have stimulated us to present our own experiences in the investigation, surveillance and prevention of this problem. The results presented are based on macroscopic plasma examination, and the criteria for evaluating lipaemia remained unchanged throughout the study period. Results of our 1998 study 3 revealed a higher frequency of lipaemic plasma in middle-aged and elderly donors and in those presenting for blood collection in the afternoon. The study was conducted from 1 August 1997 to 31 July 1998. During the study period, 58,306 plasma units were manufactured from blood collected from 38,023 donors. A total of 1,540 (2.64%) plasma units (intended for clinical use and for fractionation) were declared non-conforming because of lipaemia. The mean age of donors with lipaemia was 40 years, as compared with the mean age of 32 years in all donors during the study period. The frequency of lipaemic plasma according to timing of the blood collection and donors' age is shown in Table I. Along with the obvious continuous increase in the frequency of lipaemic donations recorded from the morning to the afternoon, χ 2 -test confirmed the statistical significance of differences in the prevalence of lipaemia between donations collected before and after 2:00 p.m. (1.44% vs. 3.93%; P<0.001; OR=2.8). The effect of blood collection timing on the frequency of lipaemic donations was investigated again in 2010, yielding almost identical results and statistically significant difference (1.49% and 3.68% of lipaemic donations before and after 2:00 p.m., respectively; P<0.001; OR=2.45). Since 1998, lipaemia of fresh-frozen plasma (FFP) for clinical use is one of quality indicators at CITM. The decision to monitor lipaemia frequency on FFP units for clinical use instead of on the overall plasma units manufactured (which also include plasma units intended for fractionation) was based on the more stringent criteria for macroscopic FFP assessment, according to which even slight turbidity is considered as a non-conformity. During the 1998-2003 period, an incremental frequency of lipaemic FFP units was recorded, as illustrated in Figure 1. This increase was due to a number of factors, mostly an increase in the mean age of the donors and a larger number of donors presenting for blood donation in the afternoon.

BACKGROUND The aim of the study is to present the results and experience in the management of complaints in a transfusion service in order to draw attention to the importance of this segment of quality management and to stimulate publication of other studies on the topic. MATERIALS AND METHODS This study is based on data from the Croatian Institute of Transfusion Medicine obtained by analysis of complaints recorded during a 13-year period (1998-2010). The distribution of the types and frequencies of complaints is presented, along with the level of their justifiability and criticality. The dynamics of the complaints is analysed overall and within particular categories. In addition, corrective actions and other factors that may have influenced the trends observed are discussed. RESULTS During the study period, 817 complaints were received, most of which (40.9%) referred to the positive direct antiglobulin test in red cell concentrates, followed by blood product issuing and distribution (12.9%) and blood product quality (9.4%). Of the 817 complaints, 177 (21.7%) were assessed as serious and 645 (78.9%) as justified based on the testing performed. CONCLUSION Data collected by systematic recording and analysis of complaints provide a basis for problem identification, implementation of corrective and preventive actions, and improvement of product and service quality, and, thereby, customer satisfaction.

BACKGROUND Continuous and efficient error management, including procedures from error detection to their resolution and prevention, is an important part of quality management in blood establishments. At the Croatian Institute of Transfusion Medicine (CITM), error management has been systematically performed since 2003. MATERIALS AND METHODS Data derived from error management at the CITM during an 8-year period (2003-2010) formed the basis of this study. Throughout the study period, errors were reported to the Department of Quality Assurance. In addition to surveys and the necessary corrective activities, errors were analysed and classified according to the Medical Event Reporting System for Transfusion Medicine (MERS-TM). RESULTS During the study period, a total of 2,068 errors were recorded, including 1,778 (86.0%) in blood bank activities and 290 (14.0%) in blood transfusion services. As many as 1,744 (84.3%) errors were detected before issue of the product or service. Among the 324 errors identified upon release from the CITM, 163 (50.3%) errors were detected by customers and reported as complaints. In only five cases was an error detected after blood product transfusion however without any harmful consequences for the patients. All errors were, therefore, evaluated as "near miss" and "no harm" events. Fifty-two (2.5%) errors were evaluated as high-risk events. With regards to blood bank activities, the highest proportion of errors occurred in the processes of labelling (27.1%) and blood collection (23.7%). With regards to blood transfusion services, errors related to blood product issuing prevailed (24.5%). CONCLUSION This study shows that comprehensive management of errors, including near miss errors, can generate data on the functioning of transfusion services, which is a precondition for implementation of efficient corrective and preventive actions that will ensure further improvement of the quality and safety of transfusion treatment.

