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Objective: The aim of the study was to investigate the prevalence of eating disorders (EDs) and their association with socio-demographic and behavioural factors among university students. Methods: A cross-sectional study among university students (Chinese and international) in Nanjing, China. We collected the data from 877 students, of which 811 were eligible for this study. They submitted a self-administered questionnaire (Eating Disorder Examination Questionnaire 6 (EDE-Q6) related to socio-demographic, health variables and lifestyle factors. Data were assessed with the help of SPSS software. Results: A total of 401 Chinese and 410 international university students (49.44% vs. 50.55%) participated in this study. Binary logistic regression showed that young female adults of 18~25 years of age had more risk of developing eating disorders. Higher body mass index (BMI), such as overweight and obesity, were more influential risk factors (p < 0.001) for eating disorders. The significant risks (p < 0.001) EDs were found in students who were athletes, physically active, and involved in various extra-curricular activities. Alcohol and smoking were significant risk factors associated with eating disorders. Conclusion: The results indicated higher risks of eating disorders followed by objective binge eating and compensatory behaviour. In this scenario, early assessment and treatment are necessary to reduce the burden of eating disorders and to promote good nutritional practices among university students.

Objective: This study aims to identify predictors of the lifetime prevalence of methamphetamine use in the population of Czech disadvantaged neighbourhoods. Methods: Using data from a face-to-face representative survey, two types of analysis were performed. A bivariate analysis (unadjusted odds ratios estimated with logistic regression) was conducted to determine the relationship with a dependent variable (lifetime prevalence of methamphetamine use). Subsequently, three multivariate binomial logistic regression models (socio-demographic and socioeconomic status, incarceration and victimization, mobility and space) were conducted to control for the influence of other variables. Results: In a series of multinomial logit models, we have found the following predictors to be significantly associated with lifetime prevalence of methamphetamine use: age, gender, Roma ethnicity, net monthly household income, unstable housing, lifetime experience with incarceration, lifetime experience with discrimination, urban-rural divide, and index of rural peripheralization. Conclusions: The results suggest that methamphetamine users are multidimensionally disadvantaged and therefore constitute a vulnerable group with specific needs. This should be considered when designing services and policies targeting methamphetamine use in disadvantaged neighbourhoods.

The case of spoilage of flavoured and sweetened soft drink occurred in the Czech Republic in 2019. After drinking it, the consumer was admitted to a hospital with sickness. The spoilage was caused by mould and an odorous substance, 1,3-pentadiene. The mechanism of food spoilage, with the formation of 1,3-pentadiene arising from the decarboxylation of sorbic acid and mould growth, is described. This could be the second case history reported worldwide of an allergic reaction to penicillin explaining how penicillin might get into the beverage. We hypothesise three possible causes of the health problem experienced with allergic reaction to penicillin or other mycotoxin produced by Penicillium mould as the most probable one.

We would like to submit the following correction to our recently published paper due to an error in the Table 2.

Objective: This study aimed to obtain sexual and reproductive behaviour data of late adolescent women in the Czech Republic and to analyse the relationships between sexual behaviour and social, demographic, and behavioural factors. Methods: Data were obtained using the Computer-Assisted Web Interviewing method from 25 April to 2 May 2018 from a representative group of sexually active women aged 18-24 years. Results were statistically evaluated using sign schema on adjusted residuals. Results: A total of 525 women participated (median age of coitarche - 16 years, condom use with/without hormonal contraception - 65%, unprotected sex - 9.3% in the sexual debut). Anamnestic artificial abortion and sexually transmitted disease (STD) rates were 5.3% and 3.8%, respectively. Early coitarche, number of sexual partners, history of abortion, and STDs were positively correlated with current hormonal contraceptive use; the number of sexual partners and use of hormonal contraception were negatively correlated. Hormonal contraceptive users were more likely vaccinated against human papilloma virus (HPV) in comparison with women without any contraception. There was no correlation between risky sexual behaviour, contraceptive use, and socio-demographic factors. Conclusion: Women with early coitarche and a high cumulative number of sexual partners have more unwanted pregnancies and STDs; moreover, those with regular coital activity without contraception are less frequently vaccinated against HPV.

