Slovenian Population Research Articles

Pro- and Anti-Angiogenic Markers as Clinical Tools for Suspected Preeclampsia with and without FGR near Delivery—A Secondary Analysis

Objective—the objective of this study was to assess the accuracy of placental growth factor (PlGF), soluble Fms-like Tyrosine Kinase 1 (sFlt-1), and endoglin (sEng) in the diagnosis of suspected preeclampsia (PE) with and without fetal growth restriction (FGR) near delivery. Methods—this is a secondary analysis of a dataset of 125 pregnant women presenting at the high risk pregnancy clinic with suspected PE, FGR or PE + FGR in the University Medical Center of Slovenia. The dataset included 31 PE cases, 16 FGR cases, 42 PE + FGR cases, 15 cases who developed with unrelated complications before 37 weeks (wks) (PTD), and 21 unaffected controls who delivered a healthy baby at term. We also analyzed a sub-group of women who delivered early (<34 wks) including 10 PE, 12 FGR, 28 PE + FGR, and six PTD. Clinical management adhered to hospital guidelines. Marker levels were extracted from the dataset and were used to develop Receiver Operating Characteristic (ROC) curves and to calculate the area under the curve (AUC), the detection rates (DRs), and the false positive rates (FPRs). Previously published marker cutoffs for yes/no admission to hospital wards were extracted from the literature. Negative and positive predictive values (NPVs and PPVs) were evaluated for their value in determining whether hospital admission was required. Non-parametric tests were applied for statistical analysis; p < 0.05 was considered significant. Results—near delivery, all the pro-and anti-angiogenic markers provided diagnostic (ROC = 1.00) accuracy for the early (<34 wks) group of FGR. Diagnostic or near diagnostic (ROC = 0.95) accuracy was achieved by all marker for early PE + FGR but lower accuracy was achieved for early PE. For all cases, all markers, especially PlGF reached diagnostic or near diagnostic accuracy for FGR and PE + FGR. At this accuracy level, they can contribute to the clinical management of FGR, and PE + FGR. All the markers were less accurate for all PE cases. The use of published cutoffs was adequate for clinical management of FGR, whether early or for all cases, using an NPV > 90%. For PE + FGR, the PPV value approached 100%, especially for early cases, and can thus be implemented in clinical management. Neither NPV nor PPV were high enough for managing all cases of PE. There was no added value in measuring the PlGF/(sFlt-1 + sEng) ratio. Conclusion—This is the first study on a Slovenian population. It shows that near-delivery angiogenic biomarkers tests may be useful for confirming the diseases in cases where there is a diagnostic doubt. However, the clinical use of the biomarkers needs to be weighed against resources available and degree of certainty of the diagnosis made with and without them for managing suspected FGR and PE + FGR requiring delivery <34 wks, where they are very accurate, and furthermore in the management of all cases of FGR and FGR+PE. The markers were less accurate for the clinical diagnosis of PE.

Dietary Intake of trans Fatty Acids in the Slovenian Population.

Consumption of trans fatty acids (TFAs) has been unequivocally linked to several adverse health effects, with the increased risk of cardiovascular disease being one of the most well understood. To reduce TFA-related morbidity and mortality, several countries have imposed voluntary or mandatory measures to minimize the content of industrial TFAs (iTFAs) in the food supply. In 2018, Slovenia introduced a ban on iTFAs on top of preceding voluntary calls to industry to reduce its use of partially hydrogenated oils (PHOs) as the main source of iTFAs. To investigate the consumption of TFAs, data available from the nationally representative dietary survey SI.Menu were analyzed. The survey consisted of two 24-h non-consecutive day recalls from 1248 study participants from three age groups (10–17, 18–64, 65–74 years old), combined with socio-demographic, socio-economic, and lifestyle parameters. The analyses demonstrated that, on average, TFAs accounted for 0.38–0.50% of total energy intake (TEI). However, 13% of adolescents, 29.4% of adults, and 41.8% of the elderly population still consumed more than 0.50% TEI with TFAs. The main sources of TFAs in the diet were naturally present TFAs from butter, meat dishes, and meat products, regardless of the age group. Results indicate that following the reformulation activities, the major sources of TFAs in the diets of the Slovenian population now represent foods which are natural sources of TFAs.

