Without knowledge of the basic demographic and health indicators, promoting the health status and health care of the elderly would not be possible.  In collaboration with Zagreb Institute of Public Health’s Gerontology Centre a group of authors from CNIPH has issued a publication “Health status and health care of elderly population in Croatia” (in Croatian).  Apart from demographic indicators, it comprises the leading causes of death, indicators of medical care utilisation and morbidity in primary health care, data on disabled, functional ability indicators, as well as vaccination figures on elderly. The focus is on cardiovascular diseases, malignant diseases, mental disorders and suicides. The bulletin could be useful not only to health workers, but also to the others concerned with the problem area of older age in any.  

INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE
(Ministry of Health’s Reference Centre for Epidemiology)
- Head, Prof. Dr Ira Gjenero-Margan

At a WHO invitation, Bernard Kaic, MSc stayed in Macedonia on 17-18 May in the capacity of a consultant.  His purpose was to present the Second generation of the monitoring systems for HIV infection in Croatia.  Next, within the Eighth International Symposium of Maritime Medicine and the Second HIV/AIDS Colloquy on Occupational Health, Dr Kaic gave a lecture on improving the accessibility of the service for voluntary consultation and testing in Croatia and our epidemiological situation. 

On 23-27 May 2005, WHO, CDC (Centers for Disease Control and Prevention), Andrija Stampar School of Public Health and CNIPH organised an International Course on HIV/AIDS Surveillance among Tuberculosis Patients.  Course takers from Ukraine, Georgia, Kyrgyzstan, Estonia, Lithuania, Latvia, and Russia have completed it.  The establishment of a regional educational centre for implementation of a strategy for HIV/AIDS surveillance protocol among tuberculosis patients is important for the future.  This is important to all countries, especially those with simultaneous presence of tuberculosis and AIDS, such as Ukraine where the developed Zagreb pilot Protocol will be applied in the Donetsk region.

CHRONIC MASS DISEASE EPIDEMIOLOGY DEPARTMENT
- Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc

To emphasise the important role of health workers in preventing the smoking epidemic, a slogan “Health workers and tobacco control” accompanied the marking of this year’s 31st of May (World No Tobacco Day).  For the occasion, the Service prepared a brochure “Health Workers and Tobacco Control”, a summary of the WHO material, to underline the important role of health workers in smoking prevention.  In connection with this day the Ministry of Health and Social Welfare has organised a conference on the same topic, with Pr Vlasta Hrabak‑Zerjavic, MSc attending with a lecture “WHO’s Framework Convention on Tobacco Control”.  

On 12-14 May 2005, Pr Vlasta Hrabak‑Zerjavic, MSc, attended a meeting in Paris of national co‑ordinators for European Strategy on Tobacco Control.  The meeting subject was preparations to draw up a new European report on tobacco control and a review of the implementation of the European strategy for tobacco control with examples of good practice, and the updating of the corresponding WHO database. 

A Working Group of the ARCAGE (alcohol related carcinomas and genetic propensity) project on 19-20 May in Dublin was attended by Ariana Znaor, MSc.  Thirteen centres, CNIPH including, from 10 European countries were involved in an International Agency for Cancer Research‑co‑ordinated study.  Subject recruitment is to end by June 2005, with an anticipated 2,000 head and neck cancer subjects and about 2,000 controls.

SOCIAL MEDICINE SERVICE

- Head, Pr Urelija Rodin, MD, MSc

To mark the 10th anniversary of the rocket attack on Children’s Disease Clinic in Zagreb, there was a symposium on Victimised Children in Croatia’s Defence War.  Pr Urelija Rodin, MSc attended with a paper “Fatal suffering of children from firearms and explosive devices in Croatia”.  It stressed that child victimisation by weapons and mines left over from the War has not stopped in Croatia yet and that it took this country more than a decade of preventive work at schools, preschool facilities and media in order to restore conditions to what they were before the war.

Croatian Society for Medical Informatics, Croatian Medical Association’s Croatian Society for Occupational Health and the National Council for Industrial Safety, organised in Zagreb a round table conference on “Information Systems for Outpatient Medical Care in Function of Economy” on 19 May 2005.  It coincided with the “Medicine and Technology” show at the Zagreb Fair.  Led by Prof. Dr Jadranka Mustajbegovic and by Prof. Dr Josipa Kern, its participants were Pr Marija Zavalic, ScD and Pr Ana Bogadi‑Sare, ScD (Croatian Institute of Occupational Health), Mirjana Pticar, MSc (Croatian Institute for Health Insurance), Pr Vlasta Deckovic-Vukres (CNIPH), and representatives of the ABA Informatika as well as an Ericsson Nikola Tesla firm’s team.  The round table conference was to seek proposals for unifying disjointed systems for the monitoring and delivery of health care and worker safety between the competent ministries for health and work, Croatian Institute of Occupational Health, Croatian National Institute of Public Health, Croatian Institute for Health Insurance and the State Inspectorate and for creating connections among them.   