Uvod: U ovom prikazu opisujemo prvi zabilježeni slucaj nastanka pseudoaneurizme arterije u kubitalnoj regiji kao posljedice darivanja krvi u HZTM, koji je zahtijevao kirursku intervenciju. Prikaz slucaja: 40. godisnja žena pristupila je u studenom 2007. dobrovoljnom darivanju krvi. Prilikom venepunkcije krv je potekla u vrecicu, a kratko nakon toga je prestala teci u sistem i pojavio se izboceni hematom velicine 2-3 cm. Tehnicar je pomicanjem igle pokusao ponovo uspostaviti protok krvi , ali to nije uspjelo pa je izvadio iglu. Nakon vađenja igle hematom je porastao, krv je pocela teci kroz ubodno mjesto i krvarenje je bilo tesko zaustaviti. Darovateljici je objasnjeno da na ruci ima hematom i da ne opterecuje ruku. Nakon dva dana darivateljica se javila u HZTM radi hematoma cijele desne podlaktice, otekline, bolova i otežanih pokreta ruke. Iako je hitno upucena nadležnom lijecniku, tek devet dana nakon darivanja krvi javila se u hitnu kirursku službu. Pri prijemu nađena je u desnoj kubitalnoj regiji uz podljev i pulsirajuca tvorba. Doppler arterija je potvrdio pseudoaneurizmu. Ucinjen je operativni zahvat u kojem je evakuirana pseudoaneurizma i presivena arterija. Nakon operacije neuroloski i vaskularni status je bio uredan. Rasprava: Posebnost ovog slucaja je u tome sto je pseudoaneurizma arterije u kubitalnoj jami nastala odmah pri pocetku punkcije ali se nije moglo zakljuciti da se radi o punkciji arterije niti po trajanju punjenja doze (krace od 4 minute), boji krvi (svijetlocrvene boje) niti po pulzacijama igle. Komplikacije poput ove iako su rijetke moraju biti prepoznate na vrijeme i adekvatno zbrinute sto ukljucuje dugotrajnu (5-6 sati), jaku kompresiju uz pracenje perifernih pulzacija. Potrebno je provoditi edukaciju svih djelatnika koji rade na uzimanju krvi kako bi prepoznali znakove punkcije arterije prilikom postupka prikupljanja krvi i primjereno tretirali mjesto uboda radi sprjecavanja ozbiljnih posljedica koje punkcija arterije može ostaviti na vaskularni i neuroloski status ruke te prouzrociti invaliditet.