Population genetic structure of the highly endangered butterfly Coenonympha oedippus (Nymphalidae: Satyrinae) at its southern edge of distribution.

The Slovenian False Ringlet Coenonympha oedippus populations are under serious threat, as in the last two decades have witnessed a sharp decline in population distribution and size due to destruction, fragmentation and/or habitat quality degradation through intensive agriculture, abandonment of use and urbanization. We investigated the genetic diversity and structure of C. oedippus from the entire range of the species in Slovenia. Our results showed that the genetic variation in the Slovenian C. oedippus populations agrees with the geographical structure and the ecotypes previously determined by morphological and ecological data. We confirmed the existence of four genetically divergent and spatially non-overlapping geographical groups (Istria, Karst, Gorica, Ljubljansko barje) and two ecotypes ("wet" and "dry"). Despite small sample sizes due to critically threatened species, the results indicated significant nuclear and mitochondrial genetic diversity within the spatial groups. By gaining new insights into the evolutionary history of the C. oedippus population, we have recommended to consider the Slovenian population as one Evolutionary Significant Unit, and four spatial populations as Management Units for conservation purposes.

Associations of adverse and positive childhood experiences with adult physical and mental health and risk behaviours in Slovenia

ABSTRACT Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48–9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46–0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity.

The MallardAnas platyrhynchosin Slovenia: a review with an estimation of its current population

AbstractAlthough the Mallard is one of the most numerous and best-studied waterbirds in the world, it received almost no attention in Slovenia. It is one of the most frequently observed waterbirds in our country, with frequency often reaching 100%. Sites with lower frequency either freeze in winter or have a low number of individuals to start with. The Mallard is also the most dominant species (17.5% and 89.0%) with higher dominance at sites less suitable for waterbirds due to the lack of available shoals. Mallards reach their maximum numbers during fall migration and winter. Spring migration has no discernible peak and has been significant only for Lake Cerknica. On shallow waters, the maximum is reached in August and September, a month before fall migration begins, indicating local movement to food-rich sites. Females make up only 36.7% of the observed Mallards and reach the maximum proportion (41.5%) in winter and the lowest in April and May (14.7%), when they nest. The breeding season in Slovenia lasts from mid-January to early December, with the majority of females rearing broods from April to July. Average brood size is 6.2 ± 2.66 and declines with season, age of young and altitude. It varies between habitat types and is highest on Treatment and Coastal Wetlands (7.3) and lowest on deep waters such as Reservoirs (5.7) and Lakes (5.6). No really high breeding densities were found in Slovenia and were similar to those in other countries. Breeding densities are higher on smaller Ponds (< 8 ha), on sites with isolated islands and breeding colonies of gulls and terns (e.g. Lake Ptuj). Breeding density also decreases with elevation. Slovenian breeding population is estimated at 1,473–3,763 bp and wintering population averages 22,237 (10,376–32,010) individuals. Data suggest a decline in the wintering population most likely due to warmer winters. The majority of Mallards winter in NE Slovenia, where eight of eleven sites have a maximum of more than 1,000 Mallards. Most Mallards winter on the Drava river with Ptuj and Ormož lakes, where the highest numbers of Mallards were also recorded (Lake Ptuj: 8,330 ind., Lake Ormož: 5,400 ind.). The highest number of individuals during spring migration was recorded on Lake Cerknica (4,581) and during autumn migration on Medvedce reservoir (3,379). Apart from standing waters, the highest density of wintering Mallards is found in urban sections of slow-flowing rivers, probably due to higher safety and food availability.72,731 Mallards were hunted between 2001 and 2018, mainly in NE Slovenia (28% in the Pomursko hunting management district). The number of Mallards hunted is declining in all hunting areas and has declined by 64% since 2001 and even more since the 1990s. According to hunt data, hunting is by far the most important cause of the Mallard mortality in Slovenia (97.4%), followed by predation (1.1%). The Mallard mortality in Slovenia is largely unstudied and natural mortality is most likely underestimated, not only because it does not include mortality in the pre-fledging period, a period with the lowest survival, but also because the detectability of natural mortality is considerably lower. In contrast to the hunted numbers, there have been only nine recoveries of ringed individuals from abroad in the last 100 years, suggesting that hunters may not be reporting recoveries to the ringing centre. Apart from the 1972–1975 period, when 87% of Mallards were ringed, the intensity of ringing of Mallards in Slovenia is low, resulting in only seven Mallards recovered abroad. The longest distance of a Mallard ringed in Slovenia comes from Ukraine (1,290 km), while the longest distance between ringing and recovery sites is 2,075 km from an individual ringed in Finland. The only colour morphs documented in Slovenia are Mallards with paler feathers, attributed to one of the colour aberrations resulting from lower melanin productivity. Only few hybrids and mixed pairings with other wild duck species were observed.

