System In Slovenia Research Articles

Neonatal Thyrotoxicosis in Infants of Mothers with Graves' Disease Treated for Radioiodine-Induced Hypothyroidism: A Literature Review.

Fetal and neonatal thyrotoxicosis occurs in up to 5% of pregnancies in mothers with Graves' disease (GD). This condition is caused by stimulating antibodies against the thyrotropin receptor (TRAbs) that cross the placenta and may stimulate the fetal thyroid, typically in the second half of pregnancy. GD is often treated with radioiodine, resulting in hypothyroidism in most patients, but TRAbs can persist for several years. Even if a pregnant mother is hypothyroid after radioiodine therapy or surgery, her TRAbs can still, although rarely, induce fetal hyperthyroidism. In this review, we first present two cases of neonatal hyperthyroidism in mothers with GD who became hypothyroid after prior radioiodine therapy, identified through a 10-year analysis of the National Perinatal System in Slovenia. Based on these cases, we provide an overview of existing data on this rare clinical condition in neonates. We also discuss the underlying mechanisms and clinical outcomes based on currently available data. In conclusion, our review highlights the importance of careful monitoring during pregnancy in all women with GD, even in those well managed after radioiodine therapy or surgery.

Top management education needs – A case study of public health system in Slovenia

Abstract Aim. The purpose of the research was to identify the gap in the existing educational content in Slovenia, which employees in the top management of public health institutions acquired during their education, and to propose a new educational program based on the analysis of the results. Material and methods. Quantitative research method and descriptive work method were used. The survey was completed by directors, expert directors and assistant directors for health care in public health institutions in Slovenia. The survey was sent to all employees in the top management of public health institutions in Slovenia (N = 216). For statistic analysis we use chi-square test and Kullback’s 2Î test. Results. A total number of 146 (67.6%) fully completed questionnaires were analyzed. After reviewing the educational programs and the needs for additional education expressed by the respondents, we noted that there is no program in Slovenia that covers all the necessary content for quality work in top management. We can add that employees in the top management of public health institutions should be required to receive special education. Conclusions. Based on the opinions expressed by the respondents, we propose the introduction of a one-year educational program that would include topics from economics, legislation, management, medicine and nursing.

Longitudinal patterns of scientific collaboration in doctoral studies

Doctoral studies play a vital role in socializing young individuals in science as they navigate the challenges of modern knowledge-based societies. Taking various forms and intensities, the mentor–mentee relationship is integral to this process. The paper therefore addresses the temporal patterns of scientific collaboration between mentors and mentees, as well as among co-mentors, given that understanding the characteristics of mentoring collaborations is essential for developing successful higher education strategies for attracting potential doctoral students and designing effective science policies. Patterns of collaboration were identified using a symbolic data clustering approach and described using linear discriminant analysis. The data come from national information systems in Slovenia and cover the period between 1991 and 2020. On the mentor–mentee level, six types of scientific collaborations were identified and classified in three broader categories: study-limited, already established, and born and raised. The most common, born and raised, is characterized by students who are isolated from the scientific community at the beginning of their studies and have become well integrated into the scientific community and highly productive researchers by the time they complete their doctoral studies. The study-limited collaboration pattern is becoming increasingly popular and more common in the natural and technical sciences. The already established is more common among older mentees. The notion that mentoring promotes long-term scientific collaboration between mentors is not confirmed by the presented study. However, higher levels of collaboration between mentors are associated with younger age, working in the same scientific discipline, and younger mentors.

Unraveling the functioning of the vadose zone in alpine karst aquifers: New insights from a tracer test in the Migovec cave system (Julian alps, NW Slovenia)

The aquifers of alpine karst and high karst plateaus are abundant water resources. They are difficult to characterise due to their complex, partly glaciokarstic, evolution in active tectonic environments, and an unsaturated zone up to two kilometres thick. We present and discuss the results of a tracing test in the alpine karst of the Julian Alps (Slovenia), more precisely in the Migovec System, the longest cave system in Slovenia (length = 43 km, depth = 972 m). The cave extends below a mountain ridge that separates the Soča and Sava Valleys, thus forming a topographic divide between the Adriatic and Black Sea basins, which gives the test greater regional significance. In early September 2019, three kilograms of uranine were injected into a perched lake in a remote part of the system, approximately 900 metres below the plateau and 100 metres above the low water table. All known springs in the valleys on either side of the mountain were monitored by manual or instrumental sampling and a field fluorometer. Due to the unexpectedly dry season, no tracer was detected at any site for two months until a heavy rainfall event in early November. Subsequently, about 60-65 % of the tracer mass appeared within 60 hours in the Tolminka River. No tracer was detected at other sites, either becauseit was not present or because it was highly diluted. The study suggests that the lake containing the tracer is bypassed by the vadose flow and that the tracer was only mobilised during large events when the lake became part of the epihreatic flow. The linear peak flow velocity from the injection site to the Tolminka Spring was only about 1.7 m/h. However, assuming that the tracer was only mobilised by the large rain event, the velocity would be 70 m/h. The study highlights the challenges and pitfalls of water tracing in alpine karst systems and suggests ways to avoid them.