Objective: The aim of the study was to compare the occurrence of occupational diseases (ODs) in the automotive industry in the Czech Republic and the Slovak Republic and to analyze their determinants. Methods: The aggregated and anonymized data on ODs from the period 2001-2017 were used. A questionnaire survey was conducted in the Czech Republic (response rate 70.6%) and in the Slovak Republic (response rate 57%). The occurrence of ODs according to socioeconomic factors, the size of enterprises and their position in the global production networks was evaluated. The quality and scope of the occupational health services were also taken into consideration. Results: Workers older than 40 years were at a significantly higher risk of ODs than the younger ones. In the Czech Republic, it corresponded to OR 2.77 (95% CI 2.41-3.19), in the Slovak Republic to OR 2.01 (95% CI 1.34-3.01). The risk of ODs in women was significantly higher than in men - in the Czech Republic it corresponded to OR 3.20 (95% CI 2.79-3.67), in the Slovak Republic to OR 2.43 (95% CI 2.05-2.87). The difference between the two states did not reach statistical significance in any of the studied factors. In both states, no ODs were reported from the microenterprises. Conclusion: Given the results of the study, it can be recommended to focus on the ergonomics of assembly work in the automotive industry. Special attention should be given to the provision of occupational health services, especially in microenterprises.

Objectives: Oral health can affect quality of life in all course of life, which is a key factor of general health. Dental caries, periodontitis and oral cancer are of the highest burden of oral diseases. Rising prevalence of soft drinks and alcoholic beverages consumption due to easy access and socio-demographic altering has increased the concerns on oral health. In this review our purpose was to show effects of the most consumed beverages on oral health in people older than 15 years. Methods: The review was based on papers published in last 10 years, searched with combined key words related to types of drinks and specific oral health problems. We included 4 older studies due to lack of newer studies on subjected topics. Results: Sugar-free soft drinks are found less cariogenic and erosive than regular versions in limited number of studies. Alcohol consumption is shown as one of the risk factors of prevalence and severity of periodontitis and is proven to have synergistic effects along with tobacco on oral cancer risk. Consumption of soft drinks and alcoholic beverages was related with tooth loss whether dental caries or periodontal diseases. Conclusion: There is good evidence for association between soft drinks and oral health problems, but still no clear answer exists about strength of association between sugar-free soft drinks and dental caries. Also the knowledge about influence of alcohol is inadequate. Since consuming style affects erosive potential of drinks manufacturers should be required to add some recommendations on labels about drinking style.

Objective: The main aim of this study is to discover and analyse the utilization of health impact assessment (HIA) among HIA certificate holders, and to ascertain their opinions on the current situation in the Czech Republic and on the possible future nationwide implementation of health impact assessment. Methods: The target group of the research was identified as holders of professional competence certificates in the field of public health impact assessment. A structured questionnaire was developed. The first part mapped the recent use of HIA in the Czech Republic, the second addressed the issue of linking HIA to regional policies and to the national strategy, the third aimed to gain information about the preparedness of the Czech Republic for the full implementation of HIA, and the last part focused on quality assessment and capacity building for HIA. Results: The results of the survey point to the inconsistencies in the perception of the whole concept of HIA in the Czech Republic by the professional public, and also to a shortage of experts in this area. There is only a narrow circle of experts, especially in the field of health care. It also lacks an informational base, which assist in the unification of processes in this area. As the results of the questionnaire showed, the problems are the lack of interest in the application of the HIA method and, subsequently, the lack of demand. Conclusion: The collected data showed obstacles and gaps in the implementation of the HIA methodology in the Czech Republic. At the same time it has revealed possible ways to change the current situation, based on the opinions of those who practice this methodology in the Czech Republic.

Objectives: Since the beginning of the civil war in Syria, over 3.5 million Syrians have fled to Turkey. Considering the massive burden of healthcare service needs of this population, the Turkish government has launched an initiative as employing Syrian doctors to provide health services to their citizens in Refugee Health Centres. In this study, we aimed to explore the social adaptation status of Syrian physicians living in Turkey using a structured questionnaire and the Social Adaptation Self Evaluation Scale (SASS). Methods: Between November 2016 and April 2018, 799 physicians who participated in "Syrian Physicians' Adaptation Training" were enrolled in the study and underwent a structured questionnaire that questioned socio-demographic data and the SASS. The participants were divided into two groups as having poor and normal/high SASS scores. The binary SASS groups were compared with some demographic data. Results: The median SASS score of the respondents was found as 43 (min. 10, max. 60, IQR 10) which can be accepted as normal. In the binary grouping, it was seen that 107 (13.39%) participants had poor social adaptation, whereas 692 (86.61%) participants had normal or high social adaptation scores. The physicians who were certain about not going back to Syria had significantly higher SASS scores. Conclusion: The social adaptation scores of the Syrian physicians were considerably high. The adaptation status was found to be associated with some characteristics like living in Turkey for a long time and having pre-knowledge about the Turkish healthcare system.