Premises and other conditions for quality aging in the case of Slovenian population older than 65 years - test study

Premises and other conditions for quality aging in the case of Slovenian population older than 65 years - test study

Vpliv kraja bivanja in izobrazbe staršev na intenzivnost inštrukcij

Research question (RQ): Among other questions in this research we have tried to answer, in relation to an increase of the use of tutoring, was whether the intensity of the use of tutoring is influenced by the place of residence and education of parents, so we formulated the following research question: “Does the place of residence and education of parents’ affect the use of tutoring?” Purpose: The basic goal of the research was to determine how extensive the use of tutoring is in the Goriška region and how/if the place of residence and education of parents is relevant. We focused on science subjects such as math, physics, chemistry, and one foreign language. Method: We surveyed primary school students, high school students, secondary schools, and students enrolled in higher education study programs in the Goriška region. By interviewing both students and parents, a quantitative research was enriched by the detailed content review of the importance of tutoring. We also conducted interviews with teachers of physics, chemistry, mathematics, and English in both primary and secondary education, and gained an insight into the increased use and need of tutoring in the context of formal education. We also used the method of observation by observing the students that use tutors and resort to tutoring. The research was conducted during the 2016/2017 school year. Results: Based on the data gained by conducting an extensive research, the following key conclusion was formed: Place of residence and education of parents do not affect the intensity of tutoring. Organization: According to the findings, the volume of tutors is increasing, and students are too focused on improving grades rather than better consolidating learning, school principals and deans could make certain changes in the delivery of learning content to students. When organizing the tutoring, it is important that it directly relates to consolidation of learning, rather than being directed only towards the improvement of grades, which are required for passing and applying for collage. Society: The contribution is important from the point of view of students, teachers and also the Ministry of Education in relation to the reform of the school system. Moreover, a broader study could offer solutions to limit the emerging gap between students and teachers, as research has shown that the use of tutoring has increased significantly. Here we should follow the example of those countries where the study is designed in such a way, that there is no need for additional tutoring. Originality: This is the first such extensive research in the Goriška region and in Slovenia in general. All school levels were included. Starting with elementary schools, high schools and higher education programs. Above all, this study expresses originality, as it seeks to answer how the place of residence and education of parents influence the tutoring process. Limitations/further research: The limitation of the research is that we conducted the research in the Goriška region only and that the selected sample was small, therefore, the findings cannot be applicable to everyone. It would make sense to conduct similar research and expand it to the entire Slovenian population. Another limitation is the fact that it was carried out before COVID-19, during which teaching, and tutoring had to adapt to the new situation.

Introducing the Early Trauma Inventory Self Report - Short Form and its Qualitative and Quantitative Validation for the Slovenian General Population.

