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Objectives: Vaccination is the primary intervention to prevent influenza infection, yet vaccine uptake remains low among children and other at-risk patients. The aim of the study is to investigate the impact of a paediatric hospital visit with laboratory-confirmed influenza on the influenza vaccination behaviour of participants and their family members in the subsequent influenza season. Methods: This study compared the influenza vaccination coverage for participants < 18 years of age with a clinical suspicion of influenza in 2017-2018 during a hospital visit, in two subsequent influenza seasons. Data was retrieved from the hospital electronic medical record and a follow-up questionnaire (2018-2019) to ascertain the common reason(s) that families did not vaccinate their children the following year (2018-2019). The children were distributed into positive- (antigen and/or PCR) and negative-influenza groups. Results: A total of 133 children were enrolled in our study. Participants' mean age was 4.6 years and 74 (55.6%) were males. Overall, 47 (35.3%) had confirmed influenza virus. A significant increase in influenza immunization was found among both positive- and negative-influenza participants between 2017-2018 and 2018-2019 (6.4% vs. 27.7%, p < 0.001; 8.1% vs. 29.1%, p < 0.001, respectively), as well as among family members of positive-influenza participants - siblings and parents (6.4% vs. 19.6%, p = 0.003; 0% vs. 17%, p < 0.001, respectively). Common reasons for failure to vaccinate included doubt in vaccine effectiveness, unlikely to get "flu", busy, and side effects. Conclusions: Our findings suggest that a paediatric hospital visit with laboratory-confirmed influenza increases vaccine uptake among families. Future studies should aim to evaluate evidence-based interventions to improve influenza vaccine uptake among children.

Objectives: The aim of this study is to determine the interdependence between life expectancy and numerous social indicators, i.e., to determine the factors that encourage an increase or decrease in life expectancy. Methods: Pearson coefficients as well as linear and logarithmic trends and correlations between the dependent variable of life expectancy and numerous independent variables were calculated and analysed. The calculations were carried out for all countries in the world for which data is available. Based on the strength of the correlations between life expectancy and numerous indicators, we have tried to determine the reasons for the different values of life expectancy in the various countries. Results: Important factors for achieving high life expectancy values are economic development and healthcare spending but the spread of "diseases of the modern era", such as obesity or diabetes, have a significant negative impact on life expectancy. Other important limiting factors for life expectancy are large income inequalities, a higher share of private healthcare expenditure in total healthcare expenditure and lower total healthcare expenditure. Less developed societies can significantly increase their life expectancy by providing clean water and safe sanitation and by combating various infectious diseases (especially HIV). Conclusions: Life expectancy is a meaningful indicator of the state of social development and accurately reflects the general state of a particular society. It has been shown that GDP per capita (PPP) is a key determinant of life expectancy, while other important factors play the role of a further modifier.

Objectives: The Slovak Medical University (SMU) holds a unique position in the health education system in Slovakia. It has a direct connection to the health sector, allowing health education to reflect the actual needs in this field. Because of increasing importance of public health in the last decades, more attention must be given to disease prevention and the promotion of healthy lifestyles. We aim to highlight the main characteristics of health higher education at one of the specialized health universities in Slovakia, with a particular focus on public health and its practical impacts. Methods: We analysed the available legal regulations for postgraduate studies in Slovakia and the officially valid documents of the Faculty of Public Health (FPH) and the Slovak Medical University in accordance with the accredited study programme in Public Health. Archived data from the Department of Science, Research, and Doctoral Studies of the Faculty over the past 10 years were used for the analysis of postgraduate studies (2013-2023). Results: PhD studies in Slovakia are conducted in accordance with Act No. 131/2002 Coll. on Higher Education Institutions and on amendments to certain acts. There are two forms of PhD study in Slovakia: full-time and external. The evaluation of study results is based on the credit system. The doctoral study programme proceeds according to an individual study plan under the guidance of the advisor. The PhD study concludes with the defence of the dissertation, which serves as the final thesis. A total of 97 students have graduated at FPH SMU in Public Health in the last 10 years. The majority of graduates were females (68% vs. 32% males) and studied in the external form of study (80.4% vs. 19.6% in the full-time programme). The most frequent research topics at FPH SMU in the last 10 years included Epidemiology and Prevention of Non-communicable (21.7%) and Infectious Diseases (11.3%), Health Management and Policy (17.5%), Environmental Health (15.5%), as well as Occupational Health (13.4%). Conclusion: High-quality and innovative postgraduate education in public health plays a crucial role in this field, preparing experts for the public health services. From a quality perspective, it is substantial to share experiences with various study programmes across the European region, as well as with other universities. Graduates of the Faculty of Public Health are highly sought-after professionals with diverse career opportunities not only in Slovakia but also within the European Union, other countries, and various important international institutions.

