The Magic Wand: A Case Study of Chronic Neck Pain

Medications used to manage chronic pain have documented side effects including drug dependency, drug interaction, and adverse systemic reactions. This case study used Interpretative Phenomenological Analysis to understand how one individual experienced chronic neck pain including pharmaceutical and non-pharmaceutical interventions. Convenience sampling identified Ms. P, an individual with a 10-year history of chronic pain. The research questions were: “How does one individual with chronic neck pain describe their experience living with neck pain?” and “How does one individual with chronic neck pain manage their pain?” Three super-ordinate themes emerged: pain pervades everything, finding relief, and recovery. Findings suggest that living with chronic pain is framed by both the experience of severe pain and the search for a cure. Fear, panic, and despair accompany ongoing pain. Initially, the participant’s physician prescribed medications including narcotics, which are described as a slippery slope. In desperation, the participant sought alternative treatments

Parental Responsibility and Blended Families

U suvremenom svijetu nameće se potreba usklađivanja složenih obiteljskopravnih odnosa među osobama koje žive u uzastopnim obiteljima. Mnoga se otvorena pravna pitanja pojavljuju kad su u pitanju uzastopne obitelji, ali predmet ovog rada bit će isključivo razmatranje faktičkog i pravnog odnosa između djeteta i novoga bračnog ili izvanbračnog druga ili partnera njegova roditelja s ciljem prepoznavanja moguće potrebe pravnog uređenja tog odnosa. Stoga će se ponajprije nastojati razmotriti pojava socijalnog roditeljstva, a zatim prepoznati kad se javlja u kontekstu uzastopnih obitelji. Pojam socijalnog roditeljstva pokušat će se povezati i s postojećim pravnim modelima roditeljske skrbi poredbenom analizom različitih pristupa koji odgovaraju većoj ili manjoj sklonosti priznavanju socijalnom roditelju, uz de facto uloge, i pravne uloge u djetetovu životu. U nastavku rada analizirat će se hrvatski pravni okvir de lege lata te će se upozoriti na određene proturječnosti. Zatim će se ponuditi pravna rješenja nekoliko inozemnih sustava, s posebnim naglaskom na francusko rješenje zato što autorica smatra da bi se ono moglo koristiti kao primjer za unapređenje tuzemnih rješenja. Zaključno, autorica će predložiti moguća rješenja de lege ferenda.The requirements of the modern world impose the need to regulate the complex family relationships between persons who live in blended families. There are many open legal issues regarding blended families; nevertheless, this paper focuses exclusively on the analysis of the relationship between the child and the new spouse or partner of the child's parent, in its factual and legal dimension. It will first take into consideration the concept of the social parenthoodin the context of blended families. Moreover, the purpose of the research is to relate the concept of the social parenthood to the existing legal models of parental responsibility, by comparing different approaches, which are more or less inclined to recognize not just de facto role, but also the legal position of the social parent in the child’s life. In addition, the Croatian legal framework de lege lata will be analyzed, trying to point out some contradictions. Subsequently, the author will offer some solutions from other legal systems, paying particular attention to French solutions, which could be taken as a model to improve the Croatian solutions. Finally, the author offers possible de lege ferenda suggestions

Untersuchungen zur therapeutischen Anwendung mesenchymaler Stammzellen bei chronischen Lebererkrankungen am Beispiel der Nicht-alkoholischen Steatohepatitis

Die Nicht-alkoholische Steatohepatitis (NASH), gehörig zu der Gruppe der chronischen Lebererkrankungen als eine schwere Form der Nicht-alkoholischen Fettleber-erkrankungen (NAFLD), nimmt in ihrer Prävalenz ständig zu. Gründe dafür sind u.a. eine gesteigerte Nahrungsaufnahme sowie Veränderungen der Nahrungszusammen-setzung. Es kommt zur Ausbildung einer Steatose, die sich unter Mitwirkung verschie-dener Einflussfaktoren zur Steatohepatitis weiterentwickeln kann, wobei die Pathoge-nese noch nicht genau verstanden ist. Die Nicht-alkoholische Steatohepatitis geht oft einher mit Insulinresistenz und starkem Übergewicht. Die Folgen für die Leber sind Funktionseinschränkungen und –verlust, hervorgerufen durch eine massive Akkumula-tion von Triglyzeriden in den Hepatozyten, Entzündungsprozesse sowie einem fibro-tischen Umbau der Leber. Im fortgeschritten Stadium wird eine Lebertransplantation unausweichlich, die jedoch aufgrund des zunehmenden Mangels an Spenderorganen oft nicht möglich ist. Eine Alternative bietet die Transplantation mesenchymaler Stammzellen (MSC). MSC können in vitro in leberzellähnliche Zellen differenziert wer-den und weisen dabei essentielle hepatozytäre Eigenschaften auf, wodurch sie als möglicher Ersatz bzw. als Überbrückungstherapie bis zur Lebertransplantation in Frage kommen. Die vorliegende Arbeit beschäftigte sich mit dieser Fragestellung. Dazu wur-de ein Tiermodell der NASH mittels Methionin-Cholin-defizienter Diät (MCD-Diät) etab-liert und die Transplantation von hepatozytär differenzierten MSC durchgeführt. An-hand spezifischer zellulärer und biochemischer Marker der NASH konnte die Wirkung des Zelltransplantats auf die Empfängerleber analysiert werden. Es hat sich gezeigt, dass die MSC einen anti-inflammatorischen, anti-fibrotischen und pro-proliferativen Einfluss auf das Empfängerparenchym hatten und somit zur Verbesserung der Symptomatik der NASH beitrugen

