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Objective: The aim of this study was to assess the frequency of exposure to psychoactive compounds amongst students of the Medical University of Bialystok. Method: This cross-sectional study included 504 students selected by means of stratified sampling based on the university faculty, study discipline and year, and participant's gender. Results: Nearly three fourths of our respondents have contact with their student colleagues who use psychoactive compounds, or have heard that such individuals exist. Approximately one fourth of the students declared that they considered using psychoactive compounds at least once. Marijuana and hashish were the psychoactive compounds our respondents used most frequently. Median age of the first contact with these substances was 18 years. Alarmingly high fraction of respondents declared that most of psychoactive compounds included in the study is easily available and obtaining them would not take them longer than one day. Furthermore, 15% of respondents admitted to being involved in the distribution of psychoactive compounds. Conclusion: The exposure of medical university students to psychoactive compounds represents similar problem as in their peers studying other disciplines. However, in view of its specific consequences (including potential threat to patients' health and life), the problem should not be underestimated.

Objectives: Although a number of human Legionnaires' disease in tourists are recorded annually in Europe, there are few cases where a direct link can be made between the infected person and the source of infection (hotel or other accommodation). We present a scheme followed in order to track down and identify the source of infection in a tourist suffering from L. pneumophila sg 5 infection, who was accommodated in seven different hotels during his holidays in the island of Crete, and we comment on various difficulties and draw-backs of the process. Method: Water samples were collected from the seven hotels where the patient had resided and analyzed at the regional public health laboratory using cultivation and molecular tests. Results: Of 103 water samples analyzed, 19 (18.4%) were positive for Legionella non-pneumophila and 8 (7.8%) were positive for L. pneumophila. A successful L. pneumophila sg 5 match was found between the clinical and environmental sample, which led us to the final identification of the liable hotel. Conclusion: Timely notification of the case, within the the European Legionnaires' Disease Surveillance Network (ELDSNet) of the partners involved, is crucial during a course of travel associated with Legionella case investigation. Moreover, the urinary antigen test alone cannot provide sufficient information for the source identification. However, acquiring clinical as well as environmental isolates for serogroup and SBT identification is highly important for the successful matching.

Objective: The aim of this study was to assess the contribution of using keystroke dynamics (KD) in combination with integrated electromyography (iEMG) for the objective evaluation of local muscular load of hands and forearms while typing on a computer keyboard and to compare it with results of the commonly used method. Method: Study was performed on 12 subjects. Data were collected using our own application for capturing KD data and using EMG Holter for detecting electromyographic potentials to determine local muscular load. Results: The results of our study revealed that currently used methods for assessment of the workload while typing on a computer keyboard are not entirely accurate. In particular, the real total number of keystrokes performed during processing of a text is significantly higher than the count of characters the text is consisting of. In addition to this count, also the so-called invisible keys, keyboard shortcuts, and especially corrections in the typed text must be taken into consideration. Conclusions: The results indicated that all probands in our study exceeded the valid hygienic limits for the total amount of the small repetitive movements of the hands and forearms and the total amount of the keyboard typing movements. Most of the probands in our study also exceeded the valid hygienic limit for the highest average time-weighted value of the percent maximum voluntary contraction (%MVC). This implies that the keystroke dynamics method has a great potential to increase the accuracy of evaluation of local muscular load when using the keyboard and thus to improve the existing methodology for investigation of occupational diseases resulting from overload while working on the computer.

Objective: Alcohol abuse is related to a wide variety of negative health outcomes including mortality in older people. Alcohol abuse in older people is characterised by certain specific features uncommon in general adult population. The main objective of this study was to analyse the autopsy protocols of deceased older people in relation to blood alcohol concentration (BAC), sex, age, and manner of death. As a positive BAC, > 0.20 g/kg was accepted. Methods: The sample consists of 1,012 deceased older people (i.e. aged 65 years and over) selected out of 2,377 autopsied subjects in the period from 2003-2013. Subjects included into the sample were chosen via the proportional sampling method. Data (BAC, sex, age, and manner of death) was recorded in a single structured protocol. Data was evaluated statistically (Kolmogorov-Smirnov two-sample test, Wilcoxon two-sample test, risk ratio). Results: Among older people, there has been a statistically significant correlation of natural death with sex (men died earlier) and with increased BAC (people with positive BAC died earlier). In case of violent death there is a difference in the types of accidents in older people with positive BAC (> 0.2 g/kg) and with negative BAC (≤ 0.2 g/kg). Drowning is more common in older people with positive BAC. Conclusions: Health campaigns in Europe and the Czech Republic aimed at reducing alcohol consumption mainly deal with young people. Alcohol abuse has an impact on premature mortality even in older people. As shown by this study, older people with positive BAC die significantly earlier.

