Primorsko-goranska County Research Articles

Validation of Contrast-Enhanced Mammography as Breast Imaging Modality Compared to Standard Mammography and Digital Breast Tomosynthesis.

Contrast-enhanced mammography (CEM) is a relatively new imaging technique that allows morphologic, anatomic and functional imaging of the breast. The aim of our study was to validate contrast-enhanced mammography (CEM) compared to mammography (MMG) and digital breast tomosynthesis (DBT) in daily clinical practice. This retrospective study included 316 consecutive patients who underwent MMG, DBT and CEM at the Centre for Prevention and Diagnosis of Chronic Diseases of Primorsko-goranska County. Two breast radiologists independently analyzed the image data, without available anamnestic information and without the possibility of comparison with previous images, to determine the presence of suspicious lesions and their morphological features according to the established criteria of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The diagnostic value of MMG, DBT and CEM was assessed by ROC analysis. The interobserver agreement was excellent. CEM showed higher diagnostic accuracy in terms of sensitivity and specificity compared to MMG and DBT, the reporting time for CEM was significantly shorter, and CEM findings resulted in a significantly lower proportion of equivocal findings (BI-RADS 0), suggesting fewer additional procedures. In conclusion, CEM achieves high diagnostic accuracy while maintaining simplicity, reproducibility and applicability in complex clinical settings.

Suicides of people over 60 years old in Primorsko-goranska County in the period from 2012 to 2021

Suicides of people over 60 years old in Primorsko-goranska County in the period from 2012 to 2021

Knowledge relevant for the implementation of sustainable tourism development – attitudes of local inhabitants and students

The purpose of this paper is to explore the attitudes and level of knowledge towards sustainable tourism development among the locals and the students. The research was conducted in Primorsko-Goranska County in Croatia. The results between the two groups were compared in order to get a clearer picture on possible similarities or differences in attitudes and knowledge levels because both of them are very important stakeholders for sustainable tourism development and need to be involved in this process. The methodology used in the paper consists of two levels of analysis. The theoretical part is based on secondary sources in the field of sustainable tourism development while the research one is presented through results from quantitative research through a questionnaire among local inhabitants and students of tourism in the Primorsko-Goranska County. A survey was distributed online, with questions related to sustainable development in tourism, its relevant elements and the knowledge connected to it. The data was then collected and analysed using independent-samples t-test, correlation analysis and other methods relevant for this research. The stakeholders assessed elements and perception of knowledge related to sustainable development in tourism. The paper emphasizes potential differences in the level of knowledge and attitude between the students and the local population. The attitudes of the stakeholders towards the topic are mostly positive, but they also underline the need for further education in the field of sustainable development, both in theoretical terms and in terms of acquiring skills and habits needed to thrive in the era of sustainability. The contribution of the paper is in identifying the necessary knowledge for the implementation of sustainable development of tourism among the local population and students of tourism. In addition, the self-evaluation of the current level of knowledge was examined. This should be the basis for the further development of educational programs and other programs for the whole local population in the field of sustainable tourism development.

The influence on fish and seafood consumption, and the attitudes and reasons for its consumption in the Croatian population

Fish makes an important part of the Mediterranean diet, which has been scientifically proven to help preserve human health by protecting against major chronic and inflammatory diseases. Eating fish and seafood is very important, not only for its proven health benefits but also for its positive impact on the environment. Due to many fish and seafood significant positive effects on human health, this study aimed to investigate the socio-demographic factors associated with the consumption of fish and seafood in the population of Primorsko-goranska County in Croatia. Another aim was to determine people's attitudes, choices, and reasons for the consumption of fish and seafood. Self-reported data from 2,910 participants were used. According to the European dietary recommendations for fish consumption, the participants were divided into two groups; the very low to low fish consumption group and the moderate to high fish consumption group, in order to examine the differences in socio-demographic and lifestyle variables, and their attitudes, opinions, and reasons for fish and seafood consumption. More fish and seafood were consumed by women, the elderly, the more educated, non-smokers, and more physically active participants. Age, the highest level of education, and a diet even moderately adherent to the Mediterranean diet was found to significantly increase the likelihood of recommended fish consumption. Participants considered the best reasons to consume more fish lower prices, buy much more locally produced fishery products, and prefer to eat wild-caught fish rather than farmed fish. The study has found a slight increase in fish consumption, although still lower than the European average. It also showed significant socio-demographic associations, also the reasons and attitudes toward higher fish and seafood consumption of the Croatian population. The obtained research data are valuable for planning future public health programs in Croatia aimed at greater consumption of fish and seafood, as well as their promotion as an important part of a sustainable diet.