Family Property Relations: National Legal Solutions and European Trends

Pravno uređenje imovinskih odnosa u obitelji znatno se razlikuje u pojedinačnim europskim pravnim sustavima. Prvi će dio rada stoga biti posvećen analizi imovinskih odnosa u braku, u izvanbračnim zajednicama te u životnim partnerstvima osoba istog spola u hrvatskome obiteljskom pravu s ciljem određivanja pravnog okvira. Nadalje, pokušat će se odgovoriti na pitanje jesu li na imovinskopravna rješenja djelovala određena poredbenopravna rješenja i/ili izvori soft lawa, poput Načela europskoga obiteljskog prava u području imovinskih odnosa bračnih drugova. U drugom će se dijelu rada nastojati razmotriti kako bi sekundarno pravo EU-a moglo utjecati na domaće obiteljsko pravo nakon što se u Republici Hrvatskoj budu primjenjivale Uredba Vijeća (EU) 2016/1103 o provedbi pojačane suradnje u području nadležnosti, mjerodavnog prava te priznavanja i izvršenja odluka u stvarima bračnoimovinskih režima i Uredba Vijeća (EU) 2016/1104 o provedbi pojačane suradnje u području nadležnosti, mjerodavnog prava te priznavanja i izvršenja odluka u stvarima imovinskih posljedica registriranih partnerstava. Na kraju, autorica će ponuditi završna razmatranja glede usporedbe između postojećih nacionalnih pravnih rješenja i europskih trendova u području imovinskih odnosa u obiteljskom pravu.The legal regulation of patrimonial relations in the family differs from one European legal system to another. The first part of the paper will be dedicated to the analysis of the patrimonial relations in the marriage, in the de facto cohabitations and in the same-sex registered partnerships in the Croatian family law in order to define the legal framework. The paper will go on to deal with the question of whether the national family law has been influenced by some legal solutions from other legal systems or by sources of soft law such as the Principles of European Family Law regarding Property Relations between Spouses. The second part of the paper will deal with the possible impact of the EU secondary legislation on the national family law after the entry into force of the Council Regulation (EU) 2016/1103 of 24 June 2016 implementing enhanced cooperation in the area of jurisdiction, applicable law and the recognition and enforcement of decisions in matters of matrimonial property regimes and the Council Regulation (EU) 2016/1104 of 24 June 2016 implementing enhanced cooperation in the area of jurisdiction, applicable law and the recognition and enforcement of decisions in matters of the property consequences of registered partnerships. Finally, the author will offer some concluding remarks regarding the comparison between national legal solutions and the European trends in the field of property relations in family law

