenje u institucije, a koje su na temelju vrsta institucija nazvane »institucije visokog povjerenja« i »institucije niskog povjerenja«. Zadnje dvije dimenzije su se u strukturalnom modeliranju promatrale kao egzogeni konstrukti, te se pokazalo da dimenzija »institucije visokog povjerenja« može poslužiti kao dobar prediktor za dimenziju »pozitivna percepcija« domoljublja (standardizirani koeficijent = 0,75), dok je za ostale promatrane odnose između dimenzija pronađena relativno slabija mogućnost predikcije (između -0,27 i -0,06). Također, pokazalo se da su prethodno opisani odnosi ostali konzistentni i nakon uvođenja u model kontrolnih varijabli spol, dob i obrazovanje.

Croatian Microscopy Society 1983-2022

This paper provides a brief overview of the history of the Croatian Microscopy Society on the occasion of its 30th anniversary as an independent society and the 40th anniversary of its foundation. The overview chronologically details the period of the Society's work as the Section for Electron Microscopy of the Croatian Natural Science Society (1983-1992), followed by its independent activity first as the Croatian Society for Electron Microscopy (1992-2006) and finally as the Croatian Microscopy Society (2006-present). The review concludes with recent trends and policies in the Society's development. The review is an extended excerpt from the opening speech held by the Chair of the 4th Croatian Microscopy Congress and a member of the Society’s board, on the occasion of the Society's anniversary, May 18th 2022.

The New Life of Baroque Castles in North-Western Croatia: The Renovation of the Erdödy and Vranyczány Families’ Castles at the End of the 19th and Beginning of the 20th Centuries


 
 
 The article examines the furnishing of country residences, the collecting practises and art patronage of members of two families of the old and new nobility, the Erdödy and the Vranyczány-Dobrinović, who played an important role in Croatian society and politics. The Erdödy furnished their castles in Jastrebarsko, Novi Marof and Bajnski dvori with Historicist furniture and decorated them with their collections, which consisted mainly of works of art by Old Masters. The Vranyczány followed the trend of Historicist interior decoration and expressed their personal taste more strongly, which was reflected in their estates of Mirkovec and Gornje Oroslavje, which became the centre of social gatherings of the modern Croatian art scene.
 
 

The Role of Mortgage Subsidies in the Croatian Economic Growth Strategy: a Political-Economy Approach to the SSK

Since 2017, Croatian housing policy has focused on promoting homeownership through the SSK programme – a form of mortgage subsidisation that covers a proportion of housing costs. Although this policy aimed to improve affordability and increase homeownership, a recent economic evaluation has shown that the SSK has in fact contributed to rising house prices and has been ineffective at raising the homeownership rate. While econometric research has identified the impact that the SSK has had on house price volatility and affordability, the underlying factors leading to the implementation of this subsidy, as well as its broader societal impacts, remain under-researched. Through a political-economy lens, this paper analyses the context that led to the inception of the SSK, its core targeting principles, and its impact on the housing market. We ask: How does this subsidy position the Croatian housing market within the national strategy for economic growth and social policy provision? We argue that this policy’s impact on housing markets is twofold. First, the SSK reinforces a shift towards financialised growth through increased asset prices. Second, this subsidy shifts the focus of social policy towards mortgage markets, thereby furthering the privatisation of the welfare state and favouring middle-income groups. This paper’s contribution resides in critically discussing the SSK beyond its stated goals and contextualising it within the broader model of economic growth dependent on private finance. Through interviews with relevant stakeholders, descriptive data indicators, and a review of policy documents, this paper characterises the Croatian growth strategy as a form of small-scale financialisation that relies on aligning social policy with mortgage markets. Finally, we position the SSK within a wider array of finance-led housing policies and suggest the formulation of a comprehensive housing strategy tailored to the broader segments of Croatian society.