Objectives: Occupational allergic respiratory diseases frequently occur in individuals working in the agricultural and food production sectors, textile manufacturing, and industries involving exposure to isocyanates. The study aimed to describe trends surrounding the prevalence of occupational asthma (OA), occupational rhinitis (OR), and occupational hypersensitivity pneumonitis (OHP) in Eastern Slovakia between 1990-2021. Methods: All cases of OA, OR, and OHP registered in a database at the Louis Pasteur University Hospital in Košice, Slovakia, between 1990 and 2021, were divided into categories based on economic sector (agricultural, food production sectors, textile manufacturing, healthcare, industrial manufacturing, and tertiary sector) and causal agent. Changes in disease prevalence, causal agents, and economic sector association over time were analysed. Results: There were 287 occupational respiratory cases (179 OA, 65 OR, and 43 OHP cases). The annual prevalence of OA declined significantly over the study period (p < 0.05). Overall, there was a significant decrease in cases from the agricultural (p < 0.001) and an increase in the industrial manufacturing (p < 0.01). The number of cases due to farming agents fell markedly over the study period, while metalworking fluids (MWFs) were found to be the most common causes of allergic respiratory diseases since 2018. Conclusions: This study found a decrease in the number of OA cases, as well as changes in economic sectors and causal agents associated with OA and OHP, specifically, in the agricultural sector, with MWFs from the industrial manufacturing sector now being the most common aetiological agent.

Objective: The objective of this study was to evaluate the effectiveness of human papillomavirus HPV test with HPV16/18 genotyping and liquid-based cytology (LBC) triage as a primary screening method for cervical cancer compared to conventional Pap test in women undergoing routine cervical cancer screening in Tbilisi. Methods: Cross-sectional, prospective study was conducted, where 1,000 enrolled women aged 30-60 years during one visit underwent conventional Pap smear and Hr-HPV testing (Roche Cobas system). Women with any positive screening results were referred for further evaluation and remaining cells from the Cell Collection Medium vial were used for LBC. The study calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each screening method and receiver-operating characteristic (ROC) curve to evaluate the accuracy of each diagnostic method in identifying people with CIN2+ diseases. Results: The HPV test with HPV16/18 genotyping and LBC triage demonstrated higher sensitivity (76.9%), specificity (71.6%), and PPV (34.5%) compared to conventional Pap tests (p < 0.05). NPV was also high with the HPV test (94.1%). The HPV test alone had the highest sensitivity (92.3%) and NPV (96.7%), but lower specificity (41.4%) and PPV (22.6%) than the HPV test with HPV16/18 genotyping and LBC triage (p < 0.05). Comparing the areas under the curve (AUCs), only the HPV with HPV16/18 genotyping and LBC triage showed a statistically significant difference when compared to conventional Pap (0.71 vs. 0.55, p = 0.03) and high figures of AUC 0.71 (95% CI: 0.58-0.85) suggesting that HPV test with HPV16/18 genotyping and LBC triage is a more reliable screening method for detecting CIN2+ disease and preventing cervical cancer, than other screening modality. Conclusion: The results suggest that the HPV test with HPV16/18 genotyping and LBC triage is a more effective primary screening method compared to conventional Pap tests. This information should be the basis for transition from cytological screening to HPV testing in Georgia.

Objectives: The aim of the study was to describe alcohol consumption and its changes in the Czech Republic during the period of governmental restrictions related to the COVID-19 pandemic. To this goal, an overview of the governmental measures that may have affected alcohol consumption was compiled from various sources (mostly media reports). Methods: The paper analyses three surveys where the group from Charles University, Prague, participated in design and execution: the European Study Group on Alcohol use and COVID-19 (ESAC) convenience online survey that (in Czechia) took place at the onset of the COVID-19 pandemic in Europe, in April through June 2020 (n = 1,434), a computer-assisted web interviews (CAWI) survey carried out in November 2021 (n = 790), and another CAWI survey carried out in November 2022 (n = 1,738). These are complemented by a brief overview of official data on alcohol sales between 2019 and 2021 in Czechia from two sources, Ministry of Finance of the Czech Republic and the Nielsen IQ market research company. Results: Changes in alcohol use appeared to be distributed among the population unequally, when the pandemic influenced different population groups in a different way. In all three surveys, the majority of respondents reported no change in their drinking frequency or quantity. Decreases in alcohol use were more prevalent than increases. Most pronounced changes were detected in at-risk drinkers, who have increased their alcohol use. Official revenue data suggest a small reduction in total alcohol sales in 2019-2021. Conclusions: Our research results do not support the hypothesis that substantial and unexpected social and economic changes caused by the COVID-19 pandemic, along with corresponding measures, acted as stressors that would have caused the majority of people in Czechia changing their behaviour related to alcohol use; however, high-risk users increased their consumption.