Objective: The purpose of this article is to describe current research trends in medical tourism and implications for public health, especially in destination countries. Methods: The methods used for this article include a literature review of available sources on the research topic in the world's acknowledged databases Web of Science, Scopus, MEDLINE, and ScienceDirect. Results: The findings indicate that there is no consensus on the definition of medical tourism. However, there are a few conceptual models which can be used in further medical tourism research and practice. The findings also reveal that there are still certain issues, which hinder the fast growth of medical tourism, such as unclear impact on healthcare systems, ethical concerns or a lack of effective tools for the measurement of quality assurance of the medical tourism services and their products. Conclusions: There is a need for data collection on medical tourism, both at national and worldwide level to provide a realistic picture of this evolving field of tourism as well as implications for public health in destination countries.

Objectives: The aim of the study was to assess the prevalence of burnout syndrome and mobbing, to determine their mutual relationship, and to identify predictors related to the probability of occurrence of burnout syndrome in general nurses working in hospitals. Methods: The work is designed as a cross-sectional study. The research took place in 2018 and the sample included 250 general nurses. Statistical evaluation was performed by means of descriptive statistics, Spearman's correlation coefficient, and logistic regression. Three standardized questionnaires were used - Maslach Burnout Inventory, Negative Questionnaire Act and SUPSO. Results: The research revealed burnout syndrome in the area of emotional exhaustion in 28.8% of nurses, of depersonalization in 15.2%, and in the area of personal accomplishment in 38.4%. 51.2% of nurses never experienced mobbing at workplace, one act of mobbing over the last six months was reported by 17.6% of respondents, two and more acts by 31.2%. Logistic regression revealed that the probability of occurrence of burnout syndrome in the area of emotional exhaustion is influenced by age, sex and by the size of an urban area, it is increased by anxiety and depression. In the area of depersonalization the probability of incidence increases with impulsiveness and dejection. In the area of personal accomplishment the probability of burnout syndrome incidence is increased by the lack of psychological wellbeing and activeness, by restlessness and impulsiveness. Though there were found significant relationships between all component parts of burnout syndrome and mobbing, multivariate logistic regression did not show the impact of any component part of mobbing on the probability of occurrence of burnout syndrome. Conclusions: The research revealed that the probability of burnout syndrome incidence is related to socio-demographic factors as well as to an individual's psychological states and perceptions. Direct impact of mobbing on the probability of burnout syndrome incidence was inconclusive.

Objective: The aim of the study was to identify similar WHO European countries in COVID-19 incidence and mortality rate during the first 12 peak weeks of pandemic outbreak to find out whether exact coherent parts of Europe were more affected than others, and to set relationship between age and higher COVID-19 mortality rate. Methods: COVID-19 cases and deaths from 28 February to 21 May 2020 of 37 WHO European countries were aggregated into 12 consecutive weeks. The fuzzy C-means clustering was performed to identify similar countries in COVID-19 incidence and mortality rate. Pearson product-moment correlation coefficient and log-log linear regression analyses were performed to set up relation between COVID-19 mortality rate and age. Mann-Whitney (Wilcoxon) test was used to explore differences between countries possessing higher mortality rate and age. Results: Based on the highest value of the coefficient of overall separation five clusters of similar countries were identified for incidence rate, mortality rate and in total. Analysis according to weeks offered trends where progress of COVID-19 incidence and mortality rate was visible. Pearson coefficient (0.69) suggested moderately strong connection between mortality rate and age, Mann-Whitney (Wilcoxon) test proved statistically significant differences between countries experiencing higher mortality rate and age vs. countries having both indicators lower (p < 0.001). Log-log linear regression analysis defined every increase in life expectancy at birth in total by 1% meant growth in mortality rate by 22% (p < 0.001). Conclusion: Spain, Belgium and Ireland, closely followed by Sweden and Great Britain were identified as the worst countries in terms of incidence and mortality rate in the monitored period. Luxembourg, Belarus and Moldova accompanied the group of the worst countries in terms of incidence rate and Italy, France and the Netherland in terms of mortality rate. Correlation analysis and the Mann-Whitney (Wilcoxon) test proved statistically significant positive relationship between mortality rate and age. Log-log linear regression analysis proved that higher age accelerated the growth of mortality rate.