Objective: The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of České Budějovice with diagnosed attempted suicide in their medical history for the period from January 2013 - June 2015. Methods: The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. Results: The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. Conclusions: The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol consumption is the highest-risk factor in connection with relapsing suicide. In case of psychiatric patients with attempted suicide in their medical history, all verified preventive and therapeutic procedures that can contribute to prevention of relapses should be used within follow-up professional care. Specific approach of the closest social environment, medical literacy of the population and state safety measures are important.

Objective: A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014. Method: Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts. Results: During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection. Conclusions: Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment.

Objective: The aim of this study was to determine the effects of a nurse-led school-based sun protection programme in Turkey. Methods: A randomized controlled trial was performed at two public schools between February and October 2014. Children with written consent from their parents were screened by nurses for skin type, and 80 children at moderate to high risk for skin cancer were included in the study. The sample was randomized by age, gender and skin type. Stratified and block randomizations were used. The participants were separated into an intervention group (n = 40) and control group (n = 40). Data were collected using a personal information form and two scales for sun protection behaviour and self-efficacy. Results: In the intervention group, the pretest mean score for sun protection behaviour was 19.25 ± 5.44 and increased significantly in the posttest assessment (33.05 ± 4.23, p < 0.001). Self-efficacy scores also increased significantly after the intervention (pretest 20.50 ± 6.68, post-test 35.85 ± 4.70, p < 0.001). However, there were no significant increases in mean sun protection behaviour or self-efficacy scores in the control group (p > 0.05). Conclusion: A nurse-led school-based sun protection programme effectively promoted children's self-efficacy and sun protection behaviour.

Objective: Metabolic syndrome is a combination of clinical risk factors for cardiovascular disease as well as for diabetes. Metabolic syndrome arises from insulin resistance accompanied with abnormal adipose deposition. The aim of our cross-sectional time trends study was to characterize the prevalence of metabolic syndrome and its five risk determinants among the clients of Health Advice Centres of Regional Public Health Authorities in Slovakia. The study was stratified by gender and age groups during the 10 year period from 2003-2012. Methods: Prevalence data were estimated in adults and children (≥ 10 years, N = 79,904) from the nationwide electronic database of Health Advice Centres of Regional Public Health Authorities in Slovak Republic "Test of healthy heart" from 2003 to 2012. Results: The overall prevalence of metabolic syndrome was 30.2% in males and 26.6% in females, abdominal obesity was confirmed in 48.3% of males and 53.9% of females. Increased triglyceride level has higher prevalence among males (33.3%) compared to females (24.2%). Blood pressure (BP) values and fasting glucose values were significantly higher in males (58.2%) than females (41.9%). During the 10 year period from 2003 to 2012, we confirmed an increased trend in the age-adjusted prevalence of metabolic syndrome. Abdominal obesity and elevated triglycerides had also increased time trends prevalence in both sexes. The prevalence of people without risk determinants of metabolic syndrome had a time decreasing trend. A surprising finding is a decrease in the proportion of persons with suboptimal HDL-cholesterol. The proportion of people with elevated BP and glucose showed little change during the reporting period. Conclusion: The increasing prevalence of metabolic syndrome, abdominal obesity, and elevated triglycerides highlights the urgency of addressing these health problems as a healthcare priority to reduce cardiovascular mortality in the Slovak Republic.