Objectives: This study examined trends in sexual behaviour and the timing of sexual initiation among 15-year-old adolescents in Czechia between 2002 and 2022, with a focus on the age of sexual debut (15 and older; early at 14; very early at 13 or younger). It also investigated trends in condom and hormonal contraceptive use at most recent intercourse. Methods: Data were drawn from six nationally representative waves of the Czech Health Behaviour in School-aged Children study, which was conducted between 2002 and 2022. Only 15-year-olds were included (N = 19,384). Descriptive trend analyses were conducted using survey weights, with subgroup comparisons by gender and age at sexual initiation. Results: The findings indicate a shift toward later sexual initiation, particularly among girls, with increasing proportions initiating at age 15 or older and declining initiation at age 14. A significant gender gap emerged in 2022, with fewer girls (13.9%) than boys (18.7%) reporting a sexual experience. The prevalence of very early initiation (age 13 or younger) remained stable over time, yet this group - especially boys - consistently accounted for a substantial minority of sexually active adolescents. Condom use declined from 81.2% to 69.9% across all initiation groups between 2014 and 2022, with the most persistent decline among very early initiators. Conclusions: The findings suggest a modest postponement of sexual debut among Czech adolescents and highlight a growing gender disparity in sexual activity by age 15. Persistent early initiation and declining condom use highlight the need for differentiated sexual health education strategies, particularly for younger initiators.

We would like to submit the following correction to our recently published paper due to an error in the Table 1.

Objectives: The first aim of this cross-sectional study was to reveal the prevalence of overweight and obesity among Czech military personnel (CMP). The second aim was to compare accuracy of the body mass index (BMI) classification with the body fat percentage (BF%), waist circumference (WC), and visceral fat area (VFA). BMI is a commonly used method to assess obesity, but its accuracy in reflecting body composition, especially in physically fit individuals, has been questioned. Methods: Data were collected from six military units in the Czech Republic. Soldiers underwent anthropometric assessments including height, weight, WC, BF%, and VFA using the bioelectrical impedance method (BIA). Results: The study group consisted of 446 soldiers (337 males, 109 females). The prevalence of obesity in Czech soldiers regardless of gender was 18%-20% according to BF% and 13%-16% according to WC. There were almost one fifth of obese males and more than 5% of females with BMI ≥ 30. The risk level of VFA was observed in 24% of male a 34% of female soldiers. In male soldiers there was a high rate (43%) of false positives according to BMI (BMI ≥ 25, BF% < 20), on the other hand, a certain part (18%) of female soldiers was classified as false negative according to BMI (BMI < 25, BF% ≥ 28). When overweight and obesity were assessed by WC and BMI, significant false positives (56%) were found in male soldiers (BMI ≥ 25, WC < 94). When obesity was evaluated using VFA and BMI, a certain rate of false negatives (30%) was found in female soldiers (BMI < 25, VFA ≥ 100). Conclusion: Through an analysis we explored the limitations of BMI, and we propose an alternative method (measurement of BF%, VFA using BIA) for a more accurate assessment of body composition in this specific population.

Objectives: The aim of the study was to analyse the attitudes and decisions regarding vaccination in general and against COVID-19 among general practitioner (GP) patients in Croatia, and to identify influencing factors, with particular attention to chronic conditions and anxiety. Methods: A total of 184 patients (stratified by sex and presence of chronic disease) from a GP's offices, aged 18-87 years (average 50.3 ± 1.3 years, 49.5% women) were included. Data were collected using a questionnaire. Results: Attitudes toward vaccination in general did not differ between patients with and without chronic diseases and were not influenced by anxiety. Chronically ill patients were more likely than those without chronic disease to believe in the efficacy of the COVID-19 vaccine and to express fear of contracting SARS-CoV-2 (p ≤ 0.003). Anxiety was associated with fear of infection (p < 0.001), but not with confidence in vaccine safety or efficacy. After controlling for sex, age, education, chronic illness, anxiety, and knowing someone infected and hospitalized with SARS-CoV-2, factors associated with the decision to be vaccinated against COVID-19 were absence of prior infection (OR = 3.9, 95% CI: 1.6-9.5, p = 0.003), history of influenza vaccination (OR = 3.8, 95% CI: 1.4-10.4, p = 0.009), and knowing someone who had died from COVID-19 (OR = 3.2, 95% CI: 1.1-9.7, p = 0.037). Conclusion: The decision to vaccinate against COVID-19 was associated with absence of prior infection, knowing someone who died from the disease, and prior influenza vaccination, but not with chronic illness, anxiety, or socio-demographic factors.

Objectives: Work of an arborist – tree climbing – is a dangerous activity associated with great physical effort, influenced by incorrect body posture and significantly stressed individual parts of the body. This research was initiated with the objective to draw attention to this hitherto little explored issue connected with ergonomics of the work of tree climbers. The goal of the research was to gather information about the fatigue of individual parts of the human body in professional tree climbers who access trees using so-called rope techniques (ascent to the tree crown, movement in the tree crown, descent from the tree crown) by means of a questionnaire. Methods: The assessment included 12 body parts (8 in the upper body, 4 in the lower body), with each part being divided into right and left parts. The research was conducted in the Czech Republic, 98 respondents were professional tree climbers. The questionnaire contained two sections of questions. Questions from the questionnaire were analysed, evaluated and plotted into clear graphs which were then statistically quantitatively described. Furthermore, the linear relationship between the duration of work performance and the occurrence of fatigue in individual parts of the body was assessed (Pearson's correlation coefficients). Results: Results indicated that the most stressed part of the body of tree climbers who access trees using rope techniques is the area of wrist and hands. On the other hand, the least stressed part of their body is lower leg. Furthermore, the results of Pearson's correlation analysis show that the relationship between the number of hours and the occurrence of musculoskeletal problems is weak, unstable, and nonlinear in most body segments. Conclusions: The research has shown that arborists who care for trees using rope techniques are exposed to varying degrees of fatigue in different parts of the body.

