Croatian Women Research Articles

Home birth in Croatia - a medico-legal perspective today.

In Croatia, the model of obstetrics-midwifery management of childbirth in maternity hospitals is still in effect, and this is how > 99% of Croatian women give birth. However, in my view, midwives are still not sufficiently educated for completely independent work notwithstanding their university education. The Law on Midwifery defined the role of the midwife in home birth without, however, setting out other organisational-communication and professional provisions. Then it began with sporadic midwifery home births of a few per year, which grew quite rapidly, especially with the impact of the Covid-19 virus pandemic, to about 100 out of a total of about 38,000 births that are performed annually in the Republic of Croatia in maternity hospitals. Since the start of planned home births many bad perinatal outcomes have been recorded in hospital maternity wards who have admitted women after such deliveries. These include puerperal sepsis, protracted labour of several days, neglected protracted labour with perinatal asphyxia and aspiration of meconium amniotic fluid and resuscitation of the newborn (who later developed cerebral palsy), severe postpartum haemorrhage with obstetric shock and postpartum hysterectomy, episiotomy infection, and stillbirth at term pregnancy. Therefore, planned home birth in Croatia should now be regarded as an unsafe birth in extraordinary circumstances and the person who takes charge of it must be professionally prepared, educated and have numerous social skills. Most Croatian gynaecologists and obstetricians give support to midwives in their efforts to be professional and independent when at work, including the controlled and legal implementation of the planned home birth. We unreservedly support self-aware midwives to maintain their profession as highly ethical and professional as possible above the wishes of non-professionals who call for autonomy, so that we do not have to discuss such problems of malpractice of Croatian midwifery in the 21st century.

Tripartite Influence Model

The effects of media on body image have been heavily investigated through the years. Recent research has shifted its focus to social media content and other behaviors on social media that can affect body and appearance satisfaction. This study aimed to test the contribution of media pressure to appearance satisfaction according to the prepositions of the Tripartite Influence Model on a sample of young Croatian women. A sample of 308 college students (average age 21.6) completed the BE-Appearance subscale of the Body Esteem Scale for Adolescents and Adults (Mendelson et al., 2001), Physical Appearance Comparison Scale (Thompson et al., 1991), and Sociocultural Attitudes Towards Appearance Questionnaire (Schafer et al., 2015). Path analysis showed that media pressure positively contributes to both appearance comparison with people on Instagram and beauty ideals internalization and negatively contributes to appearance satisfaction in young women. Results also indicate a significant negative indirect contribution of media pressure to appearance satisfaction through appearance comparison and beauty ideals internalization. Findings suggest a strong relationship between media pressure and appearance satisfaction and are discussed in the context of further investigation of media content that could be harmful to appearance satisfaction in young women.

Monitoring HPV Prevalence and Risk Cofactors for Abnormal Cytology in the Post-Vaccination Period among Croatian Women.

The incidence and mortality rate of cervical cancer in Croatia remains a health challenge despite screening efforts. Besides the persistent infection with HPV, the development of cancer is also associated with some cofactors. The goal of this study was to assess circulating HPV genotypes and risk factors for the development of cervical precancer after almost 16 years from the onset of HPV vaccination in Croatia. In this study, a total of 321 women attending gynecological care were evaluated. Relevant medical and demographic information, including cytology, were collected. HPV genotyping was performed by PCR. Comparing the HPV types found in circulation in the pre-vaccination (1999-2015) and post-vaccination periods (2020-2023), a statistically significant reduction in HPV 31 was noted, while the overall prevalence increased in the post-vaccination period. Besides the expected HPV positivity as a risk factor, the history of smoking was associated with LSIL or worse cytology at enrollment. For the first time, this population study revealed a statistically significant shift in the HPV genotype in the post-vaccination period, as well as the confirmation of risk factors for the development of abnormal cytology among Croatian women.

The Relationship between Jealousy and Mate Retention Strategies in Romantic Relationships among Women during the COVID-19 Pandemic.

Jealousy and mate retention have received attention in research over the last few decades. Despite this, most of the research has examined male jealousy and male mate retention, emphasizing cost-inflicting behavior due to its role in relationships and domestic violence. The aim of this study was to investigate the relationship between jealousy and all mate retention strategies in romantic relationships among women during the COVID-19 pandemic. The sample consisted of 772 Croatian women aged 19 to 40 who were in a heterosexual relationship at the time. This study was conducted online, and the participants completed the Multidimensional Jealousy Scale and Mate Retention Inventory. The results showed that cognitive, emotional, and behavioral jealousy were positively correlated with all mate retention strategies, which indicates that a stronger experience of jealousy can be expected to result in more frequent use of all partner retention strategies. We also found that all three dimensions of jealousy and relationship length positively predicted both cost-inflicting and benefit-provisioning mate retention behavior, whereas age was a negative predictor of benefit-provisioning behavior only. The findings of this study suggest that, although jealousy can substantially explain interpersonally risky and damaging behavior in relationships, it can also explain affectionate and attentive behavior, to some extent.

