Abstract
Background: Postpartum stress refers to an unpleasant emotional state caused by stressors that arise during the postpartum period, though its prevalence remains unclear. Previous research indicates that up to 30% of mothers experience emotional difficulties, including stress, during this time. However, postpartum stress is often neglected in maternal mental health research, leading to inconclusive findings. Additionally, studies suggest that elevated stress levels persist throughout the first year after childbirth.
Aim: This study aimed to investigate the frequency of postpartum stress in mothers and the effects of sociodemographic and obstetric variables, as well as social support, on perceived postpartum stress.
Methods: Mothers who had given birth within the previous 6-12 weeks participated in an online survey (N=199). Participants completed the Depression, Anxiety, and Stress Scales, the Maternal Postpartum Stress Scale, the Birth Satisfaction Scale-Revised, the Perceived Partner Support Scale, and the Social Support Appraisals Scale.
Results: The findings revealed that mothers reported higher levels of postpartum-specific stress compared to general stress. Significant predictors of postpartum stress included younger maternal age, planned Caesarean section (C-section), varied infant feeding methods, and lower partner support which explained 34% of the total stress variance.
Conclusion: This study offers valuable insights into the factors contributing to postpartum stress and provides guidance for future interventions aimed at preventing and reducing postpartum stress. This, in turn, can facilitate smoother maternal adjustment to parenthood and promote better child development.
Keywords: psychological stress, postpartum, mothers, birth, social support

Abstract
Isotretinoin (13-cis-retinoic acid) is a vitamin A derivative most commonly used for the treatment of acne vulgaris. While its therapeutic effectiveness in this skin condition has been demonstrated by numerous studies, oral isotretinoin therapy impacts many other organ systems by interacting with complex genetic mechanisms. Epigenetic modifications make up a large portion of these interactions and they entail induction or suppression of specific gene expressions. While gene expression modification has been shown as important for the mechanism of action of isotretinoin, it is also deemed responsible by some for certain adverse events. Studies have postulated associations between isotretinoin and inflammatory bowel disease (IBD), autoimmune thyroiditis, and skeletal system diseases in the context of specific genetic predispositions. Isotretinoin has also been shown to negatively affect the glucose and lipid metabolic profile via these interactions. Furthermore, it can alter the therapeutic
effect of other drugs by modulating the activity of their metabolizing enzymes. On the other hand, isotretinoin has shown anti-tumor activity and a positive effect in anthracycline cardiotoxicity. The other relevant component of genetic factors in isotretinoin therapy is pharmacogenetics, which entails genetic products that take part in isotretinoin metabolism. Variants in these genes alter the mechanism by which the body metabolizes isotretinoin, which can cause therapeutic ineffectiveness or toxicity depending on the variant. The aim of this review was to provide a synthesis of knowledge regarding these interactions and potentially contribute to individualized isotretinoin therapy based on certain genetic findings.
Keywords: epigenetics, isotretinoin, metabolism, pharmaco-genetics

Abstract
Background: Fetal midgut volvulus is a serious finding with a high risk of life-threatening fetal complications.
Aim: To describe a sudden intrauterine fetal death caused by midgut volvulus at term.
Methods: This is a case report of a 28-year-old G2P0 patient with no significant medical history. At 34 weeks of gestation, an ultrasound revealed a cystic formation in the right upper abdominal quadrant of the fetus. In the 38th week, abrupt fetal intestinal dilatation and the absence of bowel peristalsis in what had been a normally developing fetus prompted the decision to induce labor and perform an emergency caesarean section due to terminal bradycardia. Neonatal resuscitation was attempted but unsuccessful (Apgar score 0/0/0 at 1, 5, and 15 minutes).
Conclusion: In this case, the true diagnosis of a fetal midgut volvulus and the cause of fetal death were confirmed by autopsy and a pathologist’s finding.
Keywords: midgut volvulus, prenatal diagnosis, stillbirth, autopsy

Abstract
Background: Nursing students are knowledgeable about health promoting behavior and should be role models for patients, although it is not unusual for them to lead unhealthy lifestyles.
Aim: This study aimed to examine health behaviors, associated cognitive factors and sources of health information among nursing students.
Methods: In total, 51 undergraduate nursing students from a university in Croatia answered a self-reported questionnaire related to health behaviors, health cognition factors and sources of health information. The statistical software package SPSS was used for statistical analysis, and descriptive statistics and correlations were analyzed.
Results: The results show that the nursing students demonstrated a moderate level of health-promoting behaviors. In general, the nursing students had a high level of health consciousness, very strong health-oriented beliefs and were generally willing to seek health information. More than 90% of them believed that social networks have a strong or very strong influence on health and confidence in the healthcare system. However, they did not perceive social networks as reliable sources of health information. As for national and international sources of health information, the Croatian Institute of Public Health is the most frequently used.
Conclusion: While the nursing students demonstrated high levels of health consciousness and information orientation, it is necessary to implement interventions that aim at empowering students to adopt healthy behaviors and cultivate personal health habits.
Keywords: health behavior, health promotion, health information, nursing students