Objectives: High disease burden related to excess body weight (EBW) poses a substantial burden to healthcare systems globally. This study aims to assess the economic impact of EBW in Estonia, where over 60% of adult population are overweight or obese. Methods: Using population attributable fraction approach, this cost-of-illness study included 29 health conditions associated with overweight and obesity. The annual costs were calculated from the health care/government perspective for the year 2021 using individual level and administrative data. The direct costs were defined as a sum of treatment and medication costs, sickness benefits and care leave, while indirect costs were viewed as tax revenue lost due to premature death or incapacity for work. One-way sensitivity and scenario analyses were carried out to assess the robustness of the results. Results: The annual direct costs associated with EBW were €112.7 million, of which €107.2 million (95%) were treatment costs. Cardiovascular diseases (€58 million) had the highest treatment costs. Indirect costs of EBW were estimated at €12 million. The total annual cost of EBW among adults was €125 million (€116 per adult), from which €50.3 million was attributable to overweight and €74.4 million to obesity. Depending on assumptions and input data, the estimated total costs reached €226 million in the sensitivity analysis. Conclusions: The estimated direct costs of EBW comprise 6.9% of national health expenses in Estonia. EBW among adults is thus not only an important public health challenge but also a considerable burden for national healthcare system.

Objectives: This study aims to compare the effect of 10 thousand steps per day (10TSPD) and 3 thousand steps per 30 minutes (30M3TS) supported by medical nutritional therapy on body composition, 6-minute walking distance (6MWT), cardio-metabolic parameters comprising insulin, glucose, glycohaemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), low density lipoprotein (LDL), high density lipoprotein (HDL), and total cholesterol in women with obesity. Methods: Thirty women with obesity supported by individual-specific medical nutrition therapy were divided into two groups with a target (10TSPD) at a frequency of 3-5 days/week and (30M3TS) per 30 minutes in a single session and followed up with a pedometer at the end of 8 weeks. At the beginning and end of the study, body compositions were analysed, 6MWT values were determined and blood samples were taken. Results: Glucose, insulin, and HOMA-IR significantly decreased in the 10TSPD group (p < 0.05), while no significant metabolic changes were observed in the 30M3TS group. No significant between-group differences were observed in metabolic parameters (p > 0.05). Body weight (BW), body mass index (BMI), body fat mass and percentage, and waist and hip circumferences decreased significantly in both groups (p < 0.05), whereas lean body mass and muscle mass did not change significantly. The 6MWT distance increased in both groups (p = 0.01), with no significant difference between groups. Conclusions: Both 10TSPD and 30M3TS walking protocols combined with nutritional therapy improved body composition and walking performance in women with obesity, primarily through reductions in adiposity, while lean body mass and muscle mass remained unchanged. Metabolic improvements were observed only in the 10TSPD group; however, no significant between-group differences were detected.

Objectives: Smoking remains a major global public health problem, and pharmacological therapies are central to cessation strategies. Cytisine, a plant-derived alkaloid, has recently been introduced in Türkiye as a smoking cessation aid. This study aimed to evaluate the early effectiveness and cessation outcomes of cytisine in a Turkish population. Methods: This retrospective observational study included 289 patients who were prescribed cytisine at a smoking cessation clinic between March and May 2024. Socio-demographic characteristics, smoking history, nicotine dependence, treatment duration, and smoking cessation outcomes at 1 month and 6 months were analysed. Smoking cessation status was self-reported. Analyses were conducted using the intention-to-treat principle, with participants lost to follow-up classified as non-quitters. Results: Cytisine was prescribed according to the national 25-day tapering regimen, and the actual duration of use was recorded. In the intention-to-treat population, smoking cessation was achieved by 42.6% of participants at 1 month and by 39.8% at 6 months. At both follow-up points, participants who quit smoking were younger and had shorter smoking duration and lower cumulative smoking exposure. Higher educational attainment was associated with greater cessation success, whereas sex, marital status, chronic disease, daily cigarette consumption, smoking exposure, previous quit attempts, and baseline nicotine dependence were not. In multivariable analyses, higher educational level independently reduced the likelihood of cessation failure at 1 month (adjusted odds ratio = 0.52, 95% CI: 0.29-0.96), while longer duration of cytisine use was independently associated with greater smoking cessation success at 6 months, with each additional treatment day increasing the odds of cessation by approximately 15.0% (aOR = 1.15, 95% CI: 1.10-1.19, p < 0.001). Conclusions: Cytisine showed promising early effectiveness as a smoking cessation aid in Türkiye. Treatment adherence appears to be a key determinant of cessation success, supporting its potential role in national smoking cessation programmes.

Objectives: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. Methods: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. Results: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. Conclusion: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.