The Contribution of Croatian Women Philosophers to the Study of Croatian Philosophy

Abstract This text comprises three distinct sections. In the initial part, we give an overview of some specificities of Croatian, i.e., national philosophy. In the subsequent section, five Croatian women philosophers are represented from the perspective of their contributions to Croatian philosophy; we offer an overview of their works and evaluate their overall contributions to Croatian philosophy. Finally, in the concluding section, we provide an explanation for the notably heightened significance of Croatian women philosophers in advancing the exploration of national philosophy in comparison to their male counterparts.

Croatian mothers were 11 times more likely to give their newborn infants formula in hospital if they had used it for their older children.

We determined the prevalence and predictors of formula supplementation for healthy, term newborn infants in hospital. A cross-sectional study was conducted from 1 June to 21 October 2020 among Croatian women who gave birth to healthy newborn infants of ≥37 weeks gestation and birth weight of ≥2500 g at the University Hospital of Split, Croatia. The mothers completed a questionnaire on hospital infant feeding practices and breastfeeding self-efficacy. Multinomial logistic regression investigated associations between perinatal factors and formula supplementation. We approached 392 mothers, and 355 (90.6%) were included: 286 (80.6%) said their newborn infant received formula in hospital and it was at their request in 173/286 (60.5%) of cases. The adjusted analyses identified factors associated with increased odd ratios (OR) and 95% confidence intervals (CI) for formula supplementation: no previous breastfeeding experience (OR 9.42, 95% CI 3.51-25.28), breastfeeding difficulties in hospital (OR 9.12, 95% CI 3.46-24.09) and older children who received formula during their birth hospitalisation (OR 11.51, 95% CI 4.4-30.1). Mothers were not routinely notified of the risks. An unacceptably high proportion of healthy newborn infants received formula in hospital.

8th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

8^th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

Some Philosophical Aspects of Elza Kučera

The focus of this work are two aspects of the philosophy of Elza Kučera (1883 — 1972). Kučera received her doctorate in philosophy from the University of Zurich in 1909, becoming the first Croatian woman born in Croatia to receive a PhD in philosophy. Her main interest was psychology, and later library science, and, apart from her PhD theses, almost all her published works are within these disciplines. However, among her handwritten and unpublished works that are preserved in the archives of the National and University Library in Zagreb a certain number of “purely” philosophical texts can be found. In order to present her philosophical approach, we analyze two particular questions she dealt with. The first is the problem of causality that she discussed in her overview of Thomas Brown’s epistemology in her dissertation entitled The Epistemology of Thomas Brown: A Historical Study (Die Erkenntnislehre von Thomas Brown: eine historische Studie, Zagreb, 1909). The second is the question of national philosophy, which she developed in a short unpublished text from 1918 or 1919. Given that Elza Kučera, as the first woman philosopher, experimental psychologist, and woman librarian in Croatia, has not received due attention to this day, we also present her biography.

Powojenna diaspora. Kilka uwag o obrazie serbskiej i chorwackiej emigracji w najnowszej literaturze

The Post-War Diaspora: Some Remarks on the Depiction of Serbian and Croatian Emigrants in Recent LiteratureThe essay aims to show how modern literature of both Serbia and Croatia depicts the early South Slavic emigration of the post-World War II period. Describing historical conditions before and during WWII, the author depicts Serbian and Croatian emigration groups which differ one from the other in their mental backgrounds. But the books analysed in the essay show that, when abroad, both Serbs and Croats present identical attitudes and are involved in the same rituals, exclusion and stigmatisa­tion. The analysis is based on two texts: one written by Vladimir Tasić, a Serb emigrant to Canada, the other by Daša Drndić, a Croatian woman of many years’ emigrant experience. In their books the two authors describe members of both nations who form strongly consolidated groups abroad and exhibit nationalistic viewpoints. Both Tasić and Drndić are modern literary writers, open to novelty in art. Furthermore, they openly reject the nationally oriented state models which originated after the collapse of Yugoslavia. They also criticise representatives of the post-war emigration. The author of the essay thus concludes that, after years of silence about the post-war diaspora, the contempo­rary emigrant communities emerge in two contrasting ways in Serbian and Croatian literature and in scholarly discourse. One is represented by politically and aesthetically conservative artists and schol­ars, and has a clearly apologetic character. The other, represented by Drndić and Tasić, expresses a critical approach.