Cilj: MZ je 2007. prihvatilo projekt uspostave nacionalnog informatickog sustava u transfuzijsku službu RH za upravljanje, kontrolu i pracenje svakog aspekta djelatnosti ovlastenih zdravstvenih ustanova i bolnickih transfuzija s ciljem povecanja sigurnosti i standardizacije transfuzijskog lijecenja. Odabran je informaticki sustav eDelphyn (Hemasoft, Spanjolska) Web/Java 2EE, kao ekonomski najpovoljniji. Tvrtka Continuum (Zagreb) odgovorna je za informaticku logistiku. Temeljna verzija eDelphyn-a zahtijevala je dodatni razvoj i nadogradnju funkcija radi prilagodbe zakonodavnoj transfuzijskoj praksi u RH, međunarodnim zahtjevima i preporukama. Metode: Razvoj programa poceo je 2008. u HZTM, u ožujku 2010. uveli smo paralelni rad s tadasnjim programom, a od 01.05.2011. zapoceli smo rutinski rad samo u eDelphyn-u. Tijekom razvoja i implementacije proveli smo opsežne verifikacije funkcionalnosti svih verzija, rjesavali nesukladnosti i uvodili poboljsanja. eDelphyn radi kroz 3 modula: „Davatelji“, „Pacijenti“ i QC. Putem VPN-a radi u realnom vremenu paralelno u velikim i malim centrima i mobilnim jedinicama, jednostavan je za uporabu, ima intuitivno i prijateljsko sucelje, ima vise razina pristupa kontroliranih lozinkama. Sljedivost pruža izravan pristup podacima od davatelja do pacijenta. On- line se integrira s drugim aplikacijama (BIS, LIS) i s laboratorijskom opremom. Sve radnje korisnika bilježe se, ukljucujuci brisanje i promijene. Troskove održavanja programskog dijela, nadogradnje i VPN mreže snosi HZTM. Rezultati: eDelphyn implementiran je prvo u centre koji su osigurali dodatnu opremu. Prijedlozi za poboljsanja ce se usklađivati na nacionalnoj razini i uvrstiti u slijedecu verziju. Zakljucak: Unapređenje kvalitete i sigurnosti transfuzijskog lijecenja na nacionalnoj razini kroz eDelphyn sustav bliska je buducnost Hrvatske.

The way children cope with peer violence influence their psychological adjustment. The aim of the study was to investigate whether different roles in peer violence together with coping strategies are predictors of psychological adjustment. 478 elementary school children have been included in the study. School Relationship Questionnaire and Self – Report Coping Measure was used for assessments in peer violence and coping strategies. The standardized checklist Youth Self-Report was applied six month later for assessments of psychological adjustment. The results showed that the roles in peer violence and using of avoidance coping strategies are statistically significant predictors of different psychological adjustment. At the same time these results indicate that coping strategies are an important determinant of successful adaptation in childhood.

Cilj ovog istraživanja bio je ispitati postoje li razlike u strategijama suocavanja s nasilnim ponasanjem kod ucenika razlicite dobi i spola s obzirom na njihovu ulogu u nasilnom ponasanju. U istraživanju je sudjelovalo 478 ucenika sestih i osmih razreda osnovne skole (232 djevojcice i 246 djecaka), dobi od 11 do 15 godina. Nasilno ponasanje je procjenjeno Upitnikom skolskih odnosa (School Relationship Questionnaire -SRQ) autora Wolke i sur. (2001). Za ispitivanje suocavanja sa nasilnim ponasanjem koristena je Skala strategija suocavanja (Self – Report Coping Measure – SRCM) autora Causey i Dubow (1992). Testiranjem znacajnosti razlika u cestini koristenja pojedinih strategija suocavanja dobiveno je da djevojcice u usporedbi s djecacima znacajno vise koriste Samooslanjanje / rjesavanje problema (F(1, 412)=4, 176 ; p=0, 042) i Internaliziranje (F(1, 412)=10, 559 ; p=0, 001). Utvrđeno je također da starija djeca cesce koriste Distanciranje od djece mlađe dobi (F(1, 467)=4, 118 ; p=0, 043). Znacajni efekti uloge u nasilnom ponasanju nađeni su za strategijeSamooslanjanja/rjesavanja problema (F(3, 412)=2, 897 ; p=0, 035), Eksternaliziranje (F(3, 412)=20, 540 ; p=0, 000) i Internaliziranje (F(3, 412)=8, 933 ; p=0, 000). Djeca neukljucena u nasilje vise koriste Samooslanjanje/traženje rjesenja od žrtava/zlostavljaca. Žrtve također cesce koriste ovu strategiju od žrtava/zlostavljaca. Strategiju Eksternaliziranja vise koriste žrtve, zlostavljaci I žrtve/zlostavljaci od neutralnih, te žrtve/zlostavljaci od žrtava. Kao sto se moglo i ocekivati, Internaliziranje cesce koriste žrtve i zlostavljaci od sudionika neukljucenih u nasilno ponasanje. Znacajna interakcija uloge i spola utvrđena je jedino za Eksternaliziranje (F(3, 412)=3, 438 ; p=0, 017). Djevojcice u ulozi zlostavljaca i žrtve/zlostavljaca cesce koriste ovu strategiju, kao i djecaci neukljuceni u nasilje, te žrtve nasilnog ponasanja. Dobiveni rezultati ukazuju da je koristenje manje adaptibilnih strategija karakteristicno za sve sudionike vrsnjaskog nasilja bez obzira na njihovu ulogu u nasilnickom ponasanju.

