Impunity for human trafficking victims in Croatia – legal standard as a fiction or reality

U članku se razmatra jedno od najkompleksnijih pravnih pitanja u kontekstu trgovine ljudima – pitanje nekažnjavanja, tj. nepoduzimanja kaznenog progona prema žrtvama trgovine ljudima koje su ostvarile obilježja kaznenog djela u svezi sa svojom viktimizacijom, odnosno kao rezultat iste. Zaključci su utemeljeni na sveobuhvatnoj analizi tzv. klauzule o nekažnjavanju u obvezujućim međunarodnim dokumentima (Konvenciji Vijeća Europe, Direktivi EU), međunarodnim smjernicama i modelima (npr. Preporuke Visokog povjerenika UN-a za ljudska prava o ljudskim pravima i trgovanju ljudima), te u poredbenom zakonodavstvu i praksi. Dostupna poredbena praksa država ukazuje na nedostatke postojećih pravnih rješenja te na potrebu da se pitanje nekažnjivosti žrtava trgovine ljudima riješi na nedvosmislen način, bilo kroz uvođenje izričite i precizne odredbe o nekažnjavanju ili kroz uspostavu jasnih instruktivnih kriterija za postupanje u takvim slučajevima. Autori predlažu novi model nekažnjavanja i nepoduzimanja kaznenog progona prema žrtvama trgovine ljudima u RH, s ciljem izbjegavanja dodatne viktimizacije žrtava i u skladu s potrebama svakog konkretnog slučaja. Potreban je višedimenzionalan i fleksibilan pristup na temelju jasnih odredbi materijalnog i procesnog kaznenog prava, ali i smjernica koje će tužiteljima i sucima omogućiti da uspostave prikladnu ravnotežu između temeljnih načela hrvatskog pravnog sustava i prava osoba koje valja prvenstveno promatrati kao žrtve, a ne kao počinitelje.This article deals with one of the most vexing legal issues in context of trafficking in persons – that of non-punishment of trafficked persons for the offences they have committed in connection with or as a result of being trafficked. The conclusions are based on a comprehensive study of the so-called non-punishment clause in binding international documents (Council of Europe Convention, EU Directive, etc.) and soft law (e.g. UN Office of the High Commissioner for Human Rights, Recommended Principles and Guidelines on Human Rights and Human Trafficking, E/2002/68/), as well as on its implementation in comparative law and practice. Scarce (comparative) case law reveals deficiencies in existing framework and the necessity to address the issue of non-punishment of victims of trafficking in unambiguous manner, either through introduction of explicit non-punishment clause or through instructive set of criteria, such are those established for the Crown Prosecution Service in UK. Against this background and taking into account various approaches in comparative law, this article proposes a model for the non-criminalisation of trafficked persons in Croatia. It provides a set of guidelines foremost for the prosecutors and judges in order to help them strike an appropriate balance between fundamental principles of Croatian legal system and rights of people that are essentially victims, and not perpetrators

Clustering of neuropsychiatric disease in first-degree and second-degree relatives of patients with amyotrophic lateral sclerosis