Hydrological Behavior of Karst Systems Identified by Statistical Analyses of Stable Isotope Monitoring Results

The article presents findings of a two-year systematic study of stable isotope content in two karst groundwater resources in Primorsko-goranska county (Croatia): the Martinšćica wells (MWs) and the Dobrica spring (DBC). The temporal and spatial variation of hydrogen and oxygen isotopes is commonly studied in conjunction with hydrogeological conditions such as groundwater dynamics and discharge conditions. However, since this information was incomplete, we were forced to work with limited data and rely on analyses of stable isotope monitoring results. The obtained results show that winter precipitation is the most common recharge source for the systems, and the average residence time of water in the subsurface is less than a year. Furthermore, the MWs system is a typical dual-porosity system with dominant base flow. The results of the nonparametric regression analysis show that the possibility of seawater intrusion into the spring affecting DBC isotope content cannot be ruled out. We believe that the results presented in the paper demonstrate that when combined with statistical analyses, environmental stable isotopes are a powerful tool for gaining insights in karst hydrogeology.

Antibiotic Prescribing Habits and Antimicrobial Resistance Awareness of Dental Practitioners in Primorsko-Goranska County, Croatia.

Purpose: The goal of this study was to investigate the differences in dentists' knowledge, attitudes, and practice regarding antibiotic use and resistance among two areas of Primorsko-Goranska County (P-GC), Croatia. Materials and Methods: A cross-sectional study based on a structured questionnaire that was given to 230 dental practitioners in outpatient settings of P-GC in 2018. Results: The overall response rate was 68.3% (157/230) and 72.2% (83/115) in the city of Rijeka and 64.3% (74/115) in the rest of P-GC. Dentists from two areas of P-GC held similar knowledge about prescribing antibiotics and attitudes regarding antibiotic use (p > 0.05). Most of the dental practitioners chose penicillins (65.0% amoxicillin with clavulanic acid and 33.1% amoxicillin) as the first-choice antibiotic in patients with no medical allergies. The trend of prescribing amoxicillin decreases with the age of the dentists (p = 0.046). Clindamycin (86.6%) was the first choice for patients allergic to penicillin. Postgraduate education changed the attitude toward taking more time to consider whether or not an antibiotic is needed. Croatian dentists had a high awareness of antimicrobial resistance (99.4%). The most common situations for which dentists would prescribe antibiotics were periapical abscess (84.7%), periodontal abscess (72.6%), and implant placement (59.9%). Patient request or expectation (43.4%) and treatment uncertainty (41.5%) were found to be the main factors for prescribing antibiotics with more frequency. Conclusions: Although there is a high level of antimicrobial resistance awareness among dental practitioners, there is still too much overuse of antibiotics and personal responsibility for prudent antibiotic use should be increased. The results of this study indicate that antibiotics are frequently prescribed for indications where surgical treatment should be the first option and the broad spectrum antibiotic is the preferred treatment option.

Impact of guidelines on antibiotic prescribing approach in primary care-a 10-year study.