Aim: Cancer mortality distribution was investigated by detailed neoplasms groups, age, sex, marital status of deceased, and regions in the Slovak Republic, and examined how these determinants influence the odds of dying due to cancer. Methods: A retrospective analysis of cancer mortality statistics registered in the Slovak Republic during the years 1996-2014. For this time period, data was available only on the underlying subgroups of cancer deaths, place of death, age, year, sex, and marital status. Binary logistic regression was applied for odds of dying calculation influenced by these socio-demographic factors. Results: The most common are deaths from malignant neoplasms of digestive organs in males as well as females. The biggest difference among both genders is recognized in malignant neoplasms of lip, oral cavity and pharynx, where deaths among males are on average 7.9 times higher in comparison to females. As for place of death the Bratislava region reports the highest level of cancer mortality stated at 25.22% of all deaths, on the contrary the Banská Bystrica region reports only 21.40% of all deaths. Age has a negative influence on odds of dying due to neoplasms compared to all other causes of death by 1.7%. In all regions compared to the reference Bratislava region, the odds of dying from neoplasms are lower. Being female diminishes the odds of dying due to neoplasms by 25.7% compared to males. Yearly the relative ratio of dying from neoplasms increases with respect to all other causes of death. When single people are set as the reference category, the relation of the probability of death from cancer to the probability of death due to other causes of death is higher for married, divorced and widowed persons. Conclusions: The results should be taken into account when comparing risk of dying due to cancer among people with the mentioned socio-demographic characteristics. Health policy makers should consider place of death and cancer types while planning hospital care units.

Objective: The Czech Hydrometeorological Institute (CHMI) estimated the transboundary transport of air pollution between the Czech Republic and Poland by assessing relationships between weather conditions and air pollution in the area as part of the "Air Quality Information System in the Polish-Czech border of the Silesian and Moravian-Silesian region" project (http://www.air-silesia.eu). Estimation of cross-border transport of pollutants is important for Czech-Polish negotiations and targeted measures for improving air quality. Methods: Direct measurement of PM₁₀ and sulphur dioxide (SO₂) concentrations and the direction and wind speed from measuring stations in the vicinity of the Czech-Polish state border in 2006-2012. Results: Taking into account all the inaccuracies, simplifications and uncertainties, by which all of the measurements are affected, it is possible to state that the PM₁₀ transboundary transport was greater from the direction of Poland to the Czech Republic, rather than the other way around. Nevertheless, the highest share of the overall PM₁₀ concentration load was recorded on days with a vaguely estimated airflow direction. This usually included days with changing wind direction or days with a distinct wind change throughout the given day. A changeable wind is most common during low wind speeds. It can be assumed that during such days with an ambiguous daily airflow, the polluted air saturated with sources on both sides of the border moves from one country to the other. Therefore, we could roughly ascribe an equal level of these concentrations to both the Czech and Polish side. Conclusions: PM₁₀ transboundary transport was higher from Poland to the Czech Republic than from the opposite direction, despite the predominant air flow from the Czech Republic to Poland.

Aim: The aim of this paper is to provide information about the concentrations of airborne bioaerosols (airborne bacteria, fungi and endotoxins) in outdoor suburban environments in Ostrava, Moravian-Silesian region, Czech Republic. Methods: The methods were based on systematic bioaerosol monitoring during one calendar year, subsequent analysis of the samples and statistical processing. The regression, correlation analysis and analysis of variance for one factor and pairwise comparisons were performed on bioaerosol data to determine their dependence on season, daytime, temperature, humidity and dew point. Results: The results show higher fungi concentrations especially in summer (corrected mean 365 colony forming units - CFU per m³) compared to other seasons (75-209 CFU/m³) and higher concentrations of bacteria in the evening (380 CFU/m³) compared to other parts of the day and seasons (in summer 206-252 CFU/m³ and in winter 81-87 CFU/m³). Concentrations of endotoxins were relatively low throughout the year, on average 0,056 endotoxin units (EU) per m³. Conclusions: The concentration of bioaerosol (bacteria, fungi and endotoxins) were found in ambient air at substantially lower levels than in an indoor environment. Although the concentrations of this bioaerosol greatly fluctuate with temperature, dew point, season and daytime, they do not represent increased health risks.