Parental Responsibility and Blended Families

U suvremenom svijetu nameće se potreba usklađivanja složenih obiteljskopravnih odnosa među osobama koje žive u uzastopnim obiteljima. Mnoga se otvorena pravna pitanja pojavljuju kad su u pitanju uzastopne obitelji, ali predmet ovog rada bit će isključivo razmatranje faktičkog i pravnog odnosa između djeteta i novoga bračnog ili izvanbračnog druga ili partnera njegova roditelja s ciljem prepoznavanja moguće potrebe pravnog uređenja tog odnosa. Stoga će se ponajprije nastojati razmotriti pojava socijalnog roditeljstva, a zatim prepoznati kad se javlja u kontekstu uzastopnih obitelji. Pojam socijalnog roditeljstva pokušat će se povezati i s postojećim pravnim modelima roditeljske skrbi poredbenom analizom različitih pristupa koji odgovaraju većoj ili manjoj sklonosti priznavanju socijalnom roditelju, uz de facto uloge, i pravne uloge u djetetovu životu. U nastavku rada analizirat će se hrvatski pravni okvir de lege lata te će se upozoriti na određene proturječnosti. Zatim će se ponuditi pravna rješenja nekoliko inozemnih sustava, s posebnim naglaskom na francusko rješenje zato što autorica smatra da bi se ono moglo koristiti kao primjer za unapređenje tuzemnih rješenja. Zaključno, autorica će predložiti moguća rješenja de lege ferenda.The requirements of the modern world impose the need to regulate the complex family relationships between persons who live in blended families. There are many open legal issues regarding blended families; nevertheless, this paper focuses exclusively on the analysis of the relationship between the child and the new spouse or partner of the child's parent, in its factual and legal dimension. It will first take into consideration the concept of the social parenthoodin the context of blended families. Moreover, the purpose of the research is to relate the concept of the social parenthood to the existing legal models of parental responsibility, by comparing different approaches, which are more or less inclined to recognize not just de facto role, but also the legal position of the social parent in the child’s life. In addition, the Croatian legal framework de lege lata will be analyzed, trying to point out some contradictions. Subsequently, the author will offer some solutions from other legal systems, paying particular attention to French solutions, which could be taken as a model to improve the Croatian solutions. Finally, the author offers possible de lege ferenda suggestions

Adult child maintenance

Pravo na uzdržavanje punoljetne djece obiteljskopravni je institut, koji se vrlo često primjenjuje u praksi, budući da je većina djece starije od osamnaest godina i dalje financijski ovisna o roditeljima, ako se opredijelila za daljnje obrazovanje ili se ne može zaposliti odmah po završetku studija. Krizna se vremena neminovno odražavaju na ostvarivanje prava na uzdržavanje punoljetne djece. Bilo da se radi o nemogućnosti roditelja za daljnje uzdržavanje djeteta zbog gubitka posla ili pogoršanja financijskih prilika, bilo da se radi o nemogućnostima zapošljavanja mladih, što je u današnje vrijeme vrlo ozbiljan problem društva, ili pak neurednog i neredovitog studiranja, činjenica jest da se od početka gospodarske krize bilježi konkretan i stalan porast broja presuda koje se bave raznim aspektima uzdržavanja punoljetne djece. Nakon rekonstrukcije normativnog okvira, ovim će se radom pokušati istaknuti osnovna pitanja koja proizlaze iz sudske prakse. Također će se ponuditi kratki osvrt na rješenja što ih u kontekstu uzdržavanja punoljetne djece nude talijanski, francuski i njemački pravni sustavi, a radi usporedbe s domaćim pravnim rješenjima. Na kraju će se pokušati odgovoriti na ranije postavljena pitanja, a ponajprije na to jesu li postojeća hrvatska pravna rješenja spojiva sa socijalnom politikom te sa socijalnom slikom društva.The Law on maintenance of adult children is a family law institute frequently adopted in the practice considering that the majority of the children of age still depends economically from parents, because of the fact that they decide to study or they are no table to find an employment after the education. The crisis inevitably reflects to the realization of the law on maintenance of adult children. On one side, the reason can be the parents\u27 impossibility to maintain them longer, because of the loss of the job or because of the deterioration of their economic situation. On the other hand, it can derive from the child’s impossibility to find an employment after the education or from the irregularity in studying. Therefore, since the beginning of the crisis it can be observed a concrete and constant increase of the number of judgments, which deal with some aspects of the law on maintenance of adult children. After an overview of the legal frame, the main purpose of this paper is to point out the relevant legal question, which derives from the case law. Moreover, it will be offered a short overview of the legal solutions offered in the context of the law on maintenance of adult children by the Italian, French and German legal systems in order to make a comparison with the domestic law on maintenance. Finally, the purpose of the paper is to try to answer to the previous questions, in particular if the actual Croatian legal solutions are connectable with the social reality of the Country

