Martina Hrvačić

Background/Objectives: Healthcare staff, especially nurses, face high occupational stress, yet objective biological indicators that complement self-report are not well established. We examined whether metabolic, hormonal and physiological markers act as indicators of stress and relate to anxiety, depression and burnout in nurses and other healthcare workers. Methods: We conducted a cross-sectional study of 300 hospital employees (239 in healthcare, of whom 123 were nurses; 61 non-healthcare) at a Croatian university hospital; of 329 completed questionnaires, 300 (91.2%) met the inclusion criteria and were analysed. Fasting glucose, lipids, thyroid hormones, cortisol, heart rate and blood pressure were measured; psychological status was measured using the 42-item Depression Anxiety Stress Scales (DASS-42), Maslach Burnout Inventory and Zung scale. Analyses used Mann–Whitney and Kruskal–Wallis tests, Spearman correlation, hierarchical logistic regression adjusted for age, sex, smoking and thyroid medication use, and receiver operating characteristic (ROC) analysis. Results: Healthcare workers had more favourable glucose, total and low-density lipoprotein (LDL) cholesterol than the older non-healthcare group (all p ≤ 0.003); because the groups differed substantially in age, these unadjusted differences are descriptive only. Metabolic markers correlated only weakly with distress and burnout. Within healthcare workers, elevated stress was discriminated in univariable analysis by low high-density lipoprotein (HDL) cholesterol (area under the curve (AUC) 0.72), raised triglycerides (AUC 0.67) and glucose (AUC 0.66); however, after adjustment for age, sex, smoking and thyroid medication use, none of the markers remained independently associated with elevated stress. Conclusions: In this relatively healthy hospital workforce, routinely available biological markers showed limited value as standalone indicators of occupational stress; they are exploratory rather than validated biomarkers, and require confirmation in larger, prospective, multicentre studies before they can complement—rather than replace—psychological screening in occupational-health practice.

Background/Objectives: Healthcare professionals face high occupational stress, emotional burden, and demanding conditions that increase the risk of burnout, depression, and anxiety, with recent post-pandemic evidence indicating a high and rising global prevalence. Early identification of distress is therefore essential. This review compared three widely used instruments—the Depression, Anxiety and Stress Scales (DASS), the Maslach Burnout Inventory (MBI), and the Zung Self-Rating Depression Scale (SDS)—selected because they jointly cover depression, anxiety, stress, and burnout, unlike unidimensional tools (PHQ-9, GAD-7, PSS, CBI) that would need combining for comparable coverage. Methods: A narrative integrative review searched PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar for peer-reviewed articles (English/Croatian) published up to December 2025 (final search: 26 June 2026). Two reviewers independently screened records, resolving disagreements by consensus; quality was appraised narratively. Of 55 records, 35 were included. Results: The DASS showed a replicated three-factor structure and strong reliability, with shortened forms (DASS-8, DASS-12) enabling rapid screening at reduced domain coverage. The MBI remained the most widely used burnout measure but was limited by its emotional-exhaustion focus, proprietary licensing, and scoring heterogeneity. The Zung SDS offered a brief depression screen, though dated wording and context-dependent cut-offs favor initial-screen use. Notably, much evidence is derived from non-healthcare populations—the principal limitation. Conclusions: The instruments appear complementary rather than interchangeable; their combined use is proposed—as a reasonable suggestion from the literature, not an empirically demonstrated finding—as a multidimensional approach, contingent on context, objective, and appropriate cultural validation.

Aim: The aim of this research paper is to examine and compare the knowledge of students in health and non-health studies about diabetes mellitus type 1. Namely, the research examined whether the respondents are sufficiently educated about the disease itself, treatment and preventive measures of diabetes type 1. Their knowledge was examined with regards to their age, gender and the type of studies they attend. Respondents and methods: The research was conducted as a cross-sectional study. 101 respondents participated in the research. An anonymous online questionnaire was used as a measuring instrument, which was created for the purpose of this research. The research was conducted in July and August 2022. Results: Most respondents have good knowledge about diabetes mellitus, which is evident in the correct answers to the questions in the survey questionnaire. Statistically, significant differences were found in the students’ knowledge with regards to their age, gender and type of study. Respondents who participate in health studies have a higher level of knowledge than respondents who do not participate in health studies. Female respondents have a higher level of knowledge than male respondents. Older respondents also have greater knowledge about the disease itself. Conclusion: Students who study health studies show a higher level of knowledge than students of other studies. Most of the respondents were well educated about type 1 diabetes mellitus. Diabetes is one of the biggest public health problems nowadays, and measures of prevention and education of the population should be implemented as much as possible in kindergartens, primary and secondary schools, colleges, hospitals, and the health system.

Iron is one of the most important essential elements, required by every cell in the body. Anemia is one of the most common medical conditions, defined as a decrease in blood's ability to transport oxygen to tissues, resulting in tissue hypoxia. However, anemia is not a disease, but rather the manifestation of an underlying disorder or disease and it is an important clinical marker of a disorder that may be basic or something more complex. Therefore, once anemia has been diagnosed, the physician must determine its exact cause.Anemia is frequently associated with chronic kidney disease (CKD) as a consequential disorder of iron metabolism and erythropoiesis regulation. It is a result of a relative erythropoietin deficiency, functional iron deficiency, impaired iron absorption, or blood loss due to dialysis. CKD related anemia is associated with an increased risk of morbidity and mortality. Given the importance of public health, it is necessary to raise CKD awareness, and to encourage early diagnosis and treatment. The recommendations and guidelines of all professional societies of nephrology emphasize early diagnosis and timely treatment. It is important to ensure that patients have a good quality of life while also minimizing the risks of further complications associated with anemia.