Institute of Public Health of the Republic of Slovenia

Ljubljana, Slovenia

Institute of Public Health of the Republic of Slovenia

Ljubljana, Slovenia
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Jagodic H.K.,Psychiatric Hospital Vojnik | Rokavec T.,Institute of Public Health of the Republic of Slovenia | Agius M.,University of Essex | Agius M.,University of Cambridge | And 2 more authors.
Croatian Medical Journal | Year: 2013

Aim To investigate the influence of socioeconomic factors, mental health service availability, and prevalence of mental disorders on regional differences in the suicide rate in Slovenia. Methods The effects of different socioeconomic factors, mental health service availability, and mental disorders factors on suicide rates from 2000-2009 were analyzed using a general linear mixed model (GLMM). Pearson correlations were used to explore the direction and magnitude of associations. Results Among socioeconomic factors, unemployment rate ranked as the most powerful predictor of suicide and an increase of one unit in the unemployment rate increased regional suicide rate by 2.21 (β = 2.21, 95% confidence intervals [CI] = 1.87-2.54, P < 0.001). On the other hand, higher marriage/divorce ratio was negatively related to the suicide rate and an increase of one unit in marriage/divorce ratio reduced regional suicide rate by 1.16 (β = -1.16, 95% CI = -2.20 to -0.13, P < 0.031). The most influential mental health service availability parameter was higher psychiatrist availability (4 psychiatrists and more working at outpatient clinics per 100 000 inhabitants), which was negatively correlated with the suicide rate and reduced regional suicide rate by 2.95 (β = -2.95, 95% CI = -4.60 to -1.31, P = 0.002). Another negatively correlated factor was the antidepressant/ anxiolytic ratio higher than 0.5, which reduced the regional suicide rate by 2.32 (β = -2.32, 95% CI = -3.75 to -0.89, P = 0.003). Among mental health disorders, only the prevalence of alcohol use disorders was significantly related to the regional suicide rates and an increase of one unit in the prevalence of alcohol use disorders per 1000 inhabitants increased the regional suicide rate by 0.02 (β = 0.02, 95% CI = 0.01- 0.03, P = 0.008). Conclusions Besides unemployment, which was a very strong predictor of suicide rates, unequal availability of mental health services and quality of depressive disorder treatment may contribute to variations in suicide rates in different regions.

Tansey K.E.,King's College London | Guipponi M.,University of Geneva | Perroud N.,University of Geneva | Bondolfi G.,University of Geneva | And 30 more authors.
PLoS Medicine | Year: 2012

Background: It has been suggested that outcomes of antidepressant treatment for major depressive disorder could be significantly improved if treatment choice is informed by genetic data. This study aims to test the hypothesis that common genetic variants can predict response to antidepressants in a clinically meaningful way. Methods and Findings: The NEWMEDS consortium, an academia-industry partnership, assembled a database of over 2,000 European-ancestry individuals with major depressive disorder, prospectively measured treatment outcomes with serotonin reuptake inhibiting or noradrenaline reuptake inhibiting antidepressants and available genetic samples from five studies (three randomized controlled trials, one part-randomized controlled trial, and one treatment cohort study). After quality control, a dataset of 1,790 individuals with high-quality genome-wide genotyping provided adequate power to test the hypotheses that antidepressant response or a clinically significant differential response to the two classes of antidepressants could be predicted from a single common genetic polymorphism. None of the more than half million genetic markers significantly predicted response to antidepressants overall, serotonin reuptake inhibitors, or noradrenaline reuptake inhibitors, or differential response to the two types of antidepressants (genome-wide significance p<5×10-8). No biological pathways were significantly overrepresented in the results. No significant associations (genome-wide significance p<5×10-8) were detected in a meta-analysis of NEWMEDS and another large sample (STAR*D), with 2,897 individuals in total. Polygenic scoring found no convergence among multiple associations in NEWMEDS and STAR*D. Conclusions: No single common genetic variant was associated with antidepressant response at a clinically relevant level in a European-ancestry cohort. Effects specific to particular antidepressant drugs could not be investigated in the current study. Please see later in the article for the Editors' Summary. Tansey et al.