Publication and implementation of clinical guidelines is an important educational measure that considerably helps physicians in choosing appropriate antimicrobial drug. To evaluate long-term changes in antimicrobial prescribing habits before and after publishing the guidelines and to determine the factors that influence physician's decision to prescribe an antimicrobial drug. The study among general practitioners in Primorsko-Goranska County was conducted in three periods (January 2009, January 2011 and April 2019) by using a structured questionnaire that included general data about the physician, questions about their habits in antibiotic prescribing, criteria that influenced decision to prescribe antibiotics and antimicrobial agent(s) preferred in treating common infections. Concomitant chronic (non-pulmonary) disease was the most important factor influencing decision to prescribe an antimicrobial drug. Over 88% of physicians that completed the survey declared themselves as rational prescribers of antimicrobials but more than half of them (53.3%) sometimes prescribed an antibiotic even though it was not indicated compared to 75% of self-reported non-rational prescribers (P ˂ 0.05). Self-reported adherence to the guidelines increased from 34.6% in 2011 to 51.8% in 2019. The research showed improvement in physicians' knowledge in choosing the right antibiotic based on the analysis of answers but indicated the necessity for improving communication skills and empowering physicians not to prescribe antibiotics 'just in case' because of diagnostic uncertainty or patient demand. Further qualitative research is needed to understand physicians' prescribing behaviour and decision-making processes in order to develop interventions that will effectively improve the use of antibiotics.

Data envelopment analysis in measuring the efficiency of volleyball teams in Primorsko-Goranska County

Every sport organisation strives to evaluate its performance: its weaknesses and strengths. Measuring efficiency and sports are two interrelated concepts and it is not surprising that most of the research on sports is focused on analysing the efficiency of teams according to player techniques, attack and defence efficiency. However, there are very few studies based on the analysis of financial factors such as teams’ revenue and costs. In this paper two Data Envelopment Analysis (DEA) models were used to evaluate 16 young cadet volleyball teams in Primorsko-Goranska County based on two economic inputs. The paper aims to explain the importance of teams’ financial resources in achieving sports efficiency. To analyse the relative efficiency of teams, two frequently used models are employed, the Banker Charnes Cooper (BCC) and the Charnes Cooper Rhodes (CCR) model. In the end, a super efficiency analysis was conducted to make a distinction in efficiency scores between efficient units. Analyses showed that financial factors are not crucial factors for efficiency score and gave possibility to use obtained results and improve the performance of inefficient volleyball teams. The study was conducted on a sample of 16 teams through 4 inputs and 1 output collected during 2017/2018 season.

Laserski snimak Trsatskog kaštela kao dio strategije očuvanja kulturne baštine Rijeke

Kaštel (Gradina) Trsat je jedan od najpoznatijih objekata graditeljske baštine u Primorskogoranskoj županiji. U svrhu projekta obnove, Grad Rijeka je 2015. godine naručio snimak kompleksa (ukupno skoro 8000 m²). Za izradu snimka korištena je laboratorijska oprema Sveučilišta u Rijeci. Cilj rada je prikazati proces snimka, dati analizu mogućnosti kombiniranja laserskog snimka s drugim suvremenim metodama (snimanje bespilotnom letjelicom, fotomodeliranje), usporediti rezultate snimka s postojećim snimkama kompleksa, utvrditi nove podatke o kompleksu te provesti diskusiju o rezultatima i važnosti koje ovakvo kompleksno snimanje može imati za očuvanje kulturne baštine.

Evaluation of Hotel Companies Owning Five-Star Hotels in Primorsko-Goranska County (Croatia) Using the Multi-Criteria Approach