The relationship between birth satisfaction, posttraumatic stress disorder and postnatal depression symptoms in Croatian women.

Studies show that a woman's dissatisfaction with her birth experience may affect her well-being. This study aimed to examine: (1) the birth satisfaction in Croatian women and compare it with UK normative data; (2) the association of different dimensions of birth satisfaction with posttraumatic stress disorder (PTSD) and depressive symptoms. In a cross-sectional online study, 603 postnatal Croatian women completed the Birth Satisfaction Scale-Revised (subscales: Stress experienced during labour (SL), Women's personal attributes (WA), and Quality of care provision (QC)); City Birth Trauma Scale (subscales: Birth-related symptoms and General symptoms); and Edinburgh Postnatal Depression Scale. Subscale and total scale scores were calculated. Path analysis tested the model of three aspects of birth satisfaction effect on PTSD dimensions and depressive symptoms. The average birth satisfaction score was significantly lower compared to the UK data on the total scale and all three subscale scores. Path analysis revealed that all three dimensions of birth satisfaction (SL, WA, and QC) had an effect on Birth-related symptoms. However, only Women's personal attributes (i.e., feeling anxiety or being in control during childbirth) had an effect on General symptoms and depressive symptoms, as well. Different aspects of birth satisfaction are important for maternal mental health following childbirth.

The media presentation of the migration crisis: An analysis of the discourse on the Croatian women politicians

This article analyses links between the archetypal myths in Croatian news stories and images of woman politicians transferring through the media to the public. A total of 73 articles have been empirically analysed using content analysis to identify master myths according to Jack Lule’s classification in Croatian news articles about the migration crisis 2015. The analysis covers the period from 31 July 2015 to 8 November 2015. The articles have been selected by searching web extension of the newspapers Jutarnji list, Večernji list and 24sata from 31 July 2015 to 8 November 2015. The data has been selected, coded and analysed per chosen woman politicians, Kolinda Grabar-Kitarović, Vesna Pusić, Mirela Holy, Ruža Tomašić and Milanka Opačić. The results show that the dominant myth in all analysed statements is the myth of a good mother. In doing so, the use of lexemes indicates a stereotyped and idealized social role of a woman who cares for and protects ‘her family’. Two framing perspectives are evident: one is a patriarchal, protective and defensive attitude towards migrants, while the other is humanitarian, based on a positive attitude towards migrants. The article’s value is that it provides a perspective on mythological narration within media texts, whereby the mythological narration could be used as a tool for stereotypical and ideological construction on politician’s images in the media.

Distribution of human papillomavirus genotypes in women with high-grade cervical intraepithelial lesions and cervical carcinoma and analysis of human papillomavirus-16 genomic variants

AimTo analyze the distribution of high-risk human papillomavirus (HR-HPV) genotypes and the diversity of HPV-16 genomic variants in Croatian women with high-grade squamous intraepithelial lesions (HSIL) and cervical carcinoma.MethodsTissue biopsy specimens were obtained from 324 women with histopathologically confirmed HSIL or cervical carcinoma, 5 women with low-grade SIL, and 49 women with negative histopathology. HR-HPV DNA was detected with Ampliquality HPV-type nucleic-acid hybridization assay, which identifies 29 different HPV genotypes. HPV-16 genomic variants were analyzed by an in-house sequencing.ResultsThe most common HPV type in women with HSIL was HPV-16, detected in 127/219 (57.9%) specimens. HPV-16 was also the dominant type in squamous cell cervical carcinoma (46/69 or 66.7%) and in adenocarcinoma (18/36 or 50.0%). Out of 378 patients, 360 had HR-HPV (282 single infections and 79 multiple infections), 3 (0.8%) patients had low-risk HPV, and 15 (4%) tested negative. HPV-16 variants were determined in 130 HPV-16 positive specimens, including 74 HSIL and 46 carcinoma specimens. In HSIL specimens, 41 distinct variants were found, 98.6% belonging to the European branch and 1.4% belonging to the African branch. In cervical carcinoma specimens, 95% isolates grouped in 41 variants belonging to the European branch, one isolate (2.5%) belonged to the North American, and one (2.5%) to the Asian-American branch.ConclusionHPV-16, mainly belonging to the European branch, was the most frequent HPV genotype in women from Croatia with histologically confirmed HSIL and cervical cancer.