Iljaz R.J.,University of Ljubljana | Meglic M.,Institute of Public Health of the Republic of Slovenia | Svab I.,University of Ljubljana
BMC Medical Informatics and Decision Making | Year: 2011

Background: Slovenia's national eHealth strategy aims to develop an efficient, flexible and modern health care informatics framework that would be comparable to the most successful EU countries. To achieve this goal, the gap between availability and usage of information and communication technology by primary care physicians needs to be reduced. As recent efforts show, consensus on information and communication technology purpose and usage in primary care needs to be established before any national information and communication technology solutions are developed. The aim of this study was to identify the most appropriate measures in implementation of Slovene national eHealth strategy and to suggest an appropriate model for success by using the three round Delphi study. Methods. An e-mail based, three-round Delphi study was undertaken to achieve consensus from a selected sample of nationally recognized experts from the fields of primary health care and medical informatics. The aim of this study was to identify the most appropriate measures and key obstacles in implementation of eHealth in Slovene primary health care by using the Delphi study. Results: High levels of consensus on the majority of suggested measures were achieved among all study participants, as well as between the subgroups of experts from primary health care and medical informatics. All aims of the three-round Delphi study on eHealth implementation in Slovenian primary health care were achieved. Conclusions: The three round decision Delphi process has proven to be effective for developing outcomes, ranking key priorities in primary care eHealth development, and achieving consensus among the most influential experts in that field. This consensus is an important contribution to future national eHealth strategies in the field of primary health care. © 2011 Ilja et al; licensee BioMed Central Ltd.

Domajnko B.,University of Ljubljana | Drglin Z.,Institute of Public Health of the Republic of Slovenia | Pahor M.,University of Ljubljana
Midwifery | Year: 2011

Objective: this article argues that rhetorical skills are an important quality factor of midwifery care. In particular, it aims to identify and discuss the relevance of three classical means of persuasion: ethos, pathos and logos. Design: secondary analysis, rhetorical analysis of semi-structured interviews. Setting: Slovenia. Interviews were carried out predominantly in 2006. Data refer to childbirths in 2005 and 2006. Participants: four women with recent experience of childbirth. Findings: analysis identified the presence of all three means of persuasion in the interaction between midwives and women. Focusing on midwives, the quality of their awareness and command of rhetorical skills remains questionable. In particular, women experienced lack of a rational account of the situation and decisions made by health-care professionals involved in maternity care. Key conclusions: acknowledging professional ethics, awareness and good command of all three means of persuasion [but above all, argumentative persuasion (logos)] is an integral component of midwifery care. It can contribute to collaborative relations between midwives and women, and thus promote women-centred midwifery care. Implications for practice: knowledge of the three classical rhetorical means of persuasion should be integrated into professional midwifery curricula. © 2009 Elsevier Ltd.

Roskar S.,Institute of Public Health of the Republic of Slovenia | Podlesek A.,University of Ljubljana | Kuzmanic M.,University of Primorska | Demsar L.O.,University of Ljubljana | And 2 more authors.
Crisis | Year: 2011

Background: Different types of marital status are associated with different levels of suicidal risk. Aims: To study marital status change and the effect of its recency in relation to suicidal behavior. Methods: Suicide victims (1614) in Slovenia and matched controls (4617) were compared for incidence and recency of marital status change during the last 5 years of their lives. Results: A higher percentage of suicide victims (10.7%) had a marital status change in the last 5 years compared with the controls (5.6%). All types of marital status changes (becoming widowed, getting divorced, getting married) proved to be risk factors for suicidal behavior. Almost half of all marital status changes in suicide victims occurred in the year prior to suicide, whereas marital status changes in the control group were equally distributed over the last 5 years. For recently married and divorced people, the increase in suicide risk depended on age: The risk was higher in older people. Conclusions: Marital status change represents a risk factor for suicidal behavior. The first year after the change is critical for elevated suicidal risk, in particular for older people. © 2011 Hogrefe Publishing.

Ernst K.,B-4 Health | Irwin R.,The London School of Economics and Political Science | Galsworthy M.,Institute of Public Health of the Republic of Slovenia | McKee M.,B-4 Health | And 2 more authors.
Journal of Health Services Research and Policy | Year: 2010

Objective: European Union (EU) information from research projects, including key findings, should be available on the European Commission's Community Research and Development Information Service (CORDIS) database. We describe the results of the Health Research for Europe (HR4E) project which aimed to synthesize results of health research from the EU's Fifth and Sixth Framework Programmes (FP5 and FP6) of research. Methods: Screening of titles and abstracts of all projects funded within FP5 and FP6 to identify health-related projects followed by allocation of such projects to one of the 47 themes of the European Union's Health Portal. Extraction of key findings relevant for policy and practice from data on the CORDIS database and, in a subset of 182 projects selected fromfive themes, attempted contact with project co-ordinators to obtainmissing information. Results: The information held on CORDIS was inadequate, with many fields not completed. Data were rarely updated after the project had been funded. Of the 182 attempts to contact co-ordinators, useful information was obtained in only 17% of cases, with many contact details missing or unverifiable. Conclusions: CORDIS does not meet its stated objectives of facilitating and disseminating EU research. There is a clear need to review the systems designed to manage the CORDIS platform. © The Royal Society of Medicine Press Ltd 2010.