Objective: The article deals with occupational health protection and identification of health risks in the work environment of the Ministry of Defence (MoD) of the Czech Republic (CR). It focuses on the assessment of the incidence of occupational diseases (OD) in high-risk and risk-free occupational categories in the years 2010-2019 and compares them with data from the civilian sector. It identifies the differences between military staff and civilian employees of the MoD. Methods: From the records of OD at the Department of Occupational Diseases of the Central Military Hospital in Prague, the data on acknowledged OD from the years 2010 to 2019 were obtained and then a retrospective analysis focusing on the classification of work at risk was performed. The obtained data were compared with the data from the Czech National Registry of Occupational Diseases (NROD), which are published annually by the National Institute of Public Health. Results: In the years under review, 191 OD were confirmed at the area of MoD, 26% of all OD occurred in employees classified in the occupational risk category. Compared with the data in the NROD, where 50% of OD were found to have been caused by high-risk work, the incidence of OD caused by high-risk work in professional soldiers is lower. Only 1.6% of all OD occurred in professional soldiers whose work was classified as high-risk one. In civilian employees of MoD 24.6% of all OD were connected with high-risk work. On the contrary, the proportion of OD occurring in professional soldiers working in risk-free categories was 57.6%, in civilian employees of MoD was the ratio much lower - 16.2%. Conclusion: Work at the Ministry of Defence was not adequately categorized, therefore, in 2020 a new categorization of work was introduced, which together with preventive measures could contribute to reducing the incidence of OD at the Ministry of Defence.

Objectives: Allergic patients may be concerned about more frequent and/or more severe adverse events following vaccination, which may lead to the refusal of vaccines among these patients. The aim of this study is to assess whether allergic patients have more frequent adverse events (AEs) after vaccination than healthy individuals. Methods: Study participants (N = 591) underwent vaccination of their choice at a selected Vaccination and Travel Medicine Centre. At a 10 to 14-day interval, they were contacted for a telephone questionnaire survey on the occurrence of AEs after vaccination. A group of allergic patients (n = 188) and healthy controls (n = 403) were followed in the study. Results: No significant difference was found in the occurrence of AEs between study and control group. Only in redness and swelling, which was more common in allergic patients, but only in a few individuals. All side effects were minor, such as pain at the injection site or fatigue. No participant experienced a serious or life-threatening adverse event. In the studied group, no statistically significant differences were found even in the occurrence of AEs after singular vs. simultaneous administration of vaccines (p = 0.094), nor after vaccination with inactivated vs. attenuated vaccines (p = 0.655), or after vaccination against bacterial vs. viral infections (p = 0.140). Conclusions: Vaccination of allergic patients did not cause more frequent and/or more serious adverse events in our study compared to healthy people. If general contraindications are observed, then vaccination of allergic patients is considered safe.

Objectives: An unhealthy lifestyle, inappropriate eating habits, and inadequate physical activity are the most common risk factors affecting health and causing the premature onset of non-communicable diseases. The study aimed to evaluate lifestyle factors, eating habits, and daily regimens in a sample of Slovak adolescents. Methods: The sample involves 524 students aged 15-22 years attending selected secondary schools from the model region of Bratislava, the capital of Slovakia. We assessed the prevalence of selected lifestyle factors and investigated the relationship between negative lifestyle factors and the presence of overweight and obesity. Results: We found eating irregularities including avoidance of school lunch, inadequate daily consumption of vegetables, dairy products and wholegrain foods, and the high consumption of sweets and sweetened beverages. The prevalence of excess weight and obesity in the sample was 18.4%. Compared to the non-obese, overweight or obese students had significantly lower daily consumption of vegetables and used to avoid sports more frequently. Almost 37% of students did not do sports at all. Students who were not doing sports on regular basis used to skip breakfast more frequently, they ate fewer vegetables and more sweets and spent considerable time in sedentary activities. Conclusion: In the sample of secondary school students, we investigated several negative lifestyle factors and the relatively high prevalence of overweight and obesity. The results of the study can be used for the development of preventive measures to protect and promote the health of children and youth.

Objectives: Atopic dermatitis (AD) is a common allergic disease with potential links to environmental pollutants, including heavy metals. This study investigates the association between co-exposure to cadmium and mercury and AD among Korean children. Methods: Data from the fourth cycle of the Korean National Environmental Health Survey (KoNEHS) included 736 elementary school students. Urinary cadmium and mercury levels were measured, and their association with lifetime prevalence of AD was analysed using logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (QGC), and Bayesian kernel machine regression (BKMR). Confounders adjusted included age, sex, urinary cotinine, income, and body mass index. Sensitivity analyses used symptomatic AD and AD treatment as outcome variables. Results: Among two metals, only cadmium in the highest tertile showed an odds ratio (OR) of 2.39 (95% CI: 1.12-5.10) compared with lowest tertile, with a significant trend per tertile increase (OR 1.58, 95% CI: 1.08-2.31) in multiple logistic regression. Co-exposure analysis using WQS and QGC revealed significant associations with AD prevalence, with WQS showing an OR of 1.47 (95% CI: 1.18-1.83) and QGC showing an OR of 1.60 (95% CI: 1.20-2.13) per tertile increase of exposure. BKMR indicated a dose-dependent relationship between overall exposure and AD risk. For symptomatic AD, similar trend was found. The treatment status of AD did not show a significant association with either heavy metal. Conclusion: This study suggests a significant association between co-exposure to cadmium and mercury and atopic dermatitis, emphasizing the need to consider combined environmental exposures in epidemiological studies.