Background: Numbering about 90,000, nurses represent the largest group of health care providers in the Czech Republic. Therefore, nurses can make a significant impact in the treatment of tobacco dependence, particularly in applying brief interventions to smokers. Methods: During 2014, 279 nurses from the Czech Republic participated in an e-learning education programme consisting of two Webcasts with additional web-based resources about smoking cessation in relation to health and treatment options in daily clinical practice, particularly regarding brief intervention methods. Before viewing the e-learning programme, and three months after viewing it, the nurses completed a questionnaire documenting their interventions with smokers and their knowledge, attitudes and opinions regarding nurses' roles in smoking cessation. Results: The responses in all of the following categories significantly improved: usually/always asking patients about smoking from 58% to 69% (OR 1.62, CI=1.14-2.29, p=0.007); recommendations to stop smoking from 56% to 66% (OR 1.46, CI=1.03-2.06, p=0.03); assessing willingness to quit from 49% to 63% (OR 1.72, CI=1.23-2.42, p=0.002); assisting with cessation from 21% to 33% (OR 1.85, CI=1.26-2.71, p=0.002); and recommending a smoke-free home from 39% to 58% (OR 2.16, CI=1.54-3.04, p<0.001). The increase in arranging follow-up from 7% to 10% did not constitute a statistically significant improvement, however, this finding is understandable in relation to the status of nurses in the Czech Republic. However, nurses' confidence in helping smokers to quit smoking, their senses of responsibility and determining the appropriateness of these interventions remains inadequate. Conclusion: The nurses' brief intervention skills improved significantly after the completion of the e-learning programme, even though reservations remain among this group. The systematic education of nurses aimed at smoking cessation intervention and analyzing their motivation for treatment may contribute to improved nursing care, and thus lead to a reduction of smoking prevalence in the general population.

Aim: The problem of family care for people dependent on another person has only recently become a focus of research. As demand for health and social services has not been adequately met by public service providers, growing attention has been given to informal care and the integration of families within systems of health and social care at the community level. This paper presents the results of a survey on informal carers' views and opinions under the current conditions of social support in the Czech Republic. The survey was based on theoretical concepts of caring societies, deinstitutionalization, refamilization, and integrated community care, and aimed to shed light on caring families' experiences and needs in the Czech Republic. Methods: Family lay carers completed an original self-administered questionnaire. A convenient sample of 200 family carers was selected. Results: The survey collected information about the most influential factors in determining whether the families continue to provide care for their relatives in the household. More than 50% of the caregivers provide care from moral and emotional reasons. Financial problems, risk of losing their jobs, and further deterioration of health of the person they care for emerged as key risk factors, but overall, determination among carers to continue providing care "at any cost" was high (53%). Conclusions: Involving local communities and services, e.g. general practitioners (GPs) to a greater extent in the coordination of various social and health services, and in support mechanisms at the juncture between informal and formal care would make it easier for family carers to continue providing long-term care.

Aim: The aim of the study was to compare the prevalence and distribution of both low-risk and high-risk HPV infection of the urethra and outer genital region in Croatian men. Thus far there is a consensus that sampling the coronal sulcus and glans of the penis is essential for adequately assessing HPV status in men but less agreement is noted for urethral sampling. Methods: External genital brushing and urethral swabs were taken from 1,342 men during a 12-year period and tested with the hc2 HPV DNA Test using Hybrid Capture 2 technology. Results: The overall prevalence of male HPV infection in this study was 36.66%. Infection with high-risk HPV types (44.72%) was significantly more frequent than infection with low-risk HPV types (28.86%) or co-infection with both low-risk and high-risk HPV types (26.42%). HPV was more frequently demonstrated in the outer genital area (58.33%) when compared to the sole infection of the urethra (17.89%) or infection of both genital sites (23.78%). Conclusions: Results from this study indicate high prevalence of HPV infection in men and suggest that optimal sampling method for the testing of men is the combination of external genital and urethral swabs. Further research about the proper collection of biological samples and testing methods for HPV detection in men is necessary since our future end-goal is to implement standardized guidelines on sampling and diagnostic testing of males.

Enteroviruses (EVs) infections occur worldwide. Although, infections by these viruses are often asymptomatic and go unnoticed, they can be shed in stool for several weeks. The EVs are associated with sporadic outbreaks and a wide range of clinical symptoms, occasionally accompanied with fatal consequences. Presently in the Slovak Republic (SR) recreational waters are tested only for bacterial indicators. Our aim was to monitor EVs in recreational waters. Water samples were collected during the years 2012-2014 from different recreational natural lakes in Central and West regions of SR. The samples were concentrated by centrifugation using the two-phase separation method recommended by the World Health Organization (WHO) used for EVs surveillance in the treated sewage waste water. Each of the two phases collected from the samples was analysed by polymerase chain reaction for detection of EVs and primary sequencing was done. Our study demonstrated presence of EVs in three localities consecutively for three years, indicating a probability of constant local source of faecal contamination. This is the first monitoring report on the occurrence of EVs in the natural recreational waters in SR.