Preimplantation Genetic Testing within the Public Healthcare System in Slovenia.

Preimplantation genetic testing (PGT) is the earliest form of prenatal diagnosis that has become an established procedure for couples at risk of passing a severe genetic disease to their offspring. At UMC Ljubljana, we conducted a retrospective register-based study to present 15 years of PGT service within the public healthcare system in Slovenia. We collected the data of the PGT cycles from 2004 to 2019 and compared clinical outcomes for chromosomal and monogenic diseases using different embryo biopsy and testing approaches. In addition, we assessed the extent to which PGT has become the preferred option compared to classic prenatal diagnostics. We treated 211 couples, 110 with single gene disorder, 88 with structural chromosome rearrangement and 13 for numerical chromosome aberration. There were 375 PGT cycles with oocyte retrieval, while embryo transfer was possible in 263 cases resulting in 78 deliveries and 84 children. Altogether, the clinical pregnancy rate per embryo transfer was 31% in 2004-2016 (blastomere biopsy) and 43% in 2017-19 (blastocyst biopsy), respectively. We assessed that approximately a third of couples would opt for PGT, while the rest preferred natural conception with prenatal diagnosis. Our results show that providing a PGT service within the public healthcare system has become a considerable option in pregnancy planning for couples at risk of transmitting a severe genetic disease to their offspring. In Slovenia, approximately a third of couples would opt for PGT. Although the number of cycles is small, our clinical results are comparable to larger centres.

Gravimetry and hydrologic data to constrain the hydrodynamics of a karstic area: The Škocjan Caves study case

In this paper we employ a combination of gravity and hydrologic data to constrain a hydraulic model of the Škocjan Caves, an allogenic dominated karstic system in Slovenia. The gravity time-series recorded by a spring-based gravimeter, are carefully analyzed to remove tidal and non-tidal effects and unveil the local hydrologic contribution, which is influenced by the temporary accumulation of water in the cave system during the flood events of the Reka river.We make use of a combined analysis of three large flood events with peak river discharge of about 200, 230 and 300 m3/s, that caused significant water level and gravity variations sensed by the pressure transducer and by the gravimeter. By the integration of hydraulic modelling we study the different coupled gravimetric-hydrologic responses to these flood events: we show that, depending on the peak discharge and duration of the event, different flow conditions are present in the cave system. In addition to the information provided by the pressure transducer, the gravimeter is sensitive to the flow dynamics in a different sector of the cave due to the choice of its location; this configuration helps to better constrain the hydraulic model.Moreover, we find that the autogenic recharge by percolating water can significantly affect the gravity time-series and must be considered in related models. By inclusion of both the hydraulic model outcomes and of the modelling of the autogenic recharge, we are able to better explain the gravity transients during the two smaller magnitude events. In particular, during such events the autogenic contribution produces a transient gravity signal, which is about 4 times larger than the allogenic one, while during the largest flood the allogenic contribution drastically overcomes the autogenic effect by a factor 20.By discussing this case, we prove the potential of terrestrial gravity observation to depict the hydro-dynamics of these complex karstic systems as well as the potential of gravimetry to remotely monitor these storage units.

Neurosurgical service during COVID-19 pandemics in Ljubljana, Slovenia - lessons learned

Introduction: The novel coronavirus disease 2019 (COVID-19) became an important and urgent threat to global health. In Slovenia, the COVID-19 struck the health system immensely. Neurosurgery experienced difficulties, not only in regular, elective surgeries, but also during emergency situations. Methods: In the article, we analyse and compare the number of elective and emergency neurosurgical procedures during the time of the pandemic (from March 2018 to February 2020) and describe our protocol in the management of neurosurgical patients in the Medical Centre in Ljubljana, Slovenia. Results: There were 2597 patients treated surgically, including 1932 emergency patients and 665 emergency patients. Overall, we recorded an 11.2% drop in all neurosurgical procedures in two years after COVID-19 was declared compared to two years before. Elective procedures decreased by 13.9%, mostly on account of spinal pathology procedures (245, 23.5%), functional neurosurgical procedures (37 cases, 24.7%), endonasal endoscopy procedures (11, 12.8%), and brain lesions (31, 4.8%). Conclusion: COVID-19 had a vast impact on the healthcare system in Slovenia, including on neurosurgery. New and improved strategies to maintain neurosurgical practice during public health emergencies are necessary for the neurosurgical service and healthcare system to run smoothly in the long term and prevent disruptions during future pandemics.