Abstract Introduction. High-category hotels are considered to be one of the most important elements of every tourist destination’s supply. Recently, the lack of highly rated hotels in the Republic of Croatia has often been criticized by the public because they are believed to be a prerequisite in the creation of a competitive tourist offer. Material and methods. The authors have performed a multi-criteria decision analysis of eight companies owning five-star hotels in Primorsko-Goranska County using the Analytic Hierarchy Process (AHP) method. Their business performance was evaluated based on both financial and market criteria. The financial criteria encompassed indicators of liquidity, indebtedness, activity and profitability. Data regarding the market indicators were collected using a questionnaire. Results. The importance of market criteria in the tourism industry is visible in tourist demand, which is founded on the perception of potential hotel guests, their recognition of the brand and thus the market potential of the hotels themselves. Therefore, both the financial and market aspect have been included in the Analytic Hierarchy Process analysis and synthesized to estimate the overall priority based on which the hotels were ranked. According to all criteria and sub-criteria, the best ranked hotel company is Eles Turizam j.d.o.o with its five-star hotel Mozart (0.2540), followed by Milenij hotels d.o.o. with its Milenij and Milenij Sveti Jakov. The third place has been assigned to Liburnija Rivijera Hoteli d.o.o. and its Ambasador. Conclusions . All but one of the analyzed five-star hotels are under the ownership of the biggest hotel companies in PGŽ with a long presence in the tourism industry. Therefore, it was expected that, due to their market recognizability and, consequently, their good financial performance, they would rank first. However, the research has shown that market potential does not necessarily imply best practices. Eles Turizam and its hotel Mozart were ranked the highest according to financial and overall priority scores. It may thus be concluded that even a small family hotel company with reduced marketing costs, especially one with an elite tourist offer, can compete with big hotel companies if it continuously assures the quality of its services.

Parental Knowledge and Awareness Linked to Antibiotic Use and Resistance: Comparison of Urban and Rural Population in Croatia.

Purpose: To investigate the differences in parental knowledge, attitudes, and practice about antibiotic use and resistance among the urban and rural populations in Croatia. Materials and Methods: A cross-sectional study based on a structured questionnaire was distributed to 1,000 parents of children attending 11 elementary schools of Primorsko-Goranska County in 2017. Results: The overall response rate was 65.1% (651/1,000)-50.6% (253/500) in urban and 79.6% (398/500) in rural population. Urban parents had a higher overall knowledge about antibiotics (p < 0.001), while urban and rural parents held mostly similar knowledge and attitudes related to antibiotic use when split into individual statements (p > 0.05). Age, education, income, work, and family member working in a health-related field were significantly related with the overall knowledge about antibiotics. In the previous year, 28.2% of children and 28.9% of parents reported using an antibiotic. Croatian parents had a high level of trust in doctors' antibiotic-prescribing practices (96.3% reported trusting the doctors' decision not to prescribe antibiotics, 93.5% to prescribe antibiotics) and high awareness of antimicrobial resistance (94.8%). The public's misconception regarding the terms "bacteria" and "virus" was found in 15.5% of parents. The source of information about antimicrobial resistance was television (60.4%), internet (57.1%), newspapers (44.2%), and medical professionals (30.9%). Conclusions: Although the knowledge about antibiotics was higher in urban parents, it was not reflected on the level of antibiotic consumption. There are indications that medical professionals should be more involved in communicating the problems of antibiotic use and resistance to patients.

Improving Competitiveness of Small and Medium-Sized Enterprises with the Application of Quality Management System

In a modern global economy, small and medium-sized enterprises (SMEs) have inviolable importance and inclusion in the overall social development and economic growth. Regarding the high share of SMEs in the total number of companies, given the number of employees and the share in export orientation, the question of SMEs existence, as well as their market share and competitiveness in the global environment, represents prime relevance to any national economy. Therefore, the issue of quality becomes a critical component of achieving competitiveness in delivering products and services to their consumers (customers.) Due to this extremely delicate issue, each company establishes and implements a systematic process relationship or a quality management system as a part of its general management mechanism. This is a reason for SMEs management to strategically decide on the challenges of introducing a quality management system; thus, to improve their competitiveness on the domestic and foreign markets, which is a very demanding, exhaustive and time absorbing process requiring detailed preparation and collective engagement. The basic reasons for applying a quality management system are apostrophised in any business objectives – improving business processes, product quality and services, increasing spending as a factor of developing higher market share, better reputation (image) and sustainable business results. Due to the measurable quantitative and qualitative attributes and features that can significantly enhance the introduction of quality management systems into practice of SMEs, numerous studies have been carried out, some of which are conducted within the last two decades. For the authors, this was an initiative to conduct a survey, within this paper, in the Primorsko-goranska county (Croatia) during the month of July 2018, in which a number of SMEs were analysed in the crucial areas of quality management systems. The authors’ objective was to assess the viability of SMEs regarding their application of a quality management system. The basic hypothesis was that introducing quality management systems into SMEs contributes to their foreign competitiveness i.e. strengthening their export activity in general. Beside positive outputs of applying quality management, the authors’ research presented in this paper also established some relatively high and negative quantifications in relation to the application of the quality management system. Such outcomes represent justified reasons for future scientific research in this area.