Koristeci razlicite indikatore stresa, brojna istraživanja su ukazala na stresnost ispitnog perioda kod studenata. Polazeci od postavki nekih interakcijskih modela stresa, koji naglasavaju važnost iskustva u reakcijama na stres, za ocekivati je razlike u razini ispitnog stresa kod studenata prve i druge godine preddiplomskog sveucilisnog studija. Buduci da Bolonjski nacin studiranja ukljucuje kontinuirane provjere znanja u neispitnim razdobljima studiranja, može se također ocekivati ne postojanje razlika u razini doživljenog stresa između ispitnog i neispitnog perioda. Cilj ovog istraživanja je bio ispitati neke psiholoske reakcije na stres u ispitnom i neispitnom razdoblju kod 76 studenata prve i druge godine studija psihologije. Na istom uzorku studenata ispitana je razina aktivacije, stanje anksioznosti, te cestina i intenzitet psihosomatskih simptoma dva puta, tj. u neispitnom i ispitnom periodu. U tu svrhu, primijenjena je Thayerova skala za procjenu opce i visoke aktivacije, Spielbergerov upitnik stanja anksioznosti, kao i cek lista cestine i intenziteta psihosomatskih simptoma. Dobiveni rezultati nisu pokazali znacajne razlike u reakcijama na stres kod studenata prve i druge godine (F=0, 93 ; p=0, 44). Usporedbom ispitivanih indikatora stresa u ispitnom i neispitnom periodu utvrđena je znacajno visu razina doživljenog stresa u ispitnom periodu u odnosu na neispitni period (F=8, 83 ; p=0, 001). Kada je rijec o psihosomatskim simptomima, razlike između ispitnog i neispitnog razdoblja dobivene su jedino na skupini studenata prve godine, koji u ispitnom periodu doživljaju vise psihosomatskih simptoma (p<0.001). U skladu s ocekivanim, korelacijske analize su potvrdile znacajne i pozitivne povezanosti između visih razina aktivacije i stanja anksioznosti s doživljavanjem cescih, kao i intenzivnih psihosomatskih simptoma (r= 0, 38- 0.68 ; p<0, 01). U zakljucku se može kazati da rezultati ukazuju na stresnost ispitnog perioda kod obje skupine studenata, dok su u ispitnom razdoblju psihosomatski simptomi intenzivniji kod studenata prve godine studija. Daljnja istraživanja trebala bi ukljucivala ispitivanja protektivnih faktora u percepciji i doživljanju ispitnog stresa.