Abstract
Background: The basic problems faced by the elderly are: poor financial condition, loneliness, insufficient health care, lack of social contacts, lack of activities and low general life satisfaction.
Aim: The aim of this study was to examine the quality of life of elderly people, with regard to the support of health professionals in their homes.
Methods: This cross-sectional study was conducted on elderly individuals residing in the city of Slatina. Participants were divided into two groups: one receiving in-home support from healthcare professionals and the other not receiving such support. A standardized questionnaire was used, including general sociodemographic data and three adapted scales to assess quality of life.
Results: A total of 100 elderly individuals participated in the study, with half receiving in-home support from healthcare professionals and the other half not receiving such support. Participants receiving in-home support from health professionals have a significantly poorer health status, indicating greater health needs (p<0.001). They also show a greater need for social interaction (p=0.007) and rate their current situation as very difficult and sad (p=0.01). No significant differences were found in feelings of loneliness (p=0.85) or in overall quality of life assessment (p=0.053). However, reduced loneliness is associated with greater life satisfaction for all participants (p<0.001), especially for those receiving in-in-home support from healthcare professionals (p<0.001).
Conclusion: Participants receiving in-home support from healthcare workers tend to rate their health as poorer and perceive their health needs as greater, alongside a
more pronounced sense of loneliness. Although there is a significant association between loneliness and quality of life, this relationship was not statistically confirmed among the participants. Loneliness is increasingly becoming a concern among the elderly, highlighting the need for focused social efforts to address this issue.
Keywords: elderly, quality of life, home care

Abstract
This article aims to outline the ethical perspectives on disability discourse in medicine and nursing elucidating the necessity for a more multifaceted approach to disability and patients with disability within medical and nursing curricula. While advancements in medical engineering and pharmacology have enhanced independence and quality of life for people with disabilities, the approach to disability often results in arbitrary assumptions about disability as a concept and the objectification of people with disabilities in clinical settings. This article attempts to advocate for a more inclusive approach in medical and nursing education that incorporates an interdisciplinary understanding of disability and respect for personal experience of disability. It proposes an ethical framework that challenges contemporary views on the concept of disability and associated disability terminology in healthcare and medical education and promotes a holistic approach to the treatment of individuals with disability respectful of their experience of disability.
Keywords: disability, medical model, personalism, healthcare curriculum

Abstract
Background: Engaging in physical activity (PA) offers substantial benefits for both physical and mental health, which is particularly significant for vulnerable populations,
including individuals with disabilities. Research indicates that PA can enhance mental well-being in these groups, though more studies are needed to fully understand this relationship.
Aim: The aim of this study was to examine the differences in mental health indicators among individuals with disabilities, comparing those who participate in sports and exercise with those who do not.
Methods: We conducted an Internet-based cross-sectional study in 2024, using a nonprobability (convenience) sample. Participants reported their involvement in sports and exercise and completed scales to assess psychological well-being, life satisfaction, and positive and negative affects.
Results: The study included 120 adults with disabilities, with an average age of 43.13 years. The findings indicated that categorised athletes, uncategorised athletes, and
recreationally active individuals reported higher life satisfaction (F(2,111)=8.60, p < 0.001, ηp2=0.13) and positive affect (F(2,104), p=001, ηp2 =0.12) compared to physically inactive individuals, with categorised athletes reporting the highest levels of life satisfaction. Additionally, while negative affect was consistent across all groups, the results suggested that active uncategorised athletes and recreationally active individuals had higher psychological well-being than those who were physically inactive.
Conclusion: The study suggests that active participation in sports and recreational physical activities may play a significant role in enhancing the mental health of individuals with disabilities, potentially leading to greater life satisfaction and positive outcomes among athletes and recreationally active individuals. These findings support
public health initiatives and policies that promote physically active lifestyles, which may contribute to improved mental well-being.
Keywords: physical activity, mental health, disabled persons, sports, life satisfaction, psychological well-being