Objective: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure. Methods: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax. Results: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH. Conclusions: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

Objectives: The aim of the study was to identify potential areas for improvement in the prevention of oral diseases in pregnant women by assessing their oral care habits and awareness regarding oral health. Methods: An original, anonymous, web-based survey was conducted among women at any stage of pregnancy. The survey consisted of 23 questions regarding oral care habits, knowledge about oral health of mother and child, general and oral health changes, and attendance of oral healthcare services during pregnancy. The data analysis was performed using IBM SPSS 27.0 version software. Descriptive statistics, Chi-square and Wilcoxon signed-rank tests were used to analyse the data. The level of statistical significance was set at p < 0.05. Results: A total of 714 pregnant women participated in the study, with a mean (SD) age of 30.2 (4.4) years. Majority of the respondents demonstrated acceptable oral health-related knowledge and habits. A lack of interdental care among pregnant women was discovered. Nearly a third (27.6%) of the respondents reported a decline in their oral health during pregnancy. The most commonly reported general and oral health issues during pregnancy were increased stomach acid levels (71.3%) and gum bleeding (43.3%). Pregnant women were most frequently informed about the importance of oral care by an obstetrician-gynaecologist (25.4%). Conclusions: The study revealed the need for targeted interventions to enhance oral health awareness and practices among pregnant women in Lithuania. While overall oral hygiene habits were acceptable, deficiencies in interdental care and knowledge regarding oral health during pregnancy were evident. Higher level of education and urban residency were associated with superior oral care practices of pregnant women. In order to improve oral health of mother and child, interdisciplinary collaboration and dissemination of accessible, evidence-based information are essential.

Objectives: This study aimed to evaluate the beliefs about third-hand tobacco smoke (THS) among administrative and academic staff at a university. THS is a residual pollutant from tobacco smoke that lingers on surfaces and poses health risks, particularly to children. The study also aimed to understand these beliefs in relation to socio-demographic factors. Methods: A cross-sectional survey was conducted with 332 university employees aged 18 and over. Data were collected between September and December 2023 through face-to-face and online questionnaires. The survey included the Beliefs About Third-hand Smoke (BATHS-T) Scale and questions on socio-demographic characteristics, second-hand smoke exposure, and attitudes towards a smoke-free campus. Beliefs About Third-hand Smoke Scale total and sub-dimension scores increase, it is understood that the participantʼs belief in the negative effects of third-hand tobacco exposure on persistence and health increases. Results: The average age of participants was 36.1 years, with 38.3% being administrative personnel and 61.7% academic personnel. About 40.5% of the participants used tobacco products. The mean total BATHS-T score was 35.6, with health and persistence subscale scores averaging 19.9 and 15.7, respectively. Non-smokers had significantly higher BATHS-T scores than smokers. The participants with children scored higher on the health sub-dimension. Additionally, 78.9% supported a smoke-free campus, and those supporting it had higher BATHS-T scores. Awareness of the harms of second-hand smoke correlated with higher BATHS-T scores. Conclusion: The study highlights that non-smokers and those with children are more aware of THS risks. There is strong support for a smoke-free campus among university staff. The findings suggest a need for increased education on THS, especially targeted at smokers and those without children. Universities can play a crucial role in promoting smoke-free environments and raising awareness about the health risks associated with THS.

Objectives: Hepatitis C virus (HCV) infection remains a significant public health concern despite the introduction of direct acting antiviral agents. To reach the World Health Organization (WHO) goal of eliminating viral hepatitis as a public health threat by 2030, adequate screening strategies and early diagnosis are crucial. This study aimed to determine the prevalence of HCV infection in an Austrian cohort and assess the feasibility of incorporating HCV screening into colorectal screening programmes. Methods: The study enrolled 1,894 asymptomatic individuals during a colorectal screening programme with a mean age of 57 (± 7 years) years. Sera of the participants were screened for HCV-specific antibodies, and blood samples of individuals with detectable HCV-specific antibodies were tested by the polymerase chain reaction (PCR) to confirm a chronic HCV infection. Furthermore, we evaluated the characteristics of these individuals including their anthropometrics, biomarkers, and liver-specific information such as those obtained with a fibroscan. Results: We found that 14 (0.74%) of the participants had detectable levels of HCV-specific antibodies, with 6 (0.32%) individuals being newly diagnosed with a chronic HCV infection. One of the 6 patients showed signs of liver cirrhosis. The newly diagnosed individuals included 4 cases of HCV genotype 1a and 2 cases of 1b. Conclusion: Our study highlights the importance of screening for HCV infection in asymptomatic individuals, not only for those at risk of HCV exposure or with elevated liver enzymes. Incorporating HCV screening into colorectal screening programmes could be an effective strategy for increasing the rate of HCV diagnosis, thereby improving public health outcomes. Further investigation is needed regarding cost-effectiveness and strategies to reach individuals who have no access to screening programmes or do not adhere to regular preventive screenings.