Objective – The aim of the present study was to assess if girls and boys who are classified as bullies, victims, bully/victims and neutral differ in Eysenck's personality dimensions.  Subjects and method – Three hundred and seventy-two children, age range 10 to 14 years (mean age 12.3±1.6 years) completed a School Relationship Questionnaire (SRQ) and the Junior Eysenck Personality Questionnaire (EPQ Junior). To examine whether there are differences in the studied dimensions of personality with regard to their roles in bullying behavior and the gender of the respondents, we used one–way analysis of variance (ANOVA) with Tukey HSD Post Hoc analysis.  Results – Based on the results of the SRQ, 57% of children were classified as involved in bullying behavior, either as bullies (13%), victims (16%) or bullies/victims (28%), while 41% were neutral. Girls showed significantly higher levels of neuroticism (F (1.325) = 9.983, p<0.001) and dissimulation tendency (F(1.331) = 7.270, p<0.05) than boys, while boys showed significantly higher levels of psychoticism (F(1.331) = 37.632, p<0.001). Bullies and bully/victims had higher levels of extraversion (F(3.323) = 3.105, p <0.05) while victims and bully/victims were found to have higher levels of neuroticism (F (3.325) = 20.390, p<0.001) compared to neutral. Significantly higher levels of psychoticism (F (3.331) = 13.929, p<0.001) were found for bully/victims in relation to bullies, victims and neutrals. Victims had significantly higher levels of psychoticism in relation to neutral, and bullies in relation to victims and neutrals. Significantly higher levels of affinity towards dissimulation (F (3.331) = 23.916, p<0.001) were found for neutrals in relation to bullies and bully/victims, and for victims in relation to bullies and bully/victims.  Conclusion – Differences in Eysenck’s personality dimensions were found with regard to gender and role in bullying behavior. A higher level of psychoticism was found in boys, while girls had a higher level of neuroticism and tendency to dissimulation. Bullies and bully/victims had a significantly higher level of psychoticism than victims, and victims had significantly higher levels of dissimulation tendencies in relation to bullies and bully/victims. Differences in the level of psychoticism and tendency to dissimulation are factors that distinguish between bullies and bully/victims in relation to victims and the neutral subjects. The results of this study show that Eysenck’s personality dimensions could be an important variable in understanding bullying behavior.

Progress in understanding the genetic basis and pathophysiology of spinal muscular atrophy (SMA), along with continuous efforts in finding a way to increase survival motor neuron (SMN) protein levels have resulted in several strategies that have been proposed as potential directions for efficient drug development. Here we provide an overview on the current status of the following approaches: 1) activation of SMN2 gene and increasing full length SMN2 transcript level, 2) modulating SMN2 splicing, 3) stabilizing SMN mRNA and SMN protein, 4) development of neurotrophic, neuroprotective and anabolic compounds and 5) stem cell and gene therapy. The new preclinical advances warrant a cautious optimism for emergence of an effective treatment in the very near future.

AIM To retrospectively analyze the rate of multi-type abuse in childhood and the effects of childhood abuse and type of coping strategies on the psychological adaptation of young adults in a sample form the student population of the University of Mostar. METHODS The study was conducted on a convenience sample of 233 students from the University of Mostar (196 female and 37 male), with a median age of 20 (interquartile range, 2). Exposure to abuse was determined using the Child Maltreatment Scales for Adults, which assesses emotional, physical, and sexual abuse, neglect, and witnessing family violence. Psychological adaptation was explored by the Trauma Symptom Checklist, which assesses anxiety/depression, sexual problems, trauma symptoms, and somatic symptoms. Strategies of coping with stress were explored by the Coping Inventory for Stressful Situations. RESULTS Multi-type abuse in childhood was experienced by 172 participants (74%) and all types of abuse by 11 (5%) participants. Emotional and physical maltreatment were the most frequent types of abuse and mostly occurred together with other types of abuse. Significant association was found between all types of abuse (r=0.436-0.778, P<0.050). Exposure to sexual abuse in childhood and coping strategies were significant predictors of anxiety/depression (R(2)=0.3553), traumatic symptoms (R(2)=0.2299), somatic symptoms (R(2)=0.2173), and sexual problems (R(2)=0.1550, P<0.001). CONCLUSION Exposure to multi-type abuse in childhood is a traumatic experience with long-term negative effects. Problem-oriented coping strategies ensure a better psychosocial adaptation than emotion-oriented strategies.

Na temelju proucavanja frazeologije cetiriju naselja jugoistocne Žminjstine (naselja Krculi, Galanti, Markici i Puotrti) autorice donose klasifikaciju i primjere dijela frazeologije žminjskoga govora Krcula. Frazemi su u radu klasificirani prema strukturnome, semantickom i sintaktickom aspektu, te prema unutarjezicnoj i međujezicnoj slicnosti. Na osnovi prikazanih primjera zakljucuje se da se pojedini frazemi pojavljuju jedino u govoru Krcula, iz nekih je vidljivo da se frazeologija Krcula podudara s frazeologijom drugih cakavskih govora, standardnoga hrvatskoga jezika, ali nerijetko i nekih europskih jezika.