Underactive Bladder Syndrome: An Often Overlooked Condition

Urinary bladder outlet obstruction can cause lower urinary tract symptoms in men and women, such as a weak or interrupted urine stream, straining to void, hesitancy, and the feeling of incomplete bladder emptying. These symptoms can also be associated with underactive bladder syndrome. This urological condition has a high prevalence in both genders, especially in older age groups. The most common risk factors that can contribute to the pathogenesis of underactive bladder syndrome are aging, detrusor myopathy, neuroinflammatory, neurodegenerative and other lesions of the central and peripheral nervous system, and diabetes mellitus. Reduced detrusor contractility, or detrusor underactivity, is the most common pathology of underactive bladder syndrome. Detrusor underactivity is a urodynamic definition provided by the International Continence Society. The urodynamic trace is characterised by a low urine flow rate accompanied by low detrusor pressure or brief detrusor muscle contraction. Underactive bladder syndrome is often recognised and treated poorly in clinical practice because the symptoms are not specific. Furthermore, underactive bladder can be asymptomatic or coexist with bladder outlet obstruction and overactive bladder syndrome. The aim of this study was to review recent research concerning the aetiology, classification, diagnostic evaluation, and available treatment methods for patients with symptoms of underactive bladder syndrome. Making an accurate underactive bladder diagnosis is challenging because it is a multifactorial condition with various patterns of manifestation. Consequently, there is still no general agreement and standardisation regarding the most favourable diagnostic and therapeutical approach

THE PASTORAL COUNSELING FOR THE TERMINALLY ILL

Help and relief in the body, comfort and consolation in the spirit means, pay attention to the whole person of the patient, in his global reality, realizing not only of all its physical, psychological, relational, social and spiritual. The partner wild with pleasure to learn in order to be close to the sick, to be able to offer them a' presence of love and competent service. It is important for every person to know what are the motives of the act while carrying out a visit, which is a true' therapeutic ministry. Aware that, by the patient is not going to spend a bit 'of time, let alone to vent on him our problems and our concerns: in fact, already has enough and not add more. All the sick wherever they are, living situations of suffering, still await a visit from the aid, relief, comfort and consolation, in body and in spirit.  Article visualizations

Izkusnje uciteljev poslovne sole s studentom z motnjo avtisticnega spektra

Autism has become an increasingly relevant topic in the research of neuroscience with the objective of enabling people with this condition to become equal opportunity members of the society; this includes an exploration of the benefits of the public education system. However, the science and knowledge in this field have thus far been limited, and the results of scientific findings have been very rare. The objective of the study was to explore primarily the first experiences of higher education teachers dealing with a student with an autism spectrum disorder. The aim was to learn lessons and contribute to some new understanding of special and adapted pedagogical approaches. The methodology of the study is qualitative, using (i) a case study as an objective of the researchers, and (ii) in-depth interviews with the twelve teachers about their experience with (for them) the new demanding assignment to teach a student with an autism spectrum disorder. The case study is about three years of undergraduate studies of a student with autism spectrum disorder who, in the end, obtained a bachelor’s degree in the field of business. The findings reveal that teachers generally viewed the experience as very positive and found teaching to be a challenge. For success, cooperation with experts and parents is crucial, but the education institution (of which all are stakeholders) could and should have done more. However, taking into account that the challenge is new, this study may contribute to some further development. (DIPF/Orig.

Urinary Incontinence: Diagnostic Evaluation and First-line Treatment

Urinary incontinence is defined as involuntary leakage of any amount of urine that negatively affects the individual\u27s hygienic and social status. It is an important public health problem because it has a high prevalence and incidence. Due to various social prejudices, it is often neglected and unreported. It is also characterized by its chronic appearance and complications such as decreased quality of life, sexual dysfunction and symptoms of anxiety and depression. The financial burden for symptomatic, conservative and surgical treatment of urinary incontinence is high. Both women and men are reluctant to seek medical help, and they most often use coping strategies to deal with urinary incontinence symptoms, which include the use of incontinence aids such as adult diapers and pads. We conducted a systematic review of high-quality randomized controlled studies and of other review articles to compare circumstances surrounding the diagnostic evaluation and first-line treatment of urinary incontinence in women and men according to International Continence Society guidelines. Because urinary incontinence can occur during any stage of life, diagnostic and therapeutic approach is different in women and men. Social stigmatization created due to urinary incontinence may harm a person’s self-confidence and cause many negativities at a social level. Timely recognition of the type and severity of symptoms of urinary incontinence is necessary to reduce the occurrence of the aforementioned complications. (Radoja I, Degmečić* D. Urinary Incontinence: Diagnostic Evaluation and First-Line Treatment. SEEMEDJ 2020; 4(1); 63-73

Perinatal and Maternal Outcomes in Tuzla Canton during 1992-1995 War in Bosnia and Herzegovina