IntroductionTraumatic experience in childhood or adolescence has a significant impact on the development of chronic mental and physical conditions in adulthood. Thus, it is very important for health professionals, especially primary care physicians to have an inventory in order to detect early trauma for planning appropriate treatment, such as the Early Trauma Inventory (ETI). The aim of this paper is to test the psychometric properties of the Slovenian translation of the short, self-rated version (ETISR-SF), and to further validate the instrument.MethodsThe research was done in two parts – qualitative and quantitative. In the qualitative part, a questionnaire was translated and culturally adapted using the Delphi method. For the quantitative part, 51 patients with substance use disorders hospitalized at the Centre for the Treatment of Drug Addictions were recruited, along with 133 controls. The psychometric properties of the questionnaire were checked. Internal consistency was calculated using Cronbach’s alpha, test-retest reliability was examined graphically using a Bland-Altman plot. Discriminant validity between groups was gauged using the independent samples t-test.ResultsConsensus in the Delphi study was reached in the second round. Cronbach’s alpha varied between 0.60 - 0.85. Of the four domains, physical abuse had the lowest Cronbach’s alpha. The test-retest reliability is high for all domains, with correlation coefficients ranging from 0.82 to 0.96. The non-clinical sample differed significantly from the clinical sample.ConclusionThe Slovenian translation of ETISR-SF is a satisfactory instrument for the evaluation of trauma before the age of 18.

Screening Strategy Modification Based on Personalized Breast Cancer Risk Stratification and its Implementation in the National Guidelines - Pilot Study.

BackgroundOne of the most consistent models for estimating personalized breast cancer (BC) risk is the Tyrer-Cuzick algorithm that is incorporated into the International Breast Cancer Intervention Study (IBIS) software. Our main objective was to provide criteria for the classification of the Slovenian population, which has BC incidence below the European average, into risk groups, and to evaluate the integration of the criteria in Slovenian guidelines. Our main focus was on women age <50 with higher BC risk, since no organized BC screening is available for these women.MethodsSlovenian age-specific BC risks were incorporated into IBIS software and threshold values of risk categories were determined. Risk categories were assigned according to the individual’s ten-year risk for women aged 40 and older, and lifetime risk for women between 20 and 39. To test the software, we compared screening strategies with the use vs. no use of IBIS.ResultsOf the 197 women included in the study IBIS assigned 75.1% to the BC risk group, and the rest to the moderately increased risk. Without IBIS 80 women were offered mammographic and 33 ultrasound screening. In contrast, 28 instead of 80 would have been offered mammographic screening and there would have been no referrals for ultrasound if IBIS had been used.ConclusionsThe Slovenian IBIS has been developed, tested and suggested for personalized breast cancer risk assessment. The implementation of the software with the consideration of Slovenian risk thresholds enables a more accurate and nationally unified assessment.

Genes associated with somatic cell count index in Brown Swiss cattle.

Subclinical mastitis (SM) is one of the most common diseases of cows in milk production herds caused by contagious and/or environmental pathogens. Since there are no visible abnormalities in the milk or udder, the detection of SM requires special diagnostic tests. Somatic cell count (SCC) is the most common test used to detect changes in milk due to the inflammatory process. Previously, we developed somatic cell count index (SCCI), a new method for the accurate prediction of milk yield losses caused by elevated SCC. The aim of this study was to identify new candidate genetic markers for SCCI in the Slovenian population of Brown Swiss (BS) cattle. For that purpose, we analyzed samples of BS cows, which were genotyped using single-nucleotide polymorphism (SNP) microarray ICBF International Dairy and Beef v3 (ICBF, Ireland) for a total of 53,262 SNP markers. After quality control, the set of 18,136 SNPs was used in association analysis. Our association analysis revealed that 130 SNPs were associated with SCCI, which were used for haplotype and overlap analysis. Haplotypes generated from the genotyped data for those 130 SNPs revealed 10 haplotype blocks among 22 SNPs. Additionally, all 130 SNPs, mastitis-related quantitative trait loci, and protein-coding genes are shown on the bovine genome. Overlap analysis shows that the majority of significantly associated SNPs (70) are intergenic, while 60 SNPs are mapped within, upstream, or downstream of the protein-coding genes. However, those genes can serve as strong candidate genes for the marker-assisted selection programs in our and possibly other populations of cattle.