Importance Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative condition primarily involving the motor system. There is increasing epidemiologic evidence of an association between ALS and a wider spectrum of neurodegenerative and neuropsychiatric disorders among family members, including schizophrenia and psychotic illness and suicidal behavior. Objective To examine the frequency and range of neuropsychiatric conditions that occur within individual first-degree and second-degree relatives of patients with ALS. Design, Setting, and Participants In this population-based, case-control family aggregation study, all 202 patients included in the Irish ALS Register between January 1, 2012, and January 31, 2014, with definite, probable, or possible ALS as defined by El Escorial criteria were invited to participate. A total of 75 patients were unable or refused to participate and were excluded; the remaining 127 patients with incident ALS were genotyped for the C9orf72 repeat expansion and 132 age- and sex-matched controls were included in the study. Main Outcome and Measures The prevalence of defined neuropsychiatric disease in first-degree and second-degree relatives of patients with ALS and matched controls was determined. Results Mean (SD) age at diagnosis of the 127 patients in the study (58 women and 69 men) was 64.2 (10.7) years. Data from 2116 relatives of patients with ALS were reported, including 924 first-degree relatives, 1128 second-degree relatives, and 64 third-degree relatives. Data from controls were reported from 829 first-degree and 1310 second-degree relatives. A total of 77 patients with ALS (61.4%) and 51 control participants (38.6%) reported at least 1 first-degree or second-degree relative with a history of schizophrenia, psychosis, suicide, depression, alcoholism, or autism (relative risk [RR], 1.50; 95% CI, 1.08-2.17; P = .02). Cluster analysis suggested the following 2 subgroups based on the number of family members with a neuropsychiatric condition: expected (0-2) and high (≥3). Within the high subgroup, ALS kindreds presented a significantly higher rate of psychiatric illness than did controls (28 of 39 [71.8%]; mean [SD] number of siblings, 4.29 [1.41]; P = .001). A strong family history of schizophrenia (RR, 3.40; 95% CI, 1.27-9.30; P = .02), suicide (RR, 3.30; 95% CI, 1.07-10.05; P = .04), autism (RR, 10.10; 95% CI, 1.30-78.80; P = .03), and alcoholism (RR, 1.48; 95% CI, 1.01-2.17; P = .045) was reported in ALS kindreds. A total of 5 of 29 probands (17.2%) with a strong family history of neuropsychiatric conditions (≥3 first-degree or second-degree relatives) carried the C9orf72 repeat expansion. Conclusions and Relevance Neuropsychiatric symptoms in addition to schizophrenia, including obsessive-compulsive disorder, autism, and alcoholism, occur more frequently in ALS kindreds than in controls. The presence of the C9orf72 repeat expansion does not fully account for this finding, suggesting the presence of additional pleiotropic genes associated with both ALS and neuropsychiatric disease in the Irish population

Measuring reliable change in cognition using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS)

doi:https://doi.org/10.1080/21678421.2017.1407794Background: Cognitive impairment affects approximately 50% of people with amyotrophic lateral sclerosis (ALS). Research has indicated that impairment may worsen with disease progression. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was designed to measure neuropsychological functioning in ALS, with its alternate forms (ECAS-A, B, and C) allowing for serial assessment over time. Objective: The aim of the present study was to establish reliable change scores for the alternate forms of the ECAS, and to explore practice effects and test-retest reliability of the ECAS?s alternate forms. Method: Eighty healthy participants were recruited, with 57 completing two and 51 completing three assessments. Participants were administered alternate versions of the ECAS serially (A-B-C) at four-month intervals. Intra-class correlation analysis was employed to explore test-retest reliability, while analysis of variance was used to examine the presence of practice effects. Reliable change indices (RCI) and regression-based methods were utilized to establish change scores for the ECAS alternate forms. Results: Test-retest reliability was excellent for ALS Specific, ALS Non-Specific, and ECAS Total scores of the combined ECAS A, B, and C (all?>?.90). No significant practice effects were observed over the three testing sessions. RCI and regression-based methods produced similar change scores. Conclusion: The alternate forms of the ECAS possess excellent test-retest reliability in a healthy control sample, with no significant practice effects. The use of conservative RCI scores is recommended. Therefore, a change of ?8, ?4, and ?9 for ALS Specific, ALS Non-Specific, and ECAS Total score is required for reliable chang

Proceedings of the 12th International Conference on Kinanthropology

Proceedings of the 12th Conference of Sport and Quality of Life 2019 gatheres submissions of participants of the conference. Every submission is the result of positive evaluation by reviewers from the corresponding field. Conference is divided into sections – Analysis of human movement; Sport training, nutrition and regeneration; Sport and social sciences; Active ageing and sarcopenia; Strength and conditioning training; section for PhD students

Prognosis for patients with amyotrophic lateral sclerosis: development and validation of a personalised prediction model