Objective: Seasonal influenza vaccination is the main method for influenza prevention. The main objective of this study is to estimate the frequency of vaccinations in patients with chronic illnesses presented to a primary health care (PHC) centre. Methods: This cross-sectional study was performed in patients admitted to the Kapandriti Health Centre. Their vaccination status with an influenza vaccine and their underlying diseases were recorded. Results: 34.8% of the subjects had been vaccinated against seasonal influenza. Vaccination coverage was found to be 53.9% in pulmonary, 55.6% in chronic kidney disease, 43.7% in cardiovascular disorders, 40.6% in diabetes, 40.6% in any kind of malignancy, and finally 33.3% in neurological patients. The most significant predictors for vaccination were the age group of 60 to 79 years (OR = 3.08, 95% CI: 1.79-5.29), age over 80 years (OR = 2.91, 95% CI: 1.58-5.36), respiratory disease (OR = 2.25, 95% CI: 1.33-3.76), cardiovascular disorder (OR = 1.46, 95% CI: 1.02-2.10), and 3 to 5 visits to the unit annually (OR = 1.57, 95% CI: 1.12-2.24). Finally, it was discovered that coexistence of one to three diseases reduced the likelihood ratio for vaccine uptake (OR = 0.15, 95% CI: 0.03-0.79, p < 0.05). Conclusions: The influenza vaccination rate for the population of the present study has been found higher than that reported previously in literature. We believe that there is a need to implement new and more effective strategies such as educating vulnerable groups on the benefits of vaccination and so reducing the incidence of influenza and its complications especially in vulnerable groups.

Objective: The aim of the study was to investigate risk factors for S-ECC among infants under 24 months of age living in Banja Luka, Bosnia and Herzegovina. Methods: A cross-sectional population-based study was carried out. Considering inclusion criteria, the total sample consisted of 192 examined infants under 24 months of age. Parents/caregivers were interviewed ahead of each dental examination of children. Following data collection, outcome measures were: the presence/absence of S-ECC (children with at least one active early carious lesion on the smooth surfaces of the maxillary anterior teeth/caries-free children) and the severity of dental caries (no caries, initial caries and cavitated caries lesion). Results: Overall results of the study indicated that 22.9% of infants had initial caries, while 12.0% (95% CI: 8.1-17.3) of infants had at least one cavitated carious lesion. Multivariate logistic regression analysis showed that the age of infants (p < 0.001) and family monthly income (p = 0.003) variables were statistically significant predictors for the development of caries. Conclusions: This research found that the most important risk predictors for the development and severity (intensity) of S-ECC in infants under 24 months of age were low monthly income of parents and the infant's age.

Objectives: We aimed to study the effect of seasonal influenza (flu) vaccination on the susceptibility to coronavirus disease 2019 (COVID-19). Methods: A total of 203 healthcare workers of a pandemic centre of Istanbul, Turkey, were included in this retrospective study. According to the presence or absence of flu vaccination, participants were divided into group 1 and group 2. A comparison of the rate of COVID-19 was done between these two groups. Also, the mean age and the sex ratio of females/males were evaluated and compared between these two groups. Results: Group 1 participants (n = 65) were older than participants in group 2 (n = 138) (p < 0.05). Despite of this, interestingly, the COVID-19 infection rate was lower in the 1st group (in comparison to the 2nd group) (p < 0.05). Conclusion: Our study results showed that, even if low, the flu vaccination may have a protective effect on the susceptibility to COVID-19 infection. Using this beneficial adjuvant effect of the vaccine may help us in this unpredictable battle with the COVID-19 pandemic. Further studies are needed to confirm this assumption.