EQ-5D-5L Slovenian population norms

BackgroundThe study aims to present Slovenian EQ-5D-5L population norms for different age and gender subgroups that can be used as reference values in future studies concerning health status. The secondary aim is to compare those norms with population norms from some other countries in Europe and elsewhere.MethodsThe cross-sectional survey was conducted between November 2019 and February 2020 via online panel. 1071 adults aged 18+ were included in the survey. The general population was sampled using quota sampling in terms of age, gender, and NUTS2 region. In the study, the EQ-5D-5L Slovenian online version was used. Descriptive statistics was used to present health status by age groups and genders for the EQ-5D-5L descriptive system, EQ VAS and the EQ-5D-5L index score. The latter was derived from Slovenian EQ-3D-3L tariff, transformed to five levels using the crosswalk methodology.ResultsThe mean EQ VAS score in the Slovenian population was 79.9, mean utility index was 0.808. 28.2% of the population did not have problems on any dimension and 3.9% of the population had problems on all dimensions. Persons residing in Western Slovenia had, on average, 0.016 higher utility score, compared to Eastern Slovenia. Effect of gender was not significant. Age was negatively associated with both utility index and EQ VAS score. Education was positively correlated to health status. Problems on dimensions were generally increasing with age, except for anxiety/depression dimension, where youngest group (ages 18–29) reported more anxiety/depression compared to older counterparts. Self-reported anxiety/depression was more pronounced in women.ConclusionsSimilarly to other countries, the health generally deteriorates with age, except for the anxiety/depression dimension where the share of respondents reporting no problems was lowest in the youngest age group. The open question for the future remains, whether population norms from this online sample differ significantly from the actual EQ-5D-5L health status data of the Slovenian general population.

Spolna disfunkcija pri slovenskih pacientih z multiplo sklerozo

Uvod: Spolna disfunkcija je pri pacientih z multiplo sklerozo pogosta, ustreznih podatkov za slovensko populacijo pa ni na voljo. Namen raziskave je bil ugotoviti vrsto in delež spolne disfunkcije, razlike med moškimi in ženskami ter morebitno povezavo med spolno disfunkcijo in značilnostmi pacientov.Metode: Presečna raziskava je bila izvedena pri pacientih z multiplo sklerozo, ki so imeli spolne odnose v zadnjih šestih mesecih in so izpolnili vprašalnik MSISQ-19 (Multiple Sclerosis Intimacy and Sexuality Questionnaire). V raziskavi je sodelovalo 368 pacientov povprečne starosti 40,9 leta in trajanjem bolezni 10,2 leta. Nevrološko prizadetost smo ocenili z EDDS (Expanded Disability Status Scale). Za primerjavo številčnih spremenljivk smo uporabili neparni t-test, za primerjavo kategoričnih spremenljivk hi-kvadrat,povezanost med značilnostmi pacientov ter posamezno obliko spolne disfunkcije pa smo ocenili s pomočjo korelacijskega koeficienta po Spearmanu.Rezultati: Delež spolne disfunkcije, definiran kot odgovor 4 ali 5 na katero koli vprašanje v MSISQ-19, je znašal 37 %, deleži primarne, sekundarne in terciarne spolne disfunkcije pa 39,4 %, 39,9 % in 40,8 %. Med spoloma ni bilo statistično pomembnih razlik. Statistično značilno, a zelo šibko linearno korelacijo smo ugotovili med značilnostmi pacientov (starost, trajanje bolezni, EDSS, trajanje partnerske zveze) ter posamezno obliko spolne disfunkcije.Diskusija in zaključek: Spolno disfunkcijo ima 37 % slovenskih pacientov z multiplo sklerozo. Med spoloma ni statistično pomembnih razlik, kar velja tudi za posamezne vrste spolne disfunkcije, kot so primarna, sekundarna in terciarna.