Model of Using the Exhaustive Search Algorithm in Solving of Traveling Salesman Problem (TSP) on the Example of the Transport Network Optimization of Primorje-Gorski Kotar County (PGC)

This paper considers and presents a model of the use of an exhaustive search algorithm in solving problems of a salesman on the example of the transportation network optimization of Primorsko Goranska County. By identifying the suboptimal solutions of transportation network, that enable insight into more transportation routes and can be significantly influenced by the reduction of transportation costs and creating increased opportunities for the carrier in the context of flexible designing the structure of the commodity flows, greater utilization of transport capacity, and thus achieve greater profit. In the analyzed example, transportation network of Primorje-Gorski Kotar County (PGC) is divided into two sets (segment): 1) a set of cities (nodes) that are located (placed) on the same traffic direction (transportation route) that represents the optimal transportation route, and 2) a set of cities (nodes) that connect through a variety of transport relationships and that are included in the calculation by using the exhaustive search algorithm. In the example are also defined nodes that are common to both the two sets and that are connecting by the virtual transportation route in the spreadsheet optimization model.

A Proposal of Measures Towards a Qualitative Enhancement of Bus Transport Services in the Primorsko-goranska County

The survey, which consisted of counting, polling and recording, has provided data on the existing volume of passenger flows in public bus stations/terminals within the Primorsko-goranska (Littoral-Mountainous) County (hereinafter: the PG County), the density rate of passengers on bus lines that operate on County connections and on bus lines connecting the PG County with other counties in Croatia. In addition to the quantitative parameters, the qualitative data were analyzed that had been obtained by polling passengers at the Rijeka bus terminal, whereupon detailed opinions of direct users of the service were elaborated with the aim of obtaining a picture of the current situation of the public bus transport in the PG County. The data collected were used in evaluating the quality of the passenger transport service provided and in determining measures to be taken in order to bring both the actual quality of transport and the satisfaction of passengers to a higher level.

Caries Incidence in Children of Primorsko Goranska County, Croatia

Caries Incidence in Children of Primorsko Goranska County, Croatia

Teachers’ Attitudes towards Behaviour Patterns in Social Conflicts in Primorsko-Goranska County in Croatia

The aim of the empirical research is to determine primary school teachers’ attitudes towards behaviour patterns in social conflict. A primary school teacher is the role model for his/her pupils, so in the context of the theory of hidden curriculum, the purpose of the study is determining a better understanding of teacher’s needs for further conflict resolution training. AScale of Attitudes toward social conflicts was applied to a stratified sample of 155 teachers in the Primorje-Gorski Kotar County, Croatia, measuring three patterns of behaviour: avoidance/adaptation, cooperation, and winning. According to the results, the teachers most frequently have positive attitudes toward a pattern of cooperation, and most seldom towarda pattern of winning. Winning is negatively correlated with cooperation, and positively correlated with avoidance/adaptation. The authors recommended systematic social skills training necessary for managing conflict for a specific group of teachers. The authors believe these findings could raise interest and awareness for further studies in the field of conflict studiesin education.