Aim: Influenza virological surveillance is an essential tool for studying the evolution of influenza viruses as well as for annual updating of the vaccine composition. The aim of the present study is to analyse the circulation of the influenza viruses in Bulgaria during the four recent post-pandemic seasons. Methods: A total of 3,681 respiratory samples from patients with influenza like illness (ILI) or acute respiratory illness (ARI) were tested for influenza viruses using Real Time RT-PCR. Results: Influenza viruses were detected in 1,367 (37%) samples. Of those viruses, 941 (69%) were of type A and 426 (31%) of type B. Among the subtyped A viruses, 543 (60%) were A(H1N1)pdm09 and 369 (40%) A(H3N2). Co-circulation of all seasonal influenza types/subtypes was registered during each season, with the exception of A(H1N1)pdm09 virus in the 2011/12 season. In this study, data gathered from the antigenic and genetic analyses of influenza viruses, their antiviral susceptibility, and the epidemiological and clinical characteristics of the infections are presented. Conclusions: Yearly variations in the distribution and frequency of influenza types/subtypes and an annual shift of the predominant type/subtype were observed. In the seasons with predominant spread of A(H1N1)pdm09 virus - 2010/11 and 2013/14, a greater number of influenza-related pneumonia cases, ICU admissions and fatal cases was registered (p<0.05). The results of the present study confirm the need for continuous and comprehensive influenza surveillance.

Licit and illicit drug use in pregnant women constitutes a long lasting and serious problem worldwide. Information on long-term effects of maternal drug use on the child is limited. Nationwide registers provide a great potential to study short- and long-term consequences for children exposed to licit and illicit drugs during pregnancy. We discuss this potential, with a special emphasis on exposure to methamphetamine, heroin and prescription drugs used for opioid maintenance treatment (OMT). We also discuss the advantages of analysis using register data and of merging such data from different regions. The Czech and Scandinavian registers are largely comparable and provide great opportunities to conduct innovative research. For instance, using Czech and Scandinavian cohorts we can compare groups with similar characteristics, such as mothers in OMT and mothers addicted to other drugs while also controlling for important confounding factors such as health and socioeconomic status.

Background and Aim: Cardiovascular disease is a serious problem increasingly affecting young people worldwide. Cardio-metabolic risk factors include lipid profile parameters and atherogenic index of plasma (AIP), as well as basic anthropometric parameters such as the ratio of waist circumference to height (WHtR). The aim of our study was to determine WHtR. Method: WHtR was determined in a group of 500 clinically healthy young people aged 18-25 and, on the basis of measured data, a reference range for WHtR was designed. Results: The average WHtR value for the whole group was 0.45±0.06, with 0.46±0.06 for men, and 0.44±0.06 for women. WHtR values in respondents with all other parameters in normal range were from 0.41 to 0.52 for men and from 0.38 to 0.50 for women. Values are similar to those observed in other studies across diverse world populations. A positive correlation was observed between WHtR and atherogenic indices (AP1, AIP) uric acid levels and lipid profile parameters at p<0.001, with the exception of glucose and HDL. WHtR and HDL were negatively correlated at p<0.001. Conclusion: As WHtR can be easily determined, it can be used as another cardio-metabolic risk factor.

Aim: The aim of this study was to investigate the seasonal fluctuation of PCDD/Fs and dl-PCBs levels in the ambient air of Upper Silesia in the aspect of human inhalation exposure as well as the estimation of health risk attributed to this exposure pathway to dioxins and dl-PCBs. Methods: In the study air samples were taken in five urban districts of Upper Silesia, Poland, where the houses are heated with coal. The same sampling points in summer and winter were analyzed for dioxins/furans and dl-PCBs. In addition, information was collected on awareness of the residents about the co-incineration of plastic waste and effects of this activity on human health. Results: The results show that the average daily exposure of residents of Upper Silesia to TCDD and DLCs in the heating season was about 6.5.-fold higher than in summer. The risk assessment showed that expected excess of cancer cases per 1,000,000 people ranged from 4.5 to 13.2 in winter and from 0.9 to 2.1 in summer. The practice of mixing waste with coal for houses heating has been confirmed by investigated families, who do not associate it with the possibility of negative health effects. Conclusions: Air pollution can be a significant source of dioxin and dl-PCB for people during the winter season, as a result of co-burning coal and waste containing plastics. The dose of dioxins inhaled through the respiratory pathway in winter can be associated with the higher cancer risk in the population of Upper Silesia.