Karakteristike raka dojke ovisno o statusu mutacija u genima BRCA1 i BRCA2 u Hrvatskoj

Breast cancer (BC) represents 25% of all malignancies in Croatian women, and in 18.8% of cases, it is diagnosed before the age of 50. Croatia launched BRCA testing of people at increased family risk. Hereditary BC is mainly caused by a pathogenic mutation in the BRCA1 or BRCA2 gene and is a significant risk factor for developing breast and ovarian cancer. The present study included 127 women diagnosed with BC, with a strong family history of BC and the known status of the germline mutations in the BRCA1/BRCA2 genes. The majority of women were BRCA1/2 mutation non-carriers, while 15.7% were BRCA1/2 mutation carriers, and 4% had a variant of unknown significance (VUS). BRCA1/2 mutation carriers were younger than non-carriers (median 38.5 years vs. 44 years) (P=.01) and had tumors of higher histological grade (P<.001). The intrinsic subtype of BC differs significantly depending on the type of mutation (P<.001). Triple-negative BC prevailed (87.5%) in BRCA1 mutation carriers, and 12.5% had a luminal B/HER2-negative BC. Four patients were BRCA2 mutation carriers, and two of them had luminal B/HER2-positive BC. Most BRCA1/2 non-carriers (69.2%) and all VUS-carriers have luminal B/HER2-negative BC. Our results show that BRCA1/2 mutation testing is essential for women with a family history burden. It is a piece of valuable information in breast cancer risk assessment and contributes to early diagnosis.

Lifestyle characteristics influencing hypertension in middle-age to old people: comparison of two populations

Background: Hypertension is a significant global public health problem and the data suggest a wide health disparity in hypertension prevalence worldwide. Our objective was to assess some epidemiological determinants in individuals ≥ 50 years influencing blood pressure/hypertension in United States and Croatia and derive some meaningful conclusions and recommendations. Material and methods: We used the American National Health and Nutrition Examination Survey (NHANES) (n = 1,556; 48.9% women) and the Croatian Adult Health Cohort Study (CroHort) (n = 2,182; 66% women), both taken in 2008. The health indicators compared were anthropometries, blood pressure, socioeconomic and marital status, education and lifestyle, including physical activity, alcohol and coffee consumption, smoking and presence of dyslipidemia and diabetes. Results: Prevalence of hypertension based either on medication use or blood pressure values was significantly higher in Croatian men and women compared to American (all p < 0.001). Waist circumference was the main positive predictor and education a negative predictor for blood pressure in CroHort; significance was not reached in NHANES, although the trends were similar. Taking medications for diabetes decreased the odds for hypertension in NHANES, while taking medications for both diabetes and dyslipidemia decreased the odds in CroHort. Conclusions: Croatian people older than 50 years have higher prevalence of hypertension compared to their counterparts in the U.S. The difference in the prevalence of hypertension in two populations cannot be explained by different prevalence of risk factors examined, except education level. Higher prevalence of hypertension diagnosed by medication use indicates a relatively good control of the disease in both populations.

Uloga sukoba radne i obiteljske uloge te zadovoljstva intimnom vezom u seksualnoj dobrobiti zaposlenih osoba

Juggling the responsibilities of work and family domains has become a part of everyday life for most working adults. Research has shown that work-family conflict can potentially have negative effects on general well-being, health, relationship quality and job satisfaction. However, the potential effects of work-family conflict on sexual well-being of working adults is presently unknown. The primary aim of this study is to analyze the association between two directions of work-family conflict (work-to-family conflict – WIF, and family-to-work conflict – FIW) and sexual well-being among working adults, while taking into account the mediating role of relationship satisfaction. Data was collected in an online survey on a sample of 584 Croatian men and women that are currently living with a partner. The data was analyzed within a structural equations modelling framework. The analyses show that WIF conflict was negatively associated with sexual well-being, but only among women. On the other hand, relationship satisfaction mediated the relationship between FIW conflict and sexual well-being for both men and women. This study contributes to sparse and inconsistent knowledge on the relationship between work- -family conflict and sexual well-being among working adults.

Impact of Breast Density Awareness on Knowledge about Breast Cancer Risk Factors and the Self-Perceived Risk of Breast Cancer.

Breast density (BD) reduces sensitivity of mammography, and is a strong risk factor for breast cancer (BC). Data about women’s awareness and knowledge of BD are limited. Our aim is to examine whether the BD information disclosure and BD awareness among women without BC are related to their knowledge about BC risk factors. We examined self-reported BC risk perception and its association to BD awareness and level of health literacy. A cross-sectional, single site study included 263 Croatian women without BC who had mammographic examination. Data were collected by interviews using questionnaires and a validated survey. Of the total, 77.1% had never heard of BD, and 22.9% were aware of their BD. Most participants who knew their BD (88.2%, p < 0.001) had higher levels of education. Majority of subjects (66.8%) had non-dense breasts and 33.2% had dense breasts. Subjects aware of their BD knew that post-menopausal hormone replacement therapy (p = 0.04) and higher BD (p = 0.03) are BC risk factors. They could more easily access information about health promotion (p = 0.03). High-BD informed women assessed their lifetime BC risk as significantly higher than all others (p = 0.03). Comprehension of BD awareness and knowledge is crucial for reinforcement of educational strategies and development of amendatory BC screening decisions.