Objectives: In 2022, about 17% of Andalusian population lived in disadvantaged areas, which accounted for 21% of tuberculosis (TB) cases. This concentration of cases resulted in TB rates in these areas being higher than both the regional and national averages. The aim of the present study was to understand the behaviour of TB in terms of person, time, and place in the city of Cordoba during the period 2015-2021 and its association with areas in need of social transformation (ANST). Methods: A retrospective observational analytical study was conducted on cases reported to the Andalusian Epidemiological Surveillance System (Spanish acronym SVEA). Membership in ANST was determined by the SVEA. Results: A total of 136 cases were reported, with 26.5% in ANST. The incidence rate (IR) in the city was 5.97 cases per 100,000 population per year, higher in ANST (11.82) compared to non-ANST (5.06), RR = 2.34 (95% CI: 1.60-3.42). In 2020, fewer cases were reported (IR: 3.99). The mean age was 44.82 years, lower in ANST (38.08) than in non-ANST (47.25), with a p-value < 0.05. Hospitalizations were more frequent in ANST (78% vs. 68%, p = 0.3). In ANST, the IR was highest in men over 60 years old and lowest in women of the same age. No significant difference was found between the groups regarding risk factors, except for HIV status (p = 0.02). Conclusions: TB incidence rates in Andalusia vary by area of residence. To make better public health decisions, it is crucial to enhance the collection of socio-demographic and clinical data related to these cases.

Objectives: In the Czech Republic, employers and employees are bound by legal regulations that ensure occupational health and safety. These regulations are based on international conventions of the International Labour Organization and directives of the European Parliament and Council and have long been incorporated into Czech legislation. During the COVID-19 epidemic, emergency and crisis measures led to a limitation of occupational health examinations (OHEs) in the Czech Republic, which represented a significant disruption of the occupational health and safety system. The aim of the study was to assess the impact of these measures in order to find the right model for providing occupational health services in similar situations in the future. Methods: The method used was a survey, with participants including representatives of employers, state organizations, and employees (trade unions). Results: Participants from all three groups showed differing views on limiting OHEs during emergencies. While representatives of public administration and employers were generally open to postponing or adjusting pre-employment or periodic OHEs for non-hazardous work, the majority consistently opposed any limitation of OHEs for hazardous work. Statistical differences were observed particularly in attitudes toward future regulation of OHEs during epidemics. Conclusions: The dominant conclusion of the survey is a strong recommendation against limiting initial occupational health examinations for jobs with occupational risks and in high-risk work categories.

Objectives: Smoking remains a significant public health concern in Ukraine. Recent efforts to combat smoking have shown some progress, but Ukraine's current approach largely overlooks the potential benefits of harm reduction strategies. Concurrently, the use of e-cigarettes has been on the rise among Ukrainian adults. Our study aims to estimate the potential impact of e-cigarettes on reducing the mortality rate associated with cigarette smoking in Ukraine. Methods: We conducted a replication study using a dynamic population simulation model initially developed for the US. We ran simulations for 210 e-cigarette scenarios, varying assumptions on how e-cigarettes may affect smoking behaviour and health outcomes. A sensitivity analysis was performed to test the robustness of the results. Results: A substantial majority of e-cigarette scenarios (88.10%) resulted in positive life-years saved (LYS). The LYS ranged from -1.13 to 13.11 million, with a median of 3.17 million, accounting for 4.55% of the total life-years lost (LYL) due to smoking. Among the most plausible e-cigarette scenarios, the LYS varied from 2.73 to 4.88 million (3.92% to 6.99% of LYL due to smoking). Furthermore, these scenarios demonstrated that the long-term smoking prevalence would stabilize at around 5.56-6.40%. Conclusions: Our simulation analysis demonstrates the potential of e-cigarettes to significantly reduce the burden of smoking in Ukraine. Most e-cigarette scenarios result in positive LYS, while scenarios with negative LYS are unlikely. These findings support the idea that the benefits of e-cigarettes outweigh potential harm, aligning with previous studies in other countries.