Physically active workers from Primorsko-goranska County, Croatia adhere more to Mediterranean diet

Physically active workers from Primorsko-goranska County, Croatia adhere more to Mediterranean diet

Net fiscal positions of counties in Croatia from 2011 to 2013

The main aim of this study was to determine the net fiscal positions of counties, i.e. the net fiscal positions of all cities and municipalities in the territory of each county. The analysis was carried out for the period from 2011 to 2013. The distribution of general government revenue and expenditure of around HRK 129bn was carried out according to established distribution keys and the net fiscal positions of counties were determined. The results revealed that, out of 21 counties (20 counties and the City of Zagreb), only four recorded positive net fiscal positions. The best average annual net fiscal position was found in the City of Zagreb (HRK 13.7bn), followed by the positions of Istarska County (HRK 795m), Primorsko-goranska County (HRK 731m) and Zagrebacka County (HRK 134m). Other counties recorded negative net fiscal positions, with the weakest (negative) ones identified in Vukovarsko-srijemska County (HRK 1.69bn of annual deficit) and Osjeckobaranjska County (HRK 1.67bn).

Assessment of Forest Damage in Croatia Caused by Natural Hazards in 2014

Background and Purpose: Recent natural disasters (ice-breaks, torrents, floods) that affected five Croatian counties caused significant damage on forest stands and forest infrastructure. Since in Croatia there is no common methodology for fast and reliable assessment of forest damage, the aim of this paper is to develop and present methodology for rapid damage assessment and to prescribe urgent recovery measures, as well as to provide first preliminary results of the total damage to forests. Materials and Methods: An attempt was made to develop the methodology which would rely on existing legislations, regulations, instructions and experiences for forest damage assessment as much as possible. Estimation of forest damage was based on field observations, spatial data of forest management units and data from the existing Forest management plans. Results: According to conducted assessment, forests of Primorsko-goranska County are the most affected by the overall damage caused by ice- storm. Major damages occurred both on the forest and on forest roads. Ice-storm also caused serious damages on forests and on forest roads in Licko- senjska County and Karlovacka County, while floods and torrents caused damages on forest roads in Zagrebacka County, Sisacko-moslavacka County and Karlovacka County. Money-wise, the total forest damage amounts 942 252 183 €. Conclusions: Methodology for rapid damage assessment presented in this paper resulted on first preliminary estimate of range, intensity and cost of forest damage caused by recent natural disturbances. More precise data on forest damage will be known after the implementation of the proposed emergency recovery measures. Also, certain improvements of methodology in terms of precision and collection of data may be achieved by incorporating remote sensing methods.

Potentially inappropriate prescribing in elderly outpatients in Croatia

The purpose of this study was to determine the prevalence of inappropriate prescribing to the elderly and to identify possible gender-related differences in prescribing certain potentially inappropriate medications (PIMs) to outpatients by using large administrative prescription database. Medications prescribed for elderly outpatients (≥ 65 years) in Primorsko-Goranska County, Croatia, who received five or more different drugs simultaneously in 2010, were analyzed. The prevalence of potentially inappropriate drugs prescribed to the elderly was assessed using the new comprehensive protocol developed by authors Mimica Matanović and Vlahović-Palčevski. A total of 62.4 % of patients received at least one medication with unfavorable benefit/risk ratio in the elderly. Female patients were given inappropriate medications in a significantly higher percentage than men (69.3 % vs. 50.5 %; p < 0.001). The average number of prescriptions for PIMs that should have been avoided with certain diseases or conditions was 0.88 per patient in the survey. The most common drug combination potentially leading to serious drug-drug interactions (DDIs) included an angiotensin-converting enzyme (ACE) inhibitor and a potassium supplement. Our study has shown that every tenth medication prescribed to a patient > 65 years and receiving five or more drugs was potentially inappropriate. Elderly women were prescribed PIMs more often than men. Drugs of concern in female patients were benzodiazepines, antidepressants, and nonsteroidal anti-inflammatory drugs (NSAIDs). In male patients, there was a significantly higher proportion of possible interactions with warfarin, theophylline, and medications affecting the cardiovascular system, such as ACE inhibitors and amiodarone.