27-Year-Old Woman With Fever, Headache, and Anemia

27-Year-Old Woman With Fever, Headache, and Anemia

Body Image and Sociocultural Predictors of Body Image Dissatisfaction in Croatian and Chinese Women.

In the current paper, two different studies were designed to investigate body image dissatisfaction and perception of the attractive female body in Chinese and Croatian women and men using the correlational and experimental study research approach. Study 1 comprised 266 Chinese (160 women; 106 men) and 261 Croatian participants (161 women; 100 men). Women from both countries were asked to complete the measures of the Contour Rating Scale, SATAQ – 4, Body Area Scale and demographic data, while men were asked to complete the measures of the Contour Rating Scale and demographic data via online surveys. The obtained results indicated that thin internalization predicted body image dissatisfaction in both samples. Besides, while both samples scored relatively high on thin-ideal internalization, Chinese women, who were also in general less satisfied with their body image, had higher scores. Chinese women also scored higher on musculature internalization and felt more pressure from family, friends, and media to conform to standard beauty norms compared to Croatian women. The samples also differed in their perceptions of preferable body size, where Chinese women had a more negative perception of their actual body size. The obtained results furthermore revealed that Chinese men preferred thinner women compared to Croatian men. Moreover, both samples misjudged what their female counterparts found attractive, thinking that women wanted to have even thinner bodies than they actually reported. Similarly, women from both cultures revealed a preference for thinner figures than the ones selected as the most attractive by the opposite sex. Finally, in Study 2, experimental manipulation of thin-ideal was used to examine whether thin priming affected body image dissatisfaction. The obtained results revealed that when primed with thin-ideal women from both countries felt lower satisfaction with their body size. The observed effect was stronger for Chinese participants. Limitations of the current study are discussed in the conclusion.

Knowledge and awareness of iodine intake - survey among Croatian women of reproductive age.

IntroductionAppropriate iodine intake is important for the entire population, especially in fertile women due to decisive role of thyroid hormones in normal foetal brain development. The aim of this study was to investigate knowledge on iodine role among Croatian women of reproductive age.Materials and methodsThe survey was conducted among 378 women of reproductive age during May-September 2018. Data on age, education level, salt intake habits, knowledge of the iodine role and possible presence of thyroid disease were collected and results were presented as numbers or percentage of total number of participants. Comparison between groups was performed by Chi square test.ResultsOf 378 participants, 178 reported to be familiar with the iodine role in the body (P = 0.115). Significantly higher proportion of the younger woman and woman with lower degree of education weren’t familiar with the iodine role (P < 0.001). More woman were introduced to consequences of insufficient than to excessive iodine intake (273 vs 213; P < 0.001). In addition, participants mainly weren’t familiar with obligation of salt iodination (P < 0.001). Presence of thyroid disease was recorded in 75 subjects with higher prevalence in subjects 36-49 years (P < 0.001). Presence of thyroid disease was not associated with knowledge on iodine role on health.ConclusionWomen of reproductive age are not completely aware of the consequences of excessive iodine intake. Thus, further education focusing on more sensitive groups such as woman of younger age should be considered in order to preserve their and their children’s health.

Gender Socioeconomic Inequalities in Intimate Relationships

Inspired by the materialist feminist theoretical approach, this study starts from an underlying assumption that research of gender socioeconomic inequalities in intimate relationships requires the analysis of specific variables that constitute the socioeconomic status of intimate partners. Based on five indicators relevant for contemporary Croatian society, the GSEI index was constructed and applied to a representative sample of Croatian women in intimate relationships. The results showed significant gender socioeconomic inequalities between intimate partners, mostly in favour of men. The highest level of inequality between intimate partners was discovered with regard to real-estate ownership, whereas the highest level of equality between partners was found in their level of education. Although socioeconomic inequalities between intimate partners in favour of men prevail regardless of the geographic and social context, they are more pronounced in regions with more traditional values, among couples who live in rural areas, and among those who are married (in comparison with those who live in domestic partnership). A recommendation for further research and GSEI index application is to consider which are the relevant indicators for measuring gender socioeconomic inequalities in intimate relationships depending on the wider social context.