Optimal Network of General Hospitals in Slovenia

This article explores how the minimum number of general hospital locations can be determined with optimal population coverage. Due to the increasing financial problems of hospitals and the poor organization of general hospital healthcare, Slovenia is currently working to reform the healthcare system. Defining the optimal network of hospital providers is one of the key elements in reforming the healthcare system. To define the optimal network of general hospitals, the allocation-location model was used, and the maximize attendance model was used as the central method. The chief purpose of maximize attendance model is to optimize the demand attendance with respect to distance and time spent getting to the point of demand. In the analysis of optimal locations and the number of Slovenian general hospitals, we used data on the locations of settlements with their number of inhabitants and data on the Slovenian road network, based on which we defined average travel speeds on the categorized road network. The hypothetical locations of general hospitals and the number of optimally located general hospitals that provide access to the nearest provider were determined in three different time intervals. We found that the same accessibility to hospital services as provided by the existing network of general hospitals can be achieved with only ten optimally located general hospitals within a 30-min time interval. This means that two general hospitals could be rationalized or reorganized, which would bring significant savings in the field of hospital activity, which creates a large loss in the health system in Slovenia.

Country Profile of Slovenia: Sport Policy System in a Small State

ABSTRACT The profile provides an overview of the contemporary sport policy system in the small, and relatively young, state of Slovenia. The paper begins by outlining some of the specific characteristics of Slovenia which provide important contextual understanding. A brief overview of the historical development of sport in Slovenia after gaining independence in 1991 is also included. Next, a detailed description of the contemporary structure of the sport policy system in Slovenia is provided, including relevant organisational and financial structures. The paper then discusses some of the specificities of the Slovene context that have also influenced the contemporary sport policy system including characteristics of scale, culture, and the natural environment. Finally, the paper concludes by highlighting the contextual factors that may be relevant to the future of the sport policy system in Slovenia.

Performance of PV systems in Slovenia with the help of typical daily profiles and automatic detection of orientation and inclination angles

Operators of photovoltaic (PV) systems, especially the small ones, monitor only the produced energy output, since they are not equipped with a meteorological station, or there is none in the neighbourhood. When evaluating a large number of PV systems across a region or country, access to the data due to privacy restrictions is usually very limited. To resolve both aspects, we report on a methodology to evaluate the performance of photovoltaic systems where only produced energy data and rated power of the PV system are available and all other data, including orientation and inclination angles, and the exact location are missing. We developed a novel algorithm for automatic detection of orientation/inclination angles and used the recently developed Typical Daily Profiles (TDP) methodology for a fast and accurate evaluation of PV systems. TDPs are representative hourly profiles of the observed parameter (e.g., power, irradiance and temperature) on a monthly basis. For the PV system degradation rate extraction, year-to-year TDPs are used. The case study of 957 PV systems in Slovenia in the period 2015–2019 reveals an average PV system performance ratio exceeding 85% and an average PV system rated power degradation rate of −0.7% per year.

Integration of Telecare into the National Long-term Care - System The Case of Slovenia

In Europe and beyond, there are countries that are only now working intensively on the integration of remote care into home care, while in other countries the use of information and communication technology (ICT) is already routine. Among these countries is Slovenia, which in December 2021 adopted a systemic Long-term Care (LTC) Act, which formally introduces the right to e-care in home care. The integration of ICT services are essential to ensure adequate home care. This has been demonstrated by the LTC pilot projects in Slovenia, financed by the European social found which provided financial support for testing solutions that were later adopted in the LTC Act. The pilot projects drew attention to areas that still need to be researched, especially in rural communities. From this point of view, projects are an important starting point for the further development of social infrastructure in local communities. This paper shows what has directly conditioned and influenced the development of the LTC system in Slovenia and the consequent integration of e-Care in home care system. The case shows that the integration of ICT in LTC depends less on the actual needs that may influence the redirection of budget spending towards health and social care and more on the will of each government to do its "core business" in the struggle for how much, to whom and when to allocate resources to enforce the rights. The article draws attention to shortcomings that would be useful to take into account when developing a sustainable system of long-term care for an aging society.