Skaza A.T.,Institute of Public Health of Celje | Kurincic T.S.,General Hospital of Celje | Beskovnik L.,Institute of Public Health of Celje | Paragi M.,Institute of Public Health of the Republic of Slovenia | Bozanic V.,Institute of Public Health of Celje
Eurosurveillance | Year: 2011

We report here on the identification of the first meningococcal meningitis case in Slovenia caused by Neisseria meningitidis serogroup Z' in December 2010. The 19-year-old patient had not left the country during the incubation period. The patient was hospitalized and given the antibiotic treatment with cefotaxime very early in the course of the disease. The patient did not develop any complications during hospitalization and was discharged on 5 January 2011.

Mesec Rodi P.,Primary Health Care Center Skofja Loka | RoSkar S.,Institute of Public Health of the Republic of Slovenia | MaruSic A.,Institute of Public Health of the Republic of Slovenia | MaruSic A.,University of Primorska
International Journal of Social Psychiatry | Year: 2010

Background: Previous studies have reported that many suicide victims have had contact with their physicians a week or month prior to their suicide. Aims: To assess the date of the last appointment (and complaint) of suicide victims in the Åkofja Loka region within Slovenia. Method: We included all suicide victims in the region in the period 1993-2003. Each of the cases was assigned the closest control in terms of age and gender. Medical death certificates served as a source of demographic data information and information about suicide method. From personal medical records we obtained the date of the last appointment (and the complaint) with the primary care physician. The same was done for the control group. The groups were compared for their last appointment with their physician (date and complaint). Results: Thirty out of 77 suicide victims visited their physician in the last month before suicide (14/77 in the last week); only 16/77 controls did so before the index day (3/77 in the last week). In 30% of suicide victims, the reason for the last visit was mental health problems (only 3% in the control group). Conclusion: The results emphasize the important role of primary care physicians in suicide prevention. © The Author(s), 2010.

Goodwin R.D.,Queens College, City University of New York | Mocarski M.,Queens College, City University of New York | Marusic A.,Institute of Public Health of the Republic of Slovenia | Beautrais A.,University of Auckland
Suicide and Life-Threatening Behavior | Year: 2013

The association between thoughts of self-harm and help-seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School-aged Children Study (n = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help-seeking behaviors among youth with and without thoughts of deliberate self-harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help-seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self-harm in community and school settings. © 2013 The American Association of Suicidology.

Grilc E.,Institute of Public Health of the Republic of Slovenia | Socan M.,Institute of Public Health of the Republic of Slovenia
Zdravstveno Varstvo | Year: 2014

Background: The assessment of the incidence of acute gastrintestinal infections (AGI) derived from the notifications underestimates the real burden of AGI. The symptoms of AGI are usually not severe enough for consultation with a physician. The more exact data on the burden of AGI are gained through cross sectional population-based studies. To estimate the burden of AGI in Slovenia, a period prevalence study was conducted. Methods: A simple random sample consisting of 5000 Slovenian inhabitants was chosen to whom a questionnaire was sent in July 2011. The participants were asked if they experienced AGI in June 2011 according to a symptombased case definition. The participants were asked to fill in the questionnaire on a paper or via a web page created for study purposes. Results: Out of 5000 participants, 1500 filled out the questionnaire, giving a response rate of 33%. The number of women responding out-numbered men-there were 58% female and 42% male responders. 66 (4.4%) of the responders claimed to have had AGI in June 2011. The incidence rate of acute AGI was therefore 4400 per 100,000 inhabitants. Comparatively, the incidence rate of notified cases in the same month was 78.9 per 100,000 inhabitants. The difference between the incidence of AGI, based on notified cases and incidence, calculated in the first Slovenian cross sectional study, showed that one out of 56 cases of AGI in the community has been notified. Conclusion: the incidence of AGI among the Slovenian population, based on data from our cross sectional study, is as expected higher than the incidence calculated from notification data from the same period.

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