Background/Objectives: Healthy lifestyle behaviors are major contributors to overall health and disease prevention. This cross-sectional study aimed to assess attitude toward a healthy lifestyle and its associations with lifestyle behaviors, body mass index (BMI), excess body weight, sociodemographic characteristics, and self-rated health in adults. Methods: The Attitudes toward a Healthy Lifestyle Questionnaire was administered to 570 Croatian adults between November and December 2025. Multiple linear and binary logistic regression models were used to examine associations between lifestyle behaviors (number of daily meals, sitting time, sleep duration), smoking and e-cigarette use, alcohol consumption, BMI, self-rated health, and attitude toward a healthy lifestyle. Results: The median attitude toward a healthy lifestyle score was 52.0 (IQR = 10), corresponding to 62% of the maximum possible score. A more positive attitude toward a healthy lifestyle was associated with a higher number of daily meals (β = 0.16, p = 0.001), longer sleep duration (β = 0.17, p < 0.001), lower sitting time (β = -0.11, p = 0.010), and lower BMI (β = -0.24, p < 0.001). Smoking was negatively associated with attitude toward a healthy lifestyle (β = -0.18; p < 0.001), while e-cigarette use was associated with fewer daily meals (β = -0.10; p = 0.025). Longer sleep duration increased the odds of excellent self-rated health (OR = 1.31, p = 0.014), and a more positive attitude toward a healthy lifestyle was associated with lower odds of excess body weight (OR = 0.92, p < 0.001). Conclusions: Attitude toward a healthy lifestyle is significantly associated with lifestyle behaviors, BMI, excess body weight, and self-rated health, highlighting the importance of psychological factors in promoting sustainable healthy lifestyles.
Background: Enterovirus-D68 (EV-D68) was long underreported, with only sporadic cases of respiratory disease worldwide until 2014, when numerous countries experienced significant outbreaks of EV-D68. In Croatia, sporadic detections have primarily resulted from an absence of systematic surveillance. Following the increased incidence of EV-D68 across Europe in 2022, we started to characterize EV-positive respiratory samples in Zagreb to confirm the presence of EV-D68 and identify circulating lineages through phylogenetic analysis. Methods: Respiratory samples from individuals with acute respiratory infection and additional clinical symptoms were tested at the Virology Laboratory of the Croatian Institute of Public Health, and EV-positive samples were further screened using the real-time RT-qPCR method for EV-D68. VP1 sequences were obtained by sequencing and subsequently genotyped. Results: Between March 2022 and December 2024, EV was detected in 2048 respiratory samples. Annual distributions of EV detections were 656 (10.0%) in 2022, 785 (8.1%) in 2023, and 607 (7.4%) in 2024. EV-D68 was identified in 13.1% of EV-positive samples in 2022, 1.4% in 2023, and 19.6% in 2024. The peaks in EV-D68 circulation were observed in July (n = 24) and September (n = 24) in 2022 and in September 2024 (n = 62). Phylogenetic analysis of EV-D68 VP1 sequences revealed the presence of two major clades, A2 and B3. The sequences from 2022 clustered exclusively within clade B3, while in 2024 A2 clade was newly introduced. Conclusions: We confirmed the presence of EV-D68 in Croatia with circulating lineages corresponding to those detected elsewhere in Europe. The absence of routine testing has likely led to an underestimation of EV-D68 prevalence. These findings underscore the urgent need for ongoing surveillance and genomic characterization to clarify EV-D68 epidemiology in Croatia.
Pregnancy and early infancy are periods of heightened vulnerability, with SARS-CoV-2 and influenza infections linked to adverse pregnancy outcomes, including preterm birth, and stillbirth. Maternal vaccination provides direct protection to mothers by active immunisation and to infants by passive immunisation. This scoping review mapped and described published literature on maternal vaccination against COVID-19, influenza, pertussis, and RSV, including which outcome domains were studied and the timing of vaccination examined, with the aim of identifying evidence gaps and supporting decision-makers in choosing priority areas for subsequent systematic review topics. A comprehensive literature search across multiple databases of studies published from January 2000 to October 2025 identified 636 publications (541 primary studies, 95 evidence syntheses). Studies on COVID-19 (261 studies, 45 reviews), influenza (161 studies, 29 reviews), pertussis (113 studies, 20 reviews), and RSV (20 studies, 11 reviews) were analysed. Substantial evidence on COVID-19, influenza, and pertussis vaccination on efficacy, effectiveness, safety and immunogenicity outcomes and the optimal timing of vaccination in relation to these outcomes during pregnancy is available. RSV vaccination evidence is limited. Updated systematic reviews would be helpful to clarify the optimal timing of COVID-19 vaccination and the effectiveness and safety of the coadministration of influenza and pertussis vaccines.
Aims To determine the incidence of hip fracture in elderly people (≥ 65) in Croatia, and to analyse survival by sex, age group, residence and fracture type. Methods To identify individual patients with hip fracture and data on death, we used the Hospital Discharge Database for the period of calendar year 2018 and the Cause of Death Database for the period from 1 January 2018 to 31 December 2020. Incidence of hip fracture was estimated and reported as annual incidence per 100,000 people for 2018, further stratified by age, sex and region of residence. Survival analysis was performed with the Kaplan-Meier method. Survivor function was calculated and presented at various follow-up times. Results 5052 hip fracture cases among the elderly in 2018 were identified. The overall crude incidence of hip fracture in 2018 was 607/100,000 (355/100,000 in males and 778/100,000 in females). Higher incidence was estimated in females across all age groups. Males had a shorter median survival time than females (538 days versus 1036 days). Log-rank test confirmed the significance of difference in survivorship between the sexes, as well as between different age groups and between patients residing in different regions. Survivorship between patients who have suffered different types of femur fracture did not differ significantly. Conclusion Elderly females are more affected by hip fracture in terms of incidence, while men have shorter survival. Results for Croatia are in line with the current knowledge. As hip fracture remains a major public concern, additional efforts need to be put in prevention.