Study trips and fieldwork in sloveniantourism studies: experience from Turstica

The education system in Slovenia is generally supportive of study trips or school excursions, which are organised already at primary and secondary school level to give the pupils and students an additional opportunity to learn about their homeland and neighbouring regions/countries. Study trips and fieldwork are an essential form of the study process in Slovenian higher education as well. This is especially true for the field of geography and its related disciplines. The review of higher education programmes of tourism studies (in the period before the COVID-19 pandemic) shows the importance of practical training and acquiring different competencies through study trips and fieldwork – either while learning about business tourism systems or tourist offer in the selected destinations. In paper, we focus on the experiences of conducting study trips and fieldwork at the University of Primorska, Faculty of Tourism Studies - Turistica, which stands as the only higher education institution in Slovenia with a degree in tourism at all three levels (BSc, MA and PhD). Study trips are an integral part of the curriculum, especially in the first cycle programmes, dominated by the cultural tourism study programme, where humanistic views and approaches in tourism take substantial part (e.g., anthropology, ethnology and geography). At Turistica, various study trips and fieldwork take place, ranging from one-day or two-day excursions in the local and regional environment or across Slovenia, to multi-day study tours abroad. The most complex example is a one-week study trip to Prague and Berlin, which is a study to which we pay special attention in the paper. It is a successful model of fieldwork, which will, with appropriate modifications, also be used as a model for shaping and arranging the future study trip of Turistica’s students to Bosnia and Herzegovina.

The Impact of Slovenian Qualifications Framework: Stakeholders’ Perspective

This paper examines the impact of the national qualifications framework on the education and training system in Slovenia in the context of the European qualifications framework for lifelong learning and its influence on the design of the Slovenian qualifications framework. Although the role of the European Union in educational policy-making has received considerable attention, of which national qualifications frameworks are part of, only a few studies have focused on measuring the impacts of the European qualifications framework influenced national qualifications frameworks in Europe. By drawing on the theoretical concept of policy transfer in the analysis of European/global education policies, the study shows how European qualifications framework policy transfer influenced Slovenian qualifications framework development through soft instruments. Furthermore, this study examined the extent to which the Slovenian qualifications framework’s objectives have been achieved according to key stakeholders (n = 50) using a quantitative research approach. The findings indicate that, unlike objectives related to the Slovenian qualifications framework’s reform role, i.e. support for lifelong learning, the objectives related to the Slovenian qualifications framework’s communication role, i.e. recognisability, understanding and transparency of qualifications and coordination of the qualifications subsystems, are mostly being met from the stakeholders’ perspective.

Legal basis for the development of the Slovenian health system - from the enlightenment to the second world war

Throughout the history of medicine, patient-doctor relationships remained intimate and were based on the patient’s expectations, which were more or less limited by the expert knowledge of the physician. At first, the economic relationship between patient and doctor was based on a personal agreement; state regulations were only involved later. In Roman times the relationship was affected indirectly by the state, mostly by the adoption of the Act on Hygiene and partly by various socialeconomic regulations. However, in the early Middle Ages, the charitable activities undertaken by the monastic population, with their limited medical knowledge, proved to be a backward step in the development of the healthcare system. It was not until the development of medical knowledge at the emerging universities, especially during the Renaissance, that regulations reentered healthcare and the better education of physicians marked the new era. During the investigated period (from the Enlightenment to the Second World War), the state, as a third party, was completely integrated in the system. Furthermore, in addition to the existing health services, health insurance was established, which marked the beginning of a healthcare system. This formed a solid foundation for the development of modern medicine and the regulation of the so-called welfare state. This article discusses the basic healthcare legislation in Slovenia during four different development periods; the Habsburg Monarchy, the Austro- Hungarian Monarchy, the State of Slovenes, Croats and Serbs, and the Kingdom of Yugoslavia. The development of the healthcare system during this sensitive era is clearly described; the changes in healthcare services are presented and healthcare insurance is analysed from a legal point of view. All of this led to the formation of the social healthcare policy, which signifies the existence of a modern state.
 The development of the health system in Slovenia was mainly influenced by two significant factors: firstly, by the reforms initiated by Empress Maria Theresa and her son Joseph II at the end of the 18th century and, secondly, by the establishment of insurance some one hundred years later.

Inclusion of Social Economy Topics into the Higher Education Business Study Programmes in Slovenia

The author is addressing the problem of systematic inclusion of the topics of social economy into the accredited higher education study programmes in Slovenia. To support the actuality of the research problem, education in social economy is shown as public policies priority on national and European level. The paper aims to answers the question of existence of social economy courses in the study programmes on business (and business-related management) and the question about correspondence of the content of these courses to the needs for competences of actors in the sector of social economy. The paper also presents different types of inclusion of the topics of social economy into the systems of higher education in Europe with the purpose to show possible directions for further development of social economy education in higher education system in Slovenia. The results of the research aim to have didactical, developmental and advocacy value and applicability.

Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness

The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.

Development Processes for Changing the Party System in Slovenia and Montenegro

Abstract This paper explores differences in the party system development of two former Yugoslav republics: Slovenia and Montenegro. Despite sharing a communist institutional system, after that disintegrated Slovenia had a much faster pace of democratic consolidation and economic development than Montenegro. Similarly, the nature of the party competition and party system structure are also quite different. Using a quantitative and descriptive approach applied to the period between 1990 and 2018, we outline patterns of party competition and party system development and explore how they complement the stages of democratisation. We investigate how the comparatively faster democratisation in Slovenia is reflected in the competitive party system with a focus on the ideological divide as the chief source of electoral competition. In contrast, we look at how the prolonged transition in Montenegro is reflected in the closed party system with party competition occurring mainly along ethnic lines.

Democratisation of Defence Policies and Systems in Slovenia and Montenegro: Developmental and Comparative Aspects

Abstract The democratisation of national defence policies and systems plays a vital role in making any country more democratic. The democratic transition of this sector in Slovenia and Montenegro has experienced a challenging reform process and it is now time for reflection. This paper aims to identify the main characteristics and issues of the democratisation process in the field of national defence in both countries and, by comparing them, to look for key similarities and differences. The paper argues and confirms that the Slovenian and Montenegrin national defence and security systems were initially faced with serious post-socialist democratic deficits, but gradual democratisation then brought drastic improvements to the quality of their democracy. The process of joining NATO and the change from a military threat perception to a non-military threat perception created space for many reforms. Greatest steps forward in democratisation in both countries entailed nominating civilian defence ministers, having a reasonable number of civilian defence experts involved in the military business, establishing working parliamentary monitoring committees, reducing defence budgets and reallocating funding to other sectors. Progress was also observed in reducing the total number of soldiers, establishing a fully professional armed force, assuring that women in the armed forces were properly represented and increasing the deployment of soldiers to foreign stabilisation operations in a sign of becoming security providers.

Steps Towards Comprehensive Heat Communication in the Frame of a Heat Health Warning System in Slovenia.

Occupational heat stress has an important negative impact on the well-being, health and productivity of workers and should; therefore, be recognized as a public health issue in Europe. There is no comprehensive heat health warning system in Slovenia combining public health measures with meteorological forecasts. The aim of this research was to provide insight into the development of such a system in Slovenia, turning the communication from the current meteoalarm into a broader system that has more information for different social groups. To achieve this goal, the following steps were used: Analysis of summer temperatures and issued meteoalarms, a survey of the general knowledge about heat among the public, organization and management of two stakeholder symposia, and a final survey on workers’ opinions on heat stress and measures, supplemented by interviews with employers. Summer average daily temperature distributions in Slovenia changed during the investigated period (1961–2019) and the mean values increased over time by 2–3 °C. Additionally, the number of days with fulfilled yellow (potentially dangerous) and especially orange (dangerous) meteoalarm conditions increased significantly after 1990. The survey of the general public about heat stress and warnings showed that efforts to raise awareness of heat issues need to be intensified and that public health measures should effectively target vulnerable groups. Stakeholder symposia and further surveys have shown that awareness and understanding of the negative effects of heat stress on health and productivity are still quite low, so effective ways of disseminating information to different sectors while striking the best balance between efficiency, feasibility and economic cost have to be found.

Stimulating collective action to preserve High Nature Value farming in post-transitional settings. A comparative analysis of three Slovenian social-ecological systems

The main research challenge of this paper is to gain a better understanding of collective action to preserve High Nature Value (HNV) farming in the specific setting of post-transitional EU Member States of Central and Eastern Europe, which we explore using Slovenia as a model country. We apply the Social-ecological Systems (SES) framework and combine participatory and action research in considering different options for stimulating collective action of local actors in three social-ecological systems in Slovenia. We describe the systems, focussing on first-tier variables, and provide a comparison of their characteristics influencing the readiness to engage in collective action. Characteristics of system actors had the greatest influence on outcomes, followed by the social, economic and political setting (macro issues) and governance arrangements. Strong leaders enjoying the community’s trust are needed; rules must be transparent and individuals must have a personal interest to engage in cooperation. In a post-transitional setting, overcoming the issue of lack of trust is a limiting factor when attempting to stimulate collective action.