Development, validation and performance of a newly designed tool to evaluate functional medication literacy in Slovenia.

Background Medication literacy refers to the ability of individuals to safely and appropriately access, understand and act on basic medication information. It is vital for correctly and safely using medications. General health literacy measures do not adequately address specific skills for medication literacy, and there are no general, self-administered, performance-based instruments for assessing patients' medication literacy. Objective The aim was to develop and validate a self-administered performance-based questionnaire measuring functional medication literacy and to evaluate functional medication literacy among the Slovenian general population. Setting A random sample of adult Slovenian residents received the questionnaires at their home addresses. Method The initial content was derived from medication counselling literature. Thirteen patients and 14 healthcare professionals provided feedback about its comprehensibility, comprehensiveness, and difficulty thus supporting content and face validity. The developed questionnaire, comprising 30 items divided into 5 categories (dosage, adverse effects, interactions, precautions, and other information), was sent to a random sample of 1500 adult Slovenian residents. The overall validity of the questionnaire was assessed via reliability, criterion and discriminant validity using the Kuder-Richardson Formula20, multiple linear regression and Mann-Whitney test. Descriptive statistics were used to evaluate medication literacy. Main outcome measure The psychometric properties of the questionnaire (reliability, content, face, criterion, and discriminant validity); level of functional medication literacy. Results A total of 402 residents returned eligible questionnaires (26.8% response rate). The Kuder-Richardson Formula20 reliability coefficient for the whole questionnaire was 0.823. One item that did not demonstrate discriminant validity was deleted. Criterion validity was supported by a significant association between age and medication literacy (β = - 0.303). Income (β = 0.243) and current self-perceived health (β = 0.187) also were associated with medication literacy. The median of medication literacy score was 24 out of 29 points. Dosage-related items requiring understanding of long text instructions and the use of numeracy skills received the most incorrect answers. Conclusion A performance-based questionnaire measuring functional medication literacy among a general population with supported validity was developed. Slovenian residents encountered difficulties when dealing with items requiring prose literacy and numeracy skills, especially related to dosing. Special attention should be paid to low-income elderly with poor self-perceived health.

Books in the Time of Screens: The Reading Habits of Slovenian Students

This research paper brings up the question of recreational reading habits among the generation of university students that were born after 1990 and grew up in a digital environment. The paper focuses on their self-reported reading habits. The students belong to two disciplinary domains (humanities and social sciences) at the University of Ljubljana, Slovenia. A significant number of them were pre-service teachers. The research was conducted on a non-random sample of 429 students. Data were gathered using a printed questionnaire that included assessment scales of students' reading habits. These data were compared with data gathered in the online reading habits survey of the general Slovenian population that took place in autumn 2019 on a sample of 1000 participants, demographically representing Slovene general population. The key finding was that university students read more than members of the general population do, but still less than would be expected of future educators who will introduce book reading to pupils as the number of non-readers in student population was higher than expected. In addition, the data revealed that practically all students were able to read in at least one foreign language (predominantly in English) what is significantly higher than in general population. The paper indicates a few reasons for such outcomes and addresses the question of why recreational book reading matters in educational settings.

Multidestination travel of the Slovenian population

Abstract This paper focuses on the multidestination travel of the Slovenian population. It presents the results of a questionnaire survey that aimed to gain insight into some relevant characteristics of the travel behaviour of the Slovenian population and its links to factors that were found in previous research to be related to the incidence of multidestination travel. A destination was defined within this research as any location where an overnight stop is made. Single-destination trips prevailed. Still, a considerable percentage of respondents’ most recent trips had been multidestination trips. The greater part of them was directed to just one country within which they visited several overnight destinations. The results indicate that duration of trip, distance of destination from tourists’ residential location, familiarity of destination, travel-group size and tourists’ activities are associated with the likelihood of multidestination travel.