Aim: The aim of the study was to assess the self-reported oral health behaviour of Scandinavian and Polish medical students studying in Poland. Methods: Three hundred and fifty subjects took part in the questionnaire survey. They were the 4th to 6th year Scandinavian and Polish medical students attending the same medical school. Test-retest reliability demonstrated an accepted level of kappa > 0.50. The questionnaire comprised issues dealing with demographics, dental health behaviour, fluoride tablet recommendation, self-rated oral health, and smoking habit. Statistical analyses were performed using the Fisher-Freeman-Halton test, Fisher's exact test and the multiple logistic regression. A p value<0.05 was considered significant. Results: Gender and nationality statistical differences were observed regarding the frequency of visiting a dentist: more Polish females visited a dentist less than a year ago (p=0.011), the reasons for visiting a dentist - check up, filling (p=0.002; p=0.040); the frequency of tooth brushing was higher among Polish females compared to Polish males and Scandinavian females (p<0.001; p<0.001). Polish males ate sweet snacks significantly more often than Polish females and Scandinavian males (p=0.018; p=0.004). In the logistic regression analysis factors were independently associated with visiting a dentist at least once a year: female gender (OR=2.310; 95% CI 1.381-3.865), Polish nationality (OR=3.833; 95% CI 2.293-6.408). Associations with the female gender were significant for the following dependent variables: visiting a dentist more than a year ago (OR=1.913; 95% CI 1.192-3.070), brushing teeth at least once a day (OR=3.759; 95% CI 1.567-9.017), and use of dental floss (OR=2.249; 95% CI 1.445-3.503). Polish nationality was associated with an increasing rate of brushing teeth for at least 3 minutes (OR=2.435; 95% CI 1.526-3.885), and smoking cigarettes (OR=2.340; 95% CI 1.336-4.098). Conclusions: Better prognosis for maintaining good oral health was established in the Scandinavian group of students. Polish females took greater care of their teeth than Polish males and the majority of their Scandinavian counterparts.

Background: Research on physical activity in relation to obesity gradually becomes more focused on environmental determinants, which can potentially influence people's health choices. The present article addresses the topic of physical activity from a wider sociological perspective. Our pilot study was designed with the objective of testing the applicability of a method included in the EC 6th Framework Programme EURO-PREVOB, in the Czech context. The method examines specific determinants of the built environment that can have an impact on physical activity at the population level. In addition, the study aims to analyze possible differences in built environment indicators and their relation to the physical activity of people living in neighbourhoods with areas of varying socioeconomic status. Methods: The field study was carried out in the city of Brno, Czech Republic, in 5 neighbourhood quintiles, i.e. areas divided according to the socioeconomic status of local residents. In each quintile, we evaluated the quality of the built environment according to the quality, aesthetics and safety of segregated cycle facilities, playgrounds/playing areas, public open spaces, marked road crossings and pavements as well as signs of incivilities and devastation. Results: Between the five quintiles, significant differences were found in the quality of parks and playgrounds/playing areas, pavements, marking of pedestrian crossings, and in general aesthetics, i.e. signs of incivilities and devastation of the built environment. No differences were found in the quality and use of cycle facilities. Conclusions: The method we used for the evaluation of the built environment proved highly applicable in Czech populated areas. Monitoring of built environment indicators in the Czech Republic should provide a basis for health maps, showing potential associations between the prevalence of high-incidence, non-infectious diseases and various social determinants of physical activity. This information might help in achieving an improvement in these determinants at a community level and promoting an increase in physical activity at the population level.

The implantable cardioverter-defibrillator (ICD) is highly effective in reducing sudden death from ventricular tachyarrhythmia among high-risk cardiac patients. Conventional advice given to patients with ICD is to avoid physical activity more strenuous than playing golf or bowling. This recommendation is given due to a theoretical risk of arrhythmia precipitation, and thus increased risk of death due to failure to defibrillate, injury resulting from loss of control caused by arrhythmia-related syncope or shock, and also due to sport related direct damage to the ICD system. Recent prospective data from an international registry involving 372 athletes with ICDs in situ and actively participating in sports has been published. This indicates that, although physical activity resulted in an increased number of shocks compared to rest, there was no significant difference between intensive physical activity and any other activity (10% vs. 8%, p=0.34) in frequency of shocks. Furthermore, over a median follow-up period of 31 months (21-46 months), in the period of sports activity and 2 hour rest directly after there were no occurrences of death, resuscitated arrest or arrhythmia, or shock-related injury. This data is likely to start a shift in every-day clinical decision-making leading to revision of the high level of precautions imposed on the rapidly enlarging ICD recipient population.