Summary Background Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive, fatal motor neuron disease with a variable natural history. There are no accurate models that predict the disease course and outcomes, which complicates risk assessment and counselling for individual patients, stratification of patients for trials, and timing of interventions. We therefore aimed to develop and validate a model for predicting a composite survival endpoint for individual patients with ALS. Methods We obtained data for patients from 14 specialised ALS centres (each one designated as a cohort) in Belgium, France, the Netherlands, Germany, Ireland, Italy, Portugal, Switzerland, and the UK. All patients were diagnosed in the centres after excluding other diagnoses and classified according to revised El Escorial criteria. We assessed 16 patient characteristics as potential predictors of a composite survival outcome (time between onset of symptoms and non-invasive ventilation for more than 23 h per day, tracheostomy, or death) and applied backward elimination with bootstrapping in the largest population-based dataset for predictor selection. Data were gathered on the day of diagnosis or as soon as possible thereafter. Predictors that were selected in more than 70% of the bootstrap resamples were used to develop a multivariable Royston-Parmar model for predicting the composite survival outcome in individual patients. We assessed the generalisability of the model by estimating heterogeneity of predictive accuracy across external populations (ie, populations not used to develop the model) using internal–external cross-validation, and quantified the discrimination using the concordance (c) statistic (area under the receiver operator characteristic curve) and calibration using a calibration slope. Findings Data were collected between Jan 1, 1992, and Sept 22, 2016 (the largest data-set included data from 1936 patients). The median follow-up time was 97·5 months (IQR 52·9–168·5). Eight candidate predictors entered the prediction model: bulbar versus non-bulbar onset (univariable hazard ratio [HR] 1·71, 95% CI 1·63–1·79), age at onset (1·03, 1·03–1·03), definite versus probable or possible ALS (1·47, 1·39–1·55), diagnostic delay (0·52, 0·51–0·53), forced vital capacity (HR 0·99, 0·99–0·99), progression rate (6·33, 5·92–6·76), frontotemporal dementia (1·34, 1·20–1·50), and presence of a C9orf72 repeat expansion (1·45, 1·31–1·61), all p<0·0001. The c statistic for external predictive accuracy of the model was 0·78 (95% CI 0·77–0·80; 95% prediction interval [PI] 0·74–0·82) and the calibration slope was 1·01 (95% CI 0·95–1·07; 95% PI 0·83–1·18). The model was used to define five groups with distinct median predicted (SE) and observed (SE) times in months from symptom onset to the composite survival outcome: very short 17·7 (0·20), 16·5 (0·23); short 25·3 (0·06), 25·2 (0·35); intermediate 32·2 (0·09), 32·8 (0·46); long 43·7 (0·21), 44·6 (0·74); and very long 91·0 (1·84), 85·6 (1·96). Interpretation We have developed an externally validated model to predict survival without tracheostomy and non-invasive ventilation for more than 23 h per day in European patients with ALS. This model could be applied to individualised patient management, counselling, and future trial design, but to maximise the benefit and prevent harm it is intended to be used by medical doctors only. Funding Netherlands ALS Foundation

THE CAPABILITIES OF USES ART THERAPY IN HEALTH EDUCATION

Arteterapia należy do terapii humanistycznych, którą można zastosować w różnych grupach wiekowych w szeroko rozumianej edukacji zdrowotnej. Arteterapia to sposób na odreagowanie napięcia emocjonalnego czy zmęczenia fizycznego. Jest ona pomocna w pracy z człowiekiem zdrowym, jak i chorym. Celem pracy było przedstawienie możliwości praktycznego wykorzystania wybranych metod arteterapii w edukacji zdrowotnej w świetle literatury przedmiotu. W pracy uwzględniono definicję zdrowia i jej holistyczny wymiar, metody arteterapeutyczne i propozycje ich wykorzystania w realizacji zadań edukacji zdrowotnej.Art therapy is part of humanities therapy and may be used for health education in various age groups. Art therapy constitutes a way to release emotional tension or fatigue. It is helpful for working with both ill and healthy people. The aim of the work was to present the possibilities of practical use of selected methods of art therapy in health education in light of the subject literature. The work includes the definition of health and its holistic dimension, art-therapy methods and proposals for their use in the implementation of health education tasks