Comparing Quality of Life of General Population and Orthopedic Patients in Slovenia

ObjectiveTo our knowledge this is the first study presenting descriptive EQ-5D health profile and VAS scores for orthopedic patients in Slovenia. Furthermore, EQ-5D-3L population norms for Slovenia are presented. The aims of this study are (1) to provide population norms for EQ-5D-3L in Slovenia according to age and sex and (2) to compare different groups of orthopaedic patients’ health state among themselves as well as to the general population. MethodsData on orthopedic patients' preoperative health status assessment were recorded (n = 1118). The health status of 4 groups of orthopedic patients was analyzed and compared using EQ VAS and the EQ-5D descriptive profile. The results were compared with Slovenian population norms, which were calculated using the EQ-5D valuation set database from year 2000 (n = 708). ResultsAs expected, a higher proportion of patients than the general population report problems on all dimensions. The opposite is true only for mobility and anxiety/depression dimension for shoulder surgery patients. Hip endoscopy patients have the lowest health-related quality of life (HRQoL) out of all patient groups using EQ VAS and EQ-5D descriptive profiles. ConclusionThe population norms presented will be useful for many researchers trying to compare HRQoL among various patient groups or the general population. Separate use of the descriptive profile of the EQ-5D is informative when assessing HRQoL in orthopedic patients and is in line with VAS values. The results can support further studies on health needs assessment as well as decisions on funds allocation among groups of orthopedic patients.

Seasonal glyphosate and AMPA levels in urine of children and adolescents living in rural regions of Northeastern Slovenia

There are extensive data on the toxicity of glyphosate (GLY) based herbicides (GBH), however the interpretation of some data (e.g. carcinogenic effect) are subject to controversy. For the appropriate health risk assessment more data on exposure levels in the general population, especially in susceptible groups such as pregnant women, the elderly and children are needed.The aims of the present study were to estimate the exposure to GLY and its major metabolite aminomethylphosphonic acid (AMPA) in children and adolescents living in agricultural areas, to identify possible determinants of the exposure, and to assess co-exposure with elements. In total, 149 children (aged 7–10 years, 55% girls) and 97 adolescents (aged 12–15 years; 44% girls) were recruited in 2018 from rural areas of Northeastern Slovenia. The effect of seasonal GLY application on the exposure was estimated using GLY and AMPA levels determined by GC–MS/MS in first morning urine in winter (n = 246) and in late-spring/early-summer seasons (n = 225). Levels of elements were determined by ICP-MS in urine in both samplings and in blood or plasma in the first sampling. Questionnaire data on basic characteristics, dietary habits, living environments and use of pesticides were obtained for all participants.GLY and AMPA were detected in 27% and 50% of urine samples from the first sampling period, respectively; and in 22% and 56% from the second sampling period, respectively. Geometric means and medians of both AMPA and GLY were below or at the limit of quantification (≤LOQ; 0.1 µg/L). Children rather than adolescents tended to have higher exposure, as did, boys rather than girls among adolescents. The exposure did not significantly differ between both sampling periods. Except for one individual, exposure was not higher among participants who reported use of GLY or herbicides in the vicinity of child’s home or live in close vicinity of agriculture, orchards, vineyards, gardens, sport courts or cemeteries. The extensive food consumption frequency data revealed higher exposure to GLY and AMPA only among individuals with higher consumption of nuts and wholegrain rice. Levels of AMPA and GLY were significantly positively correlated, with considerably stronger correlation in urine of the second than the first sampling (Spearman’s rank coefficient: 0.49 vs 0.22, respectively). Urine levels of As, Pb, Co, Zn and Cu were significantly higher in participants with GLY and/or AMPA levels ≥LOQ than with levels <LOQ.In conclusion, this first estimation of GLY and AMPA exposure in a Slovenian study population showed much lower levels when compared to levels reported in similar studies worldwide. Some results might be explained by more intensive use of GBH in spring, but in general we were unable to distinguish between exposure from the diet or use of GBH in residential environments.