The incidence of surgical site infection and urinary tract infection following orthopaedic procedures has diminished in recent years due to modern antimicrobial prophylaxis. We conducted a case-control study (100 cases, 100 controls) in order to evaluate the risk factors associated with infection after orthopaedic procedures. The following risk factors were defined: gender, age, comorbidities [rheumatoid arthritis, diabetes mellitus, obesity (>30 kg/m²), peripheral vessel disease], pre- and post-operative glucose levels, pre-operative and post-operative length of stay (days), duration (days) of urinary catheterization, type of parenteral antibiotic prophylaxis (cefotaxime or vancomycin), time of surgery (elective or scheduled), American Society of Anesthesiologists (ASA) Score (0-3), type of surgery (fracture osteosynthesis, joint replacement, spinal surgery, other), and the type of anesthesia administered (general, epidural, spinal). Urinary tract infection was the most frequent post-surgical infection (71 out of 100 cases) followed by surgical site infection (15 out of 100 cases). Using the multivariable logistic regression model, we found out that only the type of chemoprophylaxis was statistically significant risk factor (p<0.001) associated with post-surgical infection. More specifically, the use of vancomycin instead of cephalosporin is associated with a lower risk of infection.

Objective: The aim of the research was to assess the oral hygiene habits in the elderly group of study population of Southern Poland. Methods: The study was conducted in dental services in two selected cities in Southern Poland. The group of subjects consisted of 664 respond-ents (272 men, 392 women) aged 65 to 81 years. Oral hygiene was measured with the author's anonymous questionnaire consisting of twenty questions. Questions related to information on personal history and general health, comorbidities, dietary habits, alcohol consumption, smoking, taking drugs and the state of oral hygiene practices as frequency of visits to the dentist and the number of own teeth. Results: The majority of the subjects had higher n = 240 (36.1%) and secondary n = 219 (33%) education and were predominantly n = 590 (89%) professionally inactive (retirees or pensioners). No significant differences were found between the groups: women and men. But there were differences in technologies used, the examined men significantly often used computer in comparison with the women's group. In total, 19.6% had own natural teeth only, 45.0% own teeth and dentures, 30.0% dentures only, and 5.4% neither teeth nor dentures. Majority of subjects brush their teeth or dentures only 1-2 times a day (80%) and visit the dentist less than once in 2 years or once a year (75%). Women significantly more often stated use of a toothbrush and taking care of oral hygiene and compared to men, they declared higher number of own teeth. Conclusion: People aged over 65 neglect hygiene and oral care. Women pay more attention to oral hygiene and they have more own teeth than men. The most frequent cause of oral hygiene neglect in the elderly could be gender, the socio-economic conditions, behaviour habits and lack of sufficient health education. The dentist may need to consult with the patient's GP the development of the appropriate personalised treatment plan for the elderly. Young dentists need to be educated in order to provide appropriate dental care to the elderly.

Monitoring sales of medications is a potential candidate for an early signal of a seasonal influenza epidemic. To test this theory, the data from a traditional, consultation-oriented influenza surveillance system were compared to medication sales and a predictive model was developed. Weekly influenza-like incidence rates from the National Influenza Sentinel Surveillance System were compared to sales of seven groups of medications (nasal decongestants, medicines for sore throat (MST), antitussives, mucolytics, analgo-antipyretics, non-steroidal anti-inflamatory drugs (NSAIDs), betalactam antibiotics, and macrolide antibiotics) to determine the correlation of medication sales with the sentinel surveillance system - and therefore their predictive power. Poisson regression and regression tree approaches were used in the statistical analyses. The fact that NSAIDs do not exhibit any seasonality and that prescription of antibiotics requires a visit to the doctor's office makes the two medication groups inappropriate for predictive purposes. The influenza-like illness (ILI) curve is the best matched by the mucolytics and antitussives sales curves. Distinct seasonality is also observed with MST and decongestants. The model including these four medication groups performed best in prediction of ILI incidence rate using the Poisson regression model. Sales of antitussives proved to be the best single predictive variable for regression tree model. Sales of medication groups included in the model were demonstrated to have a predictive potential for early detection of influenza season. The quantitative information on medication sales proves to be a useful supplementary system, complementing the traditional consultation-oriented surveillance system.

