Subjective Well-Being and Self-Assessed Health of Adolescents: A Longitudinal Cohort Study.

BACKGROUND: The aim of this study was to investigate the stability and predictors of subjective well-being and self-perceived health in adolescents over a two-year period, focusing on the importance of mental health in overall well-being. METHODS: Participants in this longitudinal cohort study were surveyed at the ages of 15 (n = 441) and 17 (n = 354) through questionnaires. The data were analyzed using both descriptive and inferential statistical methods. Hierarchical regression was employed to investigate significant predictors of subjective well-being. The subjective well-being and self-perceived health dimensions showed a consistent level of stability throughout the two-year period of secondary education. Additionally, there was a significant correlation between well-being at the beginning and end of this education period. Furthermore, self-perceived health dimensions, particularly general health, vitality, and mental health, were positively associated with well-being at the end of secondary education, highlighting their role in overall subjective well-being. The regression analysis revealed that self-perceived health factors, notably "General health" and "Mental health", significantly predicted overall subjective well-being, enhancing the model's explanatory power beyond gender and economic status. Nevertheless, baseline subjective well-being has the strongest predictive effect on final well-being. CONCLUSIONS: This study highlights the importance of psychological and health factors, particularly mental health, that affect the overall well-being of adolescents and emphasizes the need to focus on and improve these factors in order to improve subjective well-being.

Point-of-Care Screening for Coeliac Disease in Schoolchildren Reveals Higher Disease Prevalence in Croatia.

Coeliac disease (CD) is an immune-mediated inflammatory disease triggered by dietary gluten and related proteins in genetically predisposed individuals. Point-of-care (POC) methods are non-invasive and easily performed tests, which could help to reduce the diagnostic delay of CD. The aim of our study was to determine the prevalence of CD using rapid POC test in first-grade schoolchildren in Zagreb, Croatia. A rapid qualitative immunoassay POC test designed for detection of immunoglobulin (Ig) A and IgG deamidated gliadin antibodies (DGP), as well as total IgA (to identify IgA deficient patients) in whole blood, was used to test healthy children on gluten containing diet. Out of 1404 tested children (51% female), 85 (6.05%) had a positive rapid POC test result and were referred to paediatric gastroenterologist. Finally, 7 children were diagnosed with CD (0.5%). There was no significant difference in children with CD and children with positive POC but negative serology in sex, BMI, or symptoms. However, children diagnosed with CD complained of abdominal pain significantly more often. The prevalence of CD in first-grade schoolchildren was 1:200 (0.5%), higher than in previous studies performed in Croatia. The results imply the possible benefit of IgA and IgG DGP-based POC tests in population screening.

Differences in Health-Promoting Lifestyle Profile Among Croatian Medical Students According to Gender and Year of Study

Increasing awareness of healthy lifestyle is important during the period of adolescence because habits are difficult to modify in adulthood. The aim of the study was to examine gender differences in health-promoting lifestyle among medical students and to analyze changes between the first and second year of the study. This cross sectional study was conducted on a sample of 1186 students (36% male). Data were collected by self-administered anonymous questionnaire, the Health- Promoting Lifestyle Profile [HPLP II] (Adult Version), and analyzed by descriptive statistics and nonparametric tests. The 941 HPLP II questionnaires were collected and analyzed (79% response rate). Both genders showed a medium level HPLP II total score (male M=2.68; IQR=2.42-2.92 vs. female M=2.65; IQR=2.46-2.90), without significant gender difference. A significantly higher score was observed in the subscales on health responsibility (p=0.027) and interpersonal relations (p<0.001) among female compared to male students, and a significantly higher score in the subscales on physical activity (p<0.001) and stress management (p=0.025) among male compared to female students. Considering differences in the health-promoting lifestyle between study years, a significantly higher score was recorded among second-year students in the HPLP II total score (p=0.004) and the subscales on physical activity (p=0.007), stress management (p=0.006) and spiritual growth (p=0.029). In conclusion, study results implied the need of organized health care and physical activity programs for university students based on specific requirements and needs.

Growth charts for Croatian school children and secular trends in past twenty years.