Objectives: Cervical cancer represents a significant public health concern worldwide, particularly among women of reproductive age. According to data from the Cancer Registry of the Republic of Serbia for the year 2022, cervical cancer is the fourth most common cancer in women, with an age-standardized incidence rate (ASIR) of 24.8/100,000 and the fourth leading cause of mortality, with an age-standardized mortality rate (ASMR) of 10.2/100,000. This study aimed to analyse the association between socio-demographic factors, unmet healthcare needs, and cervical cancer screening use among women in Serbia.
Methods: Research was conducted as a cross-sectional study on a sample of 3,980 women aged 25-64 in Serbia. Three types of questionnaires were used as a research instrument. The association of missed cervical smear tests in the last 3 years with independent variables was examined by univariate and binary logistic regression model.
Results: According to socio-demographic characteristics, the likelihood of missing a cervical smear test in the last 3 years increased with age, being highest among older women (OR = 1.91, 95% CI: 1.88-1.94), lower-income categories (OR = 1.76, 95% CI: 1.74-1.78), and women with the lowest levels of education (OR = 1.49, 95% CI: 1.47-1.52). The logistic regression model revealed significant territorial disparities, with the highest predicted probability for women from South and East Serbia (OR = 1.73, 95% CI: 1.70-1.76). Additionally, distance/transportation and financial constraints were significantly associated with missed cervical smear tests in the last 3 years (OR = 2.05, 95% CI: 1.99-2.11; OR = 1.10, 95% CI: 1.08-1.12, respectively).
Conclusions: Socioeconomic disparities in cervical cancer screening remain a challenge. This study highlights the need to allocate resources to areas in need of improvement and also to conduct comprehensive evaluations of screening systems, which can lead to significant reductions in cervical cancer incidence and mortality.

Objectives: The aim of the study was to evaluate the feasibility and acceptability of remote prenatal care using a smartphone application for women with low-risk pregnancies, and to compare outcomes with standard in-person care.
Methods: A prospective observational study was conducted at the Institute for Maternal and Child Care in Podolí, Prague. A total of 225 pregnant women were enrolled: 119 received combined telemedicine and standard in-person follow-ups (W-DF group), while 106 received only standard in-person care (W-PF group). Data on patient satisfaction across various domains of care were collected and analysed.
Results: Women in the W-DF group reported significantly higher satisfaction with information adequacy, confidentiality, and understanding of test results (p < 0.001). Conversely, the W-PF group showed greater satisfaction in childbirth preparedness, access to community programmes, and lifestyle guidance (p < 0.05). Overall satisfaction scores were comparable between the two groups (W-DF mean = 263.0, W-PF mean = 275.1; p = 0.263).
Conclusions: Telemedicine in prenatal care offers advantages such as reduced time and logistical burdens and improved personalization of care. However, psychosocial and lifestyle support remains stronger in traditional models. A hybrid model that integrates telemedicine with periodic in-person visits may provide more comprehensive support. Further large-scale studies are needed to optimize implementation.

Objectives: Dietitians are well qualified to work as nutrition professionals on interprofessional healthcare teams and to provide education to health professionals at academic institutions. However, opportunities for the knowledge and utilization of dietitians in health care are different around the world. With rising global rates of nutrition-related diseases and the availability of university-based dietetic programmes, it is important to consider factors that may impact opportunities for dietitians in different countries. Thus, this study aimed to explore perceptions about the role of dietitians in medical care and medical education in the Czech Republic.
Methods: Thirty-six students and faculty members from a Czech medical school participated in semi-structured interviews focusing on the role of dietitians. Interviews were transcribed, coded, and analysed using thematic analysis.
Results: From the central theme regarding the perceived role of dietitians in medical care and education, three sub-themes emerged: limited awareness and interaction in the clinical setting; importance in interprofessional care; and essential member of the medical school faculty. Conclusions: Participants expressed support for dietitians in interprofessional collaboration and medical education but identified that they had limited interaction clinically and a lack of awareness about their role as nutrition experts in medical care. To support dietitians' involvement in interprofessional collaboration and to combat and improve outcomes for nutrition-related diseases, additional research is needed to recognize possible barriers along with identifying and assessing strategies to increase awareness and recognition among medical students and faculty about the role of dietitians in medical care.

Objectives: This is the first study in Montenegro to assess food safety knowledge, hygiene practices, and perceived barriers among childcare centre employees (N = 972) with both direct and indirect contact with food. It aimed to identify high-risk practices through structured observation and evaluate the need for targeted educational interventions in preschool institutions in Podgorica. Two hypotheses were tested: H1: there is a difference in knowledge and practices between employees with direct and indirect food contact. H2: socio-demographic characteristics influence the knowledge and practices of employees involved in food handling.
Methods: Data were collected using a structured questionnaire and an observation checklist covering food safety knowledge, self-reported and observed practices, and perceived barriers.
Results: Food safety knowledge scores were high (mean = 84.15 ± 6.22), while observed hygiene practices were substantially lower (53.09 ± 1.71%) compared to self-reported ones (78.52 ± 1.08%), revealing a marked discrepancy between knowledge and actual practices. Statistically significant differences were found between employees based on their role (direct vs. indirect contact with food), education level, prior work experience, training frequency, and presence of the Hazard Analysis and Critical Control Points (HACCP) systems (p < 0.05 to p < 0.001). Although a weak but statistically significant correlation between knowledge and practice was identified (r = 0.16, p < 0.001), it suggests that knowledge alone does not reliably predict hygiene practices. Reported barriers included time constraints, inadequate equipment, and limited workspace.
Conclusions: The findings emphasize the need for practical, job-specific training programmes and improved working conditions to effectively translate knowledge into safe hygiene practices. This evidence supports the development of context-specific policies and interventions aimed at enhancing food safety and safeguarding children's health in preschool settings. Both study hypotheses were confirmed.