Aim: The aim of the study was to determine the reliability and validity of the agreement between the Asthma Control Test (ACT) and Global Initiative for Asthma (GINA) in classifying asthma control in the Czech Republic. Methods: A sample of 316 people with asthma was recruited from the Clinic of Tuberculosis and Respiratory Diseases of the University Hospital in Ostrava between November 2011 and July 2012. Two questionnaires were used in this study, the Asthma Control Test and Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Regardless of the questionnaire results the asthma specialist assessed the asthma control status of enlisted patients according to the criteria described in the GINA 2006 guidelines. Results: The internal consistency of the five-item ACT was good. The ACT score of ≥20 predicted GINA-defined controlled asthma in 29% of cases with a sensitivity of 65% and specificity of 89%. The kappa level of agreement between the ACT classification and GINA classification of asthma control was 0.29, suggesting fair agreement. The ACT score showed the strongest correlation with the specialists' rating, followed by the FEV₁ percent predicted. Overall, in line with previous studies we confirmed significant relationship between the ACT scores and FEV₁ and health related quality of life. Conclusions: ACT is a reliable and simple tool that might be a significant asset in the management of outpatients with asthma in the Czech Republic. The ACT score correlates well with lung function parameters and health related quality of life. It appears to be a good tool to predict GINA-defined 'not-controlled asthma'.

Aim: The Ostrava region suffers from high levels of air pollution during winter inversions. We investigated the association between short-term elevations of air pollutant concentrations and worsening of respiratory problems, use of asthma medication and restriction of daily activities in asthmatic patients in Ostrava. Methods: One-hundred and forty-seven child and adolescent patients (aged 6-18 years) with a confirmed diagnosis of mild to moderate persistent asthma were included in the study. Participants' parents completed diaries covering the period of November 2013 to February 2014; this analysis included 18,228 person-days. Daily smoothed maps of outdoor concentrations of particulate matter (PM10), nitrogen dioxide (NO2) and sulphur dioxide (SO2) were constructed from routine monitoring data, and participants' daily exposures were estimated on the basis of time spent at home and at school. The associations between health outcomes and exposure to air pollutants were estimated using the multiple logistic regression method. Results: The odds ratios (OR) of the combined outcome for wheezing and/or difficulty in breathing, per 10 µg/m³ increase in the mean 24-h exposure were 1.07 (95% confidence interval 1.04-1.11) for PM10, 1.30 (1.18-1.44) for NO2, and 1.37 (1.18-1.59) for SO2. Additional inhaler use (in addition to usual medication) was also more frequent at higher air pollutant concentrations; the odds ratios per 10 µg/m³ increase in the mean 24-h exposure were 1.05 (1.02-1.07) for PM10, 1.19 (1.10-1.30) for NO2, and 1.26 (1.11-1.43) for SO2. Associations were less consistent for other health outcomes. Conclusions: These results suggest moderately strong associations between air pollutant concentrations and respiratory difficulties among asthmatic children and adolescents. More detailed analyses are required to confirm these preliminary findings.

Aim: Cervical cancer mortality is high in Hungary, with more than 400 deaths per annum. In 2003, a national cervical cancer screening programme was launched to provide screening services for women who otherwise would not use services themselves. The aim of this survey was to study the socioeconomic and lifestyle factors related to participation in the organised cervical cancer screening programme. Methods: A questionnaire-based health survey was conducted using a representative sample of women from 25-65 years of age in 11 Hungarian counties. A logistic regression analysis was used to study the association between participation in the screening programme and socioeconomic and lifestyle factors. Results: 74% (95% CI: 70-77%) of the target population underwent a screening examination within the previous three years. Only 15% (95% CI: 5-35%) of the women, who received an invitation letter and took part in the organised screening programme, had never been previously examined by gynaecologist. The participation rates decreased significantly (p<0.05) for those subjects aged >44 years, retired, participants with low income, living in small settlements, and reported to be heavy smokers. Conclusion: Although the overall proportion of Hungary's population that undergoes regular screening for cervical cancer is not low, the organised national cancer screening programme was ineffective in engaging women not regularly visiting their gynaecologist for examination.