SCHOOL HEALTH SERVICE

- Head, Pr Marina Kuzman, MD, ScD

Under the WHO leadership, the “mapping”, respectively making of a map of population health promotion in Europe under the name “Capacity Mapping Initiative”, CMI, is under way.  Its short‑term aim is to contribute to the Sixth Global Conference of the WHO health promotion conference due to take place in Bangkok next August.  A second and more important objective is to lay the foundation for a permanent capacity‑mapping project in the health promotion area for the whole Europe.  A Hub Centre Workshop (centre for data gathering) of the CMI for Eastern and Central Europe took place in Budapest on 25-26 April 2005.  It was attended by the representatives of Hungary, Slovenia, Poland, and by Spencer Hagard from the WHO, as well as by Dr Ivana Pavic Simetic from Croatia.  A document was created in keeping with which the mapping of health promotion should be carried out in each country.  At CNIPH a workshop was held in connection with the above on May 3 on the recommendation of the WHO and Hub Centre.  It studied the subjects in detail, assigning duties and deciding that the mapping should go ahead.  The Workshop was attended by Pr Marina Kuzman, ScD, Pr Vlasta Hrabak-Zerjavic, MSc, Pr Vlasta Deckovic-Vukres, ScD, Dr Verica Kralj and Dr Ivana Pavic Simetin.

The Eighth World Congress of the International Association for Adolescent Health (IAAH) taking place in Lisbon on 11-14 May had a thematic title “Positive Youth Development – Empowering Youth in a World in Transition”.  There were five Croatian representatives there.  On behalf of a group of authors, who included the staff of school health services of the Primorsko-Goranska County and Splitsko-Dalmatian County, and the two towns’ Town Offices of Health representatives, she presented the experiences of setting up the youth open centres created based on the RAR study (Youth Friendly Services – From Research to Practice) of 2002.  The positive experience from the pilot project has resulted in the opening of the first guidance centre for reproductive health at the Rijeka Public Health Institute in March 2005.  The Congress was attended by about different 400 professionals from the five continents who were involved in the medical care and education of children and youths.  Owing to parallel running of several round table conferences or workshops and oral presentations, the exchange of experience was very dynamic.

On 18-20 May 2005, the Twelfth Working Meeting of National Coordinators of the European Network of Health Promoting Schools was held in Edinburgh.  Dr Ivana Pavic Simetin attended as a substitute for the national co‑ordinator Pr M. Kuzman, ScD.  Co‑ordinators from some 40 European countries, the representatives of Azerbaijan and Kosovo as potential members of the Network, and the representatives of the Council of Europe, European Commission and WHO/EURO were present.  The accounts illustrated the importance of obesity prevention in schoolchild and adolescent populations, which would be the scope of action within the Network in the forthcoming period.  Displayed by this Project was a clear trend to overgrow into a Programme.  On this track, the focus of action, which, in a major part of the West European countries, was on individual schools, changed direction toward developing a health promotion policy.  Thus in 2001, the Scottish Executive set a goal for all schools to become health promoting schools by 2007.  A health promotion department was set up (Scottish Health Promoting Schools Unit) as a multidisciplinary body.  Affording interest is the example of Netherlands, where regional health institutions have received an important role, notably school health service as a basic structure in programme implementation, and particularly on the level of development of a health promoting policy in schools and of providing care to pupils individually. 

The annual Meeting of the HBSC (Health Behaviour in School-aged Children) project research teams was held in Malta on 25-27 May 2005.  Pr Marina Kuzman, MD, ScD, the principal investigator of the Project, attended it.  The whole meeting was devoted to technical and scientific issues related to the organisation and execution of the next study in 2006.  HBSC is a WHO reference study on children and youths in the social environment.  Consequently, all the countries having joined the study carry it out regularly every four years.  In Croatia, this will be the second time that it is running the study.  Thus, because of the importance and continuity, the research team has not only the task of organising and running the study, but also of finding the funds for all necessary activities.

ADDICTION PREVENTION SERVICE

Acting Head, Pr Marina Kuzman, MD, ScD

MICROBIOLOGY SERVICE
- Head, Prof. Dr Gordana Mlinaric-Galinovic

The Seventh Croatian Congress on Clinical Microbiology with International Participation took place in Zagreb on 18-20 May 2005.  It was organised by Croatian Medical Association, Croatian Society for Medical Microbiology and Parasitology, and Academy of Medical Sciences.  News from microbiological diagnostics and subjects devoted to infections in surgery, prevention of nosocomial infections, preoperative prophylaxis, bacterial resistance, and infections in immunocompromised patients were its main topics.  Taking part as lecturers from CNIPH were Professor G. Mlinaric‑Galinovic

(with a paper “Microbiological diagnosis of zoonoses”), Dr V. Katalinic‑Jankovic (on the topic “Molecular M. tuberculosis strain typing in Croatia”) and E. Mlinaric‑Missoni, ScD with a lecture “Fungal infections of diabetic foot wound”.  Six posters showing the activity of professional groups were also presented.  The first, authored by S. Ljubin Sternak, B. Hunjak, Z. Persic, A. Babic Erceg, I. Pristas and R. Stevanovic, was titled “Incidence of bacterial sexually transmitted diseases: CNIPH’s findings”.  The authors of the second poster, named “Leptospirosis in Croatia in 2004”, were Z. Persic, D. Karlovic Martinkovic, G. Mlinaric‑Galinovic, and Z. Baklaic.  The authors of our third poster, “Gas chromatography in anaerobic bacterial diagnostics”, were M. Franotovic, M. Obrovac, and Z. Persic.  M. Sviben and D. Horvat Krejci authored the fourth poster, titled “Serodiagnosis of infection with Toxoplasma gondii.  “The influence of rheumatoid factor on IgM antibody detection”.  T.Vilibic Cavlek, S. Ljubin Sternak, B. Kaic, K. Zarkovic, B.M. Della Marina, Lj. C. Sojat, A. Basnec, V. Kruzic, N. Bauk, B. Turkovic, and G. Mlinaric authored the fifth poster, “Subacute sclerosing panencephalitis in Croatia”.  D. Perkovic and V. Kruzicevic were the authors of the sixth poster titled “Phage typing of S. enteritidis under the old and new classifications and result comparison”.