Parental Responsibility and Blended Families

U suvremenom svijetu nameće se potreba usklađivanja složenih obiteljskopravnih odnosa među osobama koje žive u uzastopnim obiteljima. Mnoga se otvorena pravna pitanja pojavljuju kad su u pitanju uzastopne obitelji, ali predmet ovog rada bit će isključivo razmatranje faktičkog i pravnog odnosa između djeteta i novoga bračnog ili izvanbračnog druga ili partnera njegova roditelja s ciljem prepoznavanja moguće potrebe pravnog uređenja tog odnosa. Stoga će se ponajprije nastojati razmotriti pojava socijalnog roditeljstva, a zatim prepoznati kad se javlja u kontekstu uzastopnih obitelji. Pojam socijalnog roditeljstva pokušat će se povezati i s postojećim pravnim modelima roditeljske skrbi poredbenom analizom različitih pristupa koji odgovaraju većoj ili manjoj sklonosti priznavanju socijalnom roditelju, uz de facto uloge, i pravne uloge u djetetovu životu. U nastavku rada analizirat će se hrvatski pravni okvir de lege lata te će se upozoriti na određene proturječnosti. Zatim će se ponuditi pravna rješenja nekoliko inozemnih sustava, s posebnim naglaskom na francusko rješenje zato što autorica smatra da bi se ono moglo koristiti kao primjer za unapređenje tuzemnih rješenja. Zaključno, autorica će predložiti moguća rješenja de lege ferenda.The requirements of the modern world impose the need to regulate the complex family relationships between persons who live in blended families. There are many open legal issues regarding blended families; nevertheless, this paper focuses exclusively on the analysis of the relationship between the child and the new spouse or partner of the child\u27s parent, in its factual and legal dimension. It will first take into consideration the concept of the social parenthoodin the context of blended families. Moreover, the purpose of the research is to relate the concept of the social parenthood to the existing legal models of parental responsibility, by comparing different approaches, which are more or less inclined to recognize not just de facto role, but also the legal position of the social parent in the child’s life. In addition, the Croatian legal framework de lege lata will be analyzed, trying to point out some contradictions. Subsequently, the author will offer some solutions from other legal systems, paying particular attention to French solutions, which could be taken as a model to improve the Croatian solutions. Finally, the author offers possible de lege ferenda suggestions

Amputee Perspectives of Virtual Patient Education

Amputees have expressed the need for more information on the recovery path that follows amputation. Inclusion of education in the amputation rehabilitation process empowers amputees to make decisions about their options and form realistic expectations. Virtual worlds are effective as healthcare support communities because they provide both synchronous and asynchrous communication, voice enabled technology, file sharing and more, enhanced by immersion in a visually stimulating and interactive 3-D environment. The objective of this research was to discover how a virtual world could be used to address amputees’ educational needs. A focus group of three lower limb amputees ages ranging from 39 to 82 was convened. Data were analyzed qualitatively using the thematic analysis procedure. Four themes emerged: Challenges amputees face, Getting out and doing things, Becoming empowered, and What’s next for the virtual world. The challenges voiced set an important context. While we anticipated that amputees would want both education and support in a virtual world environment, we learned that support is not only part of education but that both are empowering. Participation in the virtual world facilitated getting out and about and getting moving

Line‐field confocal optical coherence tomography and optical coherence tomography for distinguishing basal cell carcinoma from dermal nevus: a case report

Basal cell carcinoma (BCC) is the most frequent skin cancer with a rising incidence. It can imitate benign lesions for example, dermal nevus clinically and dermoscopically. Both entities show specific morphologic features in line-field confocal optical coherence tomography (LC-OCT) and optical coherence tomography (OCT). The aim was to differentiate both lesions via noninvasive imaging to prevent unnecessary surgery. A 63-year-old woman presented with a light brownish nodule on the left cheek and a brownish nodule on the right nasal slope/cheek, which were both evident since a few months. The clinical and dermoscopic appearance of both lesions was very similar including the differential diagnosis of a dermal nevus or BCC. Dynamic OCT of the lesion on the left cheek showed multiple hyporeflective nodules in the dermis with hypervascularization. Using LC-OCT several hyporeflective round to ovoid nodules with hyporeflective clefting embedded in a hyperreflective surrounding connective tissue could be observed. These specific morphological criteria called millefeuille pattern led to the diagnosis of a nodular BCC. The lesion of the right cheek presented with a thickened epidermis and elongated rete ridges in dynamic OCT. Upon LC-OCT examination a so-called large wave like pattern presenting as undulating hyporeflective and hyperreflective lobular structures could be identified. Therefore, the diagnosis of a dermal nevus was made. Both lesions were identified correctly as confirmed histopathologically after shave excision. Since BCC can imitate benign lesions for example, dermal nevi, the use of OCT and LC-OCT can facilitate the identification of BCC and its imitators. Noninvasive imaging can help to avoid unnecessary biopsy especially in areas where the skin is vulnerable to punch biopsy