The aim of this study was to construct new Croatian growth charts for body height and weight of boys and girls aged 6.5 to 18.5 years and to investigate differences between our and pre-existing studies. Analysis was based on a multistage stratified sample representative for school children aged 6.5 to 18.5, 6046 boys and 5656 girls. Growth reference was constructed using LMS method. Present results demonstrated an increment of body height and weight during the last two decades. Highest increase of body height is in boys aged 13-14 years 6.5 cm, in girls aged 12 years is 5.0 cm. Highest increase of body weight is in 16 year age group of boys 8.7 kg and in 11-12 year age group of girls 5.2 kg. In conclusion, regarding presence of secular trend because previously used growth charts in Croatia are obsolete.

Behavioral pattern of overweight and obese school children.

The aim of this study was to determine socio economic, health status, nutritional and behavioral differences in obese, overweight and normal weight children attending first grade elementary school. In overweight group there is 13.8% of boys and 12.6% of girls, in obese group 8.3% of boys and 6.9% of girls. In factor analysis 12 factors was excluded with cumulative loading of 60% variability. Discriminant analysis was performed with 12 factors as predictive variables and discriminant variables were three BMI groups: normal weight, overweight and obese. Function 1 discriminate well normal weight group from overweight and obese group. Overweight and obese groups is described with lower number of children in the family and lower order of birth, higher education of parents, they eat less vegetables and fruits, spend more time playing computer games, have less physical activity, drink more alcohol with their meals, exactly opposite to normal weight group.

Elevated blood pressure in school children and adolescents--prevalence and associated risk factors.

Elevated blood pressure (BP) in children and adolescents is determined on normative distribution of BP in healthy children. The aim of this study was to determine prevalence of high normal and elevated BP among school children and to assess associated risk factors. The study comprised 965 children (48.7% girls) in 8th grade of primary school. Data were obtained from questionnaire and anthropometric measurements. The prevalence of high normal BP was 28.5% in girls, 36.8% in boys, and elevated BP 7.9% in girls and 5.3% in boys. Overweight was present in 19.4% of girls and 9.3% boys with high normal, and 29.7% of girls and 30.8% boys with elevated BP. Hypertension in family history was the most common associated factor reported by boys and girls with high normal and elevated BP. Follow-up of children throughout school age makes possible taking of preventative measures and promotion of healthy life style.

[School choice and vocational guidance for schoolchildren with chronic diseases and other health problems]. / Skolsko i profesionalno usmjeravanje ucenika s kronicnim bolestima i drugim poremecajima zdravlja.

By following a child's growth, development, and health, school medicine specialist can see opportunities for career choice. Special attention is needed for schoolchildren with chronic diseases and developmental difficulties, because of limited occupation choices. Studies report 10 % to 15 % prevalence of chronic diseases among schoolchildren. Parents and children should be informed about child's limitations before career choice. It would be helpful for the students to develop interests for occupations that are not contraindicated for their condition. Physical examination gives an insight into the psycho-physical abilities of an eighth-grade primary school student for further education. During examination, counselling and vocational guidance is provided for all students with chronic diseases and other health problems. All procedures are oriented to personal abilities and preferences. The aim of this study was to analyse the reasons for vocational guidance in the Varazdin County of Croatia. It included eighth-grade students from ten primary schools from 1998/99 to 2007/08. Of 4939 students, 458 (9.3 %) with chronic diseases and health difficulties were referred to vocational guidance. Of these, 41.3 % were referred due to mental and behavioural disorders. These students were assessed and received a recommendation for at least two occupations. Forty-eight students (10.5 %) did not follow the recommendation.In a coordinated effort, school physicians, vocational guidance experts, and school and local authorities should secure enrollment of students with chronic diseases and health difficulties in secondary schools and follow their development and education to provide them the best available career opportunities.

[Community health course--student's evaluation]. / Evaluacija predmeta "zdravlje u zajednici" studenata medicine.

INTRODUCTION: Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. AIM: The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. SUBJECTS AND METHODS: The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. RESULTS: The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar, 63% with field research, and 49% with water sampling. DISCUSSION: At some medical schools, there are similar attempts to bring students more closely to life conditions, especially to rural communities. Different schools of medicine in the world have attempted to improve and adapt current curricula towards community-oriented education of medical students during undergraduate study and residency. In some countries, there is also the need of improvement of health care in rural areas. CONCLUSION: Results of the course evaluation showed that students had recognized the exceptional value of community health course as a whole. They perceived it as the most valuable and most useful experience in their medical study. By participating in local health care and social care activities in rural area, they got an insight into both the health care system and socio-medical determinants of health.