Low prevalence of active COVID-19 in Slovenia: a nationwide population study of a probability-based sample

ObjectivesAccurate population-level assessment of the coronavirus disease 2019 (COVID-19) burden is fundamental for navigating the path forward during the ongoing pandemic, but current knowledge is scant. We conducted the first nationwide population study using a probability-based sample to assess active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, combined with a longitudinal follow-up of the entire cohort over the next 6 months. Baseline SARS-CoV-2 RNA testing results and the first 3-week follow-up results are presented. MethodsA probability-based sample of the Slovenian population comprising data from 2.1 million people was selected from the Central Population Register (n = 3000). SARS-CoV-2 RNA was detected in nasopharyngeal samples using the cobas 6800 SARS-CoV-2 assay. Each participant filled in a detailed baseline questionnaire with basic sociodemographic data and detailed medical history compatible with COVID-19. After 3 weeks, participants were interviewed for the presence of COVID-19–compatible clinical symptoms and signs, including in household members, and offered immediate testing for SARS-CoV-2 RNA if indicated. ResultsA total of 1368 individuals (46%) consented to participate and completed the questionnaire. Two of 1366 participants tested positive for SARS-CoV-2 RNA (prevalence 0.15%; posterior mean 0.18%, 95% Bayesian confidence interval 0.03–0.47; 95% highest density region (HDR) 0.01–0.41). No newly diagnosed infections occurred in the cohort during the first 3-week follow-up round. ConclusionsThe low prevalence of active COVID-19 infections found in this study accurately predicted the dynamics of the epidemic in Slovenia over the subsequent month. Properly designed and timely executed studies using probability-based samples combined with routine target-testing figures provide reliable data that can be used to make informed decisions on relaxing or strengthening disease mitigation strategies.

Crosswalk EQ-5D-5L Value Set for Slovenia.

IntroductionDue to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values.MethodsTo obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents.ResultsBy definition, 3-level and 5-level versions have the same range (from 1 to −0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a “slight” severity level (22222) in the 5-level version has a low informational value, the addition of a “severe” health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8.ConclusionThe EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.

Total and Free Sugars Consumption in a Slovenian Population Representative Sample.

Excessive free sugars consumption is associated with poor health outcomes. Thus, the World Health Organization (WHO) recommends limiting free sugars intake to no more than 10% of total energy intake. To evaluate current intakes of dietary sugars and monitor the adherence to the guidelines, the objective of this study was to comprehensively assess total and free sugars consumption of different age groups within the Slovenian population. The Slovenian national food consumption survey SI.Menu 2017/18 was conducted on representative samples of adolescents (10–17 years), adults (18–64 years), and the elderly (65–74 years) using two non-consecutive 24-h dietary recalls. The analyses were carried out on a sample of 1248 study participants. Free sugars content in food was estimated based on previously established databases. The population weighted median free sugars intake accounted for 10.1% of total energy intake (TEI) among adolescents, 6.4% among adults, and 6.5% in the elderly population. Both total and free sugars consumption in the percentage of TEI were higher among women than men, in participants with lower education, and those with higher family net income. The main sources of free sugars in adolescents were beverages, cakes, muffins, pastry, and dairy products; for adults and the elderly, the key sources of free sugars were beverages, cakes, muffins, pastry, and sugars, honey, and related products. A total of 56% of adolescents, 84% of adults, and 81% of the elderly population adhered to the WHO free sugars guidelines. Additional measures will be required to further decrease free sugars consumption among the teenage population, in which dietary patterns are still of greatest concern.