Aim: To compare perinatal and maternal outcomes in Tuzla Canton during the 1992-1995 war in Bosnia and Herzegovina with those before (1988-1991) and after (2000-2003) the war. Methods: We retrospectively collected data on a total of 59 707 liveborn infants and their mothers from the databases of Tuzla University Department for Gynecology and Obstetrics and Tuzla Institute for Public Health. Data on the number of live births, stillbirths, early neonatal deaths, causes of death, gestational age, and birth weights were collected. We also collected data on the number of medically unattended deliveries, examinations during pregnancy, preterm deliveries, and causes of maternal deaths. Perinatal and maternal outcomes were determined for each study period. Results: There were 23 194 live births in the prewar, 18 302 in the war, and 18 211 in the postwar period. Prewar perinatal mortality of 23.3 per 1000 live births increased to 25.8 per 1000 live births during the war (P<0.001), due to a significant increase in early neonatal mortality (10.3‰ before vs 15.1‰ after the war, P<0.001). After the war, both perinatal mortality (14.4‰) and early neonatal mortality (6.6‰) decreased (P<0.001 for both). The most frequent cause of early neonatal death during the war was prematurity (55.7%), with newborns most often dying within the first 24 hours after birth. During the war, there were more newborns with low birth weight (<2500 g), while term newborns had lower average body weight. Women underwent 2.4 examinations during pregnancy (5.4 before and 6.3 after the war, P<0.001 for both) and 75.9% had delivery attended by a health care professional (99.1% before and 99.8% after the war; P<0.001 for both). Maternal mortality rate of 65 per 100 000 deliveries during the war was significantly higher than that before (39 per 100 000 deliveries) and after (12 per 100 000 deliveries) the war (P<0.001 for both). Conclusion: Perinatal and maternal mortality in Tuzla Canton were significantly higher during the war, mainly due to lower adequacy and accessibility of perinatal and maternal health care

Perinatal and Maternal Outcomes in Tuzla Canton during 1992-1995 War in Bosnia and Herzegovina

Aim: To compare perinatal and maternal outcomes in Tuzla Canton during the 1992-1995 war in Bosnia and Herzegovina with those before (1988-1991) and after (2000-2003) the war. Methods: We retrospectively collected data on a total of 59 707 liveborn infants and their mothers from the databases of Tuzla University Department for Gynecology and Obstetrics and Tuzla Institute for Public Health. Data on the number of live births, stillbirths, early neonatal deaths, causes of death, gestational age, and birth weights were collected. We also collected data on the number of medically unattended deliveries, examinations during pregnancy, preterm deliveries, and causes of maternal deaths. Perinatal and maternal outcomes were determined for each study period. Results: There were 23 194 live births in the prewar, 18 302 in the war, and 18 211 in the postwar period. Prewar perinatal mortality of 23.3 per 1000 live births increased to 25.8 per 1000 live births during the war (P<0.001), due to a significant increase in early neonatal mortality (10.3‰ before vs 15.1‰ after the war, P<0.001). After the war, both perinatal mortality (14.4‰) and early neonatal mortality (6.6‰) decreased (P<0.001 for both). The most frequent cause of early neonatal death during the war was prematurity (55.7%), with newborns most often dying within the first 24 hours after birth. During the war, there were more newborns with low birth weight (<2500 g), while term newborns had lower average body weight. Women underwent 2.4 examinations during pregnancy (5.4 before and 6.3 after the war, P<0.001 for both) and 75.9% had delivery attended by a health care professional (99.1% before and 99.8% after the war; P<0.001 for both). Maternal mortality rate of 65 per 100 000 deliveries during the war was significantly higher than that before (39 per 100 000 deliveries) and after (12 per 100 000 deliveries) the war (P<0.001 for both). Conclusion: Perinatal and maternal mortality in Tuzla Canton were significantly higher during the war, mainly due to lower adequacy and accessibility of perinatal and maternal health care