Objectives: Rubella and tick-borne encephalitis (TBE) are infectious diseases caused by viruses. Rubella is an air-borne infection. TBE, on the other hand, is transmitted by virus-infected ticks. Both diseases show specific symptoms after an incubation period of approximately 10 days. The Austrian vaccination plan recommends vaccinations against both viruses, as only these can protect against both infectious diseases. Because of both, an increase in measles infections and the high endemic rate of TBE in Austria, our goal was to evaluate the vaccination rate, antibody titre and general level of knowledge with respect to these two infections amongst adults in order to identify possible nescience regarding booster vaccination and general titre rates. Methods: One hundred ninety-nine people participated in the study of the TBE and rubella titre determination. We used indirect ELISA and asked the volunteers to complete a questionnaire. Results: The analysis of the results showed a vaccination coverage rate of over 90% for both diseases. Conclusion: Our findings lead to the conclusion that the protection through immunization is very high and the vaccines used are extremely effective, particularly as some individuals do not adhere to the recommended vaccination schedule.

Objective: The aim of this study was to assess the possible associations between self-perceived sick building syndrome (SBS) symptoms among healthcare workers and healthcare associates and self-perceived parameters of indoor work environment quality. Methods: The cross-sectional study was conducted from February to April 2019. Validated standardized evaluation tools (MM 040 NA Hospital 2007 and MM 040 NA Office 2007) were used for estimating the prevalence of SBS among observed populations. Chi-square and Mann-Whitney U tests for assessing possible associations in SBS symptoms between healthcare workers and associates were used. Results: The response rate was 69.8%. The results showed a lower prevalence of six or more SBS symptoms in healthcare associates (6.4%) compared to healthcare workers (12.0%). Healthcare workers perceived the most frequent risk factors for SBS to be poor air quality, an inappropriate level of relative humidity, and inappropriate room temperature, while the least frequently self-perceived risk factors were inappropriate lighting and noise levels. Conclusions: This study represents a platform for further analyses - the identification of health risk factors with environmental monitoring.

Epidemiological data consistently show sustained upward trend in the incidence of cancer. The International Agency for Research on Cancer (IARC) estimated that in 2018 more than 18 million people were diagnosed with cancer, and in about 9.6 million cases cancer could be the cause of death. At the same time, an increasing percentage of overweight and obesity is observed in both adults and children. According to the World Health Organization (WHO), in 2016 over 1.9 billion (39% of the population) of adults were overweight, of which over 650 million (13%) were obese. Obesity is closely related to the risk of cancer development. Excessive body weight is considered as a second risk factor for the development of specific cancers after smoking. According to IARC data, high BMI index may be the cause of up to half a million cancer cases per year. In addition, overweight and obesity contribute to increased mortality due to malignancies - it is estimated that they are the cause of death in 20% of women and in 14% of men. Data from the American Cancer Society indicate increased mortality due to pancreatic cancer, liver cancer, multiple myeloma, and Hodgkin's lymphoma in connection with the occurrence of excessive body weight. The study tried to confirm the influence of obesity on the risk of cancer. To achieve this, risk factors such as excessive adipose tissue, chronic inflammation, hyperinsulinaemia and hyperglycaemia, sex steroids, and microbiome were taken into account. In addition, the study presents a simple method of estimating the risk quotient of chances of developing malignant tumors in people with excessive body mass and methods of cancer disease prevention. According to the current state of knowledge, the modification of factors significantly affecting the risk of falling ill may contribute to reducing the risk of cancer. In view of the above, the importance of the problem of overweight and obesity in society and their impact on the occurrence of some types of cancer should be emphasized. Thus, the understanding of excessive body weight as a serious health and social problem sets one of the priorities in the area of public health.

Objectives: The current study employed socio-demographic, health and lifestyle, and academic variables to assess the prevalence and independent predictors of daily smoking, attempts to quit smoking, and agreement with total smoking ban at university. Methods: Students at the University of Turku (1,177) completed an online questionnaire that assessed socio-demographic, health and lifestyle, and academic characteristics, and three smoking variables (smoking, attempts to quit, agreement with total smoking ban at university). Bivariate relationships and multiple logistic regression assessed relationships between student characteristics and the three smoking variables before and after controlling for all other variables. Results: Slightly < 80% of students never smoked, 16% were occasional, and about 6% were daily smokers, and about 40% had attempted to quit. Nearly half the sample agreed to total smoking ban at university. Physical activity, consuming alcohol, illicit drug/s use and daily smoking were significant independent predictors across > 1 of the three smoking variables. Age, health awareness, importance of achieving good grades, academic performance compared to peers, study burden, and mother's educational level were significant independent predictors of one of the three variables examined. Conclusion: Universities need to assess smoking, with specific focus on the modifiable independent predictors that were associated with > 1 the variables examined, to encourage physical activity and pay attention to reduce alcohol consumption and illicit drug/s and daily smoking, whilst targeting at-risk students. University strategies should be part of the wider country-wide effective tobacco control policies.