EXEMPTION FROM JURISDICTION IN EUROPEAN CIVIL PROCEDURAL LAW

U radu se analizira pravo na izuzeće od sudske nadležnosti (imunitet) prema međunarodnom običajnom pravu i europskom građanskom procesnom pravu prema tumačenju Suda Europske unije. Cilj je istražiti ravnotežu između ovog prava i prava na pristup sudu kao njegovog potencijalno ograničavajućeg čimbenika u praksi Suda Europske unije te je usporediti s praksom Europskog suda za ljudska prava. Prava. Odlučujući LG i drugi protiv Rine i Ente Registro Navale kao najvažniji predmet u tom pogledu, Sud Europske unije navodi da nacionalni sud pred kojim se postavlja pitanje izuzeća od nadležnosti mora biti uvjeren da postoji neće biti povrede prava na pristup sudovima, ako prihvati prigovor na imunitet. Na taj je način Sud odredio granicu izuzeća od nadležnosti dopuštajući odricanje od nadležnosti zbog poštivanja međunarodnopravnih obveza i uvažavajući potrebu očuvanja temeljnih prava. Međutim, što se tiče uvjeta tog ograničenja, Sud je ostao nejasan.The paper analyses the right to be exempt from jurisdiction (immunity) under customary international law and European civil procedural law following the interpretation of the Court of Justice of the European Union. The aim is to research the balance between this right and the right of access to the courts as its potentially restrictive factor in the case law of the Court of Justice of the European Union and to compare it with the case law of the European Court of Human Rights. In deciding the LG and Others v. Rina and Ente Registro Navale as the most important case in this regard, the Court of Justice of the European Union states that the national court before which the issue of exemption from jurisdiction arises, must be persuaded that there will be no violation of the right of access to the courts, if it accepts the immunity objection. In this way, the Court determined the limit of exemption from jurisdiction by allowing the waiver of jurisdiction for reasons of compliance with international legal obligations and noting the need to preserve fundamental rights. However, as to the terms of that limitation, the Court remained vague

THE RIGHT TO BE HEARD AND TO EXPRESS OPINION IN SPECIAL ENFORCEMENT PROCEEDINGS FOR THE RETURN OF THE CHILD AND THE ESTABLISHMENT OF PERSONAL RELATION WITH THE CHILD

U radu se analiziraju međunarodni propisi i sudska praksa Europskog suda za ljudska prava i Suda Europske unije te odredbe hrvatskoga Obiteljskog zakona u svezi s pravom na saslušanje i izražavanje mišljenja djeteta u postupku ovrhe radi predaje djeteta i ovrhe radi ostvarivanja osobnih odnosa s djetetom. Sukladno tom Zakonu, u postupku radi predaje djeteta sud može prije određivanja sredstava ovrhe saslušati osobu protiv koje se ovrha provodi. Po pitanju prava djeteta na izražavanje mišljenje u tom postupku propisano je da sud može, s obzirom na okolnosti slučaja tijekom postupka ovrhe, dijete uputi na razgovor sa stručnom osobom. S druge strane, u postupku ovrhe radi ostvarivanja osobnih odnosa s djetetom sud je dužan prije donošenja rješenja zakazati ročište na kojemu će osobno saslušati stranke kako bi utvrdio činjenice i procijenio sve okolnosti te je dužan djetetu omogućiti izražavanje mišljenja. Zaključno se iznosi da postupci radi ovrhe, posebice zbog njihove prirode (osobni i emocionalni), trebaju biti hitni i što jednostavniji. Pri njihovoj provedbi, dijete, kao niti stranke u postupku ne bi trebalo apsolutno onemogućiti u ostvarivanju prava na saslušanje i izražavanje mišljenja. Međutim, sud ne bi trebao biti obvezan održati ročište na kojem će saslušati stranku i omogućiti djetetu izražavanje mišljenje ako to nije nužno za razjašnjenje slučaja. Isto bi trebalo ovisiti o diskrecijskoj ocjeni suda s obzirom na okolnosti slučaja i uvažavajući dobrobit djeteta. Autorica rada stoga predlaže izmjenu odredbe o saslušanju u postupku radi ostvarivanja osobnih odnosa s djetetom na način da sud koji provodi ovrhu može saslušati stranke te omogućiti djetetu izražavanje mišljenja, a sve radi zaštite interesa i dobrobiti djeteta.In this paper we have analyzed the international regulations and case law of the European Court of Human Rights and the Court of Justice of the European Union and the provisions of the Croatian Family Law regarding the right to be heard and express the opinion of a child in enforcement proceedings for the return of the child and the establishment of personal relation with the child. According to this Act, in the procedure for the return of the child, the court may, before determining the means of enforcement, hear the person against whom enforcement is being carried out. Concerning the child’s right to express an opinion in these proceedings, it is prescribed that the court may, given the circumstances of the case during the enforcement proceedings, refer the child for an interview with an expert. On the other hand, in the enforcement procedure to establish personal relations with the child, the court is obliged to schedule a hearing before issuing a decision at which it will personally hear the parties establish the facts and assess all circumstances and is obliged to allow the child to express an opinion. In conclusion, it is stated that enforcement proceedings, especially due to their nature (personal and emotional), should be urgent and as simple as possible. During their implementation, the child, as well as the parties to the proceedings, should not be absolutely prevented from exercising the right to be heard and express an opinion, however, the court should not be obliged to hold a hearing to hear the party and allow the child to express an opinion unless if this is not necessary to clarify the case. This should depend on the discretion of the court given the circumstances of the case and taking into account the welfare of the child. The author of the paper therefore proposes amending the provision on hearing in proceedings to establish a personal relationship with the child so that the enforcement court may and not has to hear the parties and allow the child to express opinion, all to protect the interests and welfare of the child