Objective: Exposure to third-hand smoke (THS) poses health risk, especially for children. THS is mostly ignored in Turkey. The aim of this study is to adapt the Beliefs about Third-Hand Smoke (BATHS) scale to Turkish. Methods: The BATHS scale consists of 9 items, and the data collected from 273 people was considered sufficient for analyses in this methodological study. The BATHS scale is translated into Turkish and confirmatory factor analysis (CFA) was performed for the construct validity analysis of the scale. Results: The correlation between the overall BATHS scale and its two sub-dimensions was 0.937 (p < 0.001), and the correlation between the health and persistence sub-dimensions was 0.775 (p < 0.001). Since there was a statistically positive and highly significant relationship, the adapted BATHS scale was considered structurally compatible with the sub-dimensions. The reliability value of the entire scale is 0.90. Test-retest correlation values between the health and persistence dimensions were between 0.745 and 0.960, the values obtained were above 0.70 and had a statistically positive and high level of significant relationship (p < 0.001). Conclusions: It is concluded that the Turkish version of the BATHS scale is reliable and valid. This scale will allow further research and training on third-hand smoke exposure. Tobacco control programmes success will improve.

Objectives: This article investigates how the numbers of registered addict patients have changed in the last three decades in Hungary and whether the predicted HIV epidemic among intravenous drug users has occurred. Methods: Data were collected from the Annual Reports of the National Bureau of Statistics and National Epidemiological Centre as well as from the medical records of the author. Results: The total number of registered alcoholics decreased by about 75% during the investigated period. This decrease was more pronounced among males than females. After initial increase, the number of registered drug addicts showed stagnation with an about 50% drop-out rate. Fortunately, the anticipated HIV epidemic did not manifest. The negative effect of a poor political action upon the number of client visits could, however, be documented. Conclusion: In conclusion, negative trends are seen in the Hungarian addiction care. Numerous variables may be taken into consideration as affecting factors, but it is not yet clear to what extent these negative factors are responsible for trends. These data, however, warrant further investigations.

Objectives: Measuring malnutrition is difficult in all settings and confused with the signs of aging. Mini nutritional assessment is an effective tool designed to identify older adults who have a risk of developing malnutrition. Methods: Three hundred and one free-living elderly who lived with their family or alone were included in the study. Nutritional screening was performed with mini nutritional assessment and mini nutritional assessment short form. Dietary intake was assessed by a 3-days weighted food record. Results: According to mini nutritional assessment in the 65-74 years young-old group, malnutrition, risk of malnutrition, and normal nutrition was 2.4%, 39.5%, 58.2%, respectively, and in the 75-84 years old-old group it was 10.2%, 48.7%, 41.0%, respectively, and in the older than 85 years oldest-old group 92.3%, 7.7%, 0%, respectively. The lowest nutritional intake by recommended dietary allowance was zinc and the highest intake was sodium. Neither young-old group nor old-old group nor oldest-old group met the B12 and zinc requirements. Conclusions: The free-living elderly at an age of 85 years and above are, accompanied by the existence of factors which may mask their weight losses, under a severe risk of malnutrition unless they receive adequate medical care and attention.

Objectives: Front-of-package nutrition labels are intended to easily convey to consumers comprehensible information about the nutritional composition of pre-packaged food and are thus a tool in the combat against the growing prevalence of nutrition-related disorders, such as obesity, type 2 diabetes, cardiovascular disease, and some types of cancer. The objective of the present narrative review was first to describe Nutri-Score and then to synthesize some of the international scientific evidence for its effectiveness. Guided by scientific data and collective expertise, France formally adopted labelling of pre-packaged food with the 5-colour Nutri-Score label in October 2017 and that move was later followed by Belgium, Spain, Germany, Switzerland, the Netherlands, and Luxembourg. Methods: This article synthesizes evidence from several countries regarding the effectiveness of Nutri-Score and the associated individual-level diet quality index in terms of attitude/behaviour- and health-related outcomes. It also addresses criticism levied at the label. Results: The effectiveness of Nutri-Score has been demonstrated in terms of consumer ability to correctly classify food according to its nutritional quality, the nutritional quality of actual and intended food purchases, and portion size choices. In addition, consumption of foods that are less favourably rated on the Nutri-Score scale has been prospectively associated with chronic disease risk (cancer, cardiovascular disease, metabolic syndrome, etc.). Conclusion: The adoption and implementation of a uniform front-of-package label such as the scientifically validated Nutri-Score on pre-packaged foods/beverages across Europe could be beneficial to consumers at the point of purchase and could help reduce the incidence of diet-related chronic diseases by means of improvement in diet quality.

Objectives: Globally, child mortality from external causes is in decline, but it is still among the leading causes of child deaths. The aim of this first national study was to determine trends of mortality rates from external causes among children aged 1-14 years in Serbia. Methods: Mortality data were collected from the database of the Statistical Office of Serbia. Joinpoint analysis was used to assess the average annual percentage change (APC) and the corresponding 95% confidence interval (CI) in mortality from 1997 to 2016. Results: In the 1997-2016 period, there were 1,388 child deaths from external causes. They contributed to 29.4% of child mortality in total, from 34.8% in 1997 to 21.8% in 2016. Mortality rate was two times higher among boys (8.1 per 100,000) than girls (4.1 per 100,000). Transport accidents (37.6%), followed by drowning and submersion (18.2%), represented more than half of all deaths due to external causes. Since 1997, mortality rate showed a significant downward trend in boys by -5.4% (95% CI -6.8 to -3.9) yearly for unintentional injuries and significantly by -10% (95% CI -19.0 to 0.1) yearly for intentional injuries. Among girls, death rate for unintentional injuries decreased significantly by -7.1% (95% CI -9.0 to -5.1) yearly and decreased insignificantly for intentional injuries by -2.1% (95% CI -15.3 to 13.1) yearly. Conclusions: The external causes of death, despite the substantial decline in mortality, are still present among children aged 1-14 years in Serbia. Therefore, implementation of nationwide programmes for prevention of external causes of death is urgent.

Objectives: The aim of the article is to present the behaviour of Slovak consumers in terms of consumption in the field of functional food. Methods: The survey was initiated in all regions of Slovakia. The sample involved 1,373 families which consisted of respondents aged 18-92 years. Friedman's test and subsequent post-hoc analysis were used to determine the reasons why people buy (or do not buy) a specific type of food. The survey deals with functional foods. Additionally, another classification method, namely a decision tree, was used. Results: Decision trees help to identify factors influencing the choice of food by buyers. Based on this method, it can be stated that Slovak households still do not trust the functional foods bought in shops and are not interested in purchasing these foods. Conclusion: In short, it could be assumed that the millennium generation would dominate households, and that they will probably prefer foods, in a higher degree of choice, as being pre-prepared foods. Therefore, food sales will move in this direction, although traditional patterns of behaviour, determined by the role of the mother in the family, still dominate. This trend can be reinforced by the lack of cooking skills and confidence among the younger generation, which will lead to reduced cooking and is considered barriers to healthy eating.

Objectives: Vitamin D is a fat-soluble, prohormone vitamin that is important especially for bone mineralization and skeletal health. In recent years, vitamin D deficiency appeared as a worldwide problem, affecting many people in different ways including the Northern Cypriot population. The deficiency might be caused by the lack of exposure to sunlight, diet low in vitamin D, sedentary lifestyle, and also due to some genetic variations in the vitamin D receptor (VDR) gene. Methods: In this study, four common VDR polymorphisms and associations with vitamin D deficiency in the Turkish Cypriot population between ages 18-40 and working in office conditions was studied by PCR- RFLP analysis. Results: rs2228570 C>T variant was shown to be significantly associated with low serum vitamin D levels in the studied population. Conclusion: Together with the effect of rs2228570 C>T variant in the VDR gene, it is thought that the lifestyle changes in the Turkish Cypriot population might have caused the increased frequency of vitamin D deficiency in the young professionals.

Objectives: The paper analyses real-world data on cost of treatment in patients after stroke hospitalized in early rehabilitation units within comprehensive stroke centres in the Czech Republic. This is the first study of the kind in the Czech Republic, while such information is extremely rare worldwide. Stroke treatment witnessed a dramatic development in the last years, when the main progress was due to establishment of specialized (comprehensive) stroke units incorporating also early rehabilitation. There is a general agreement among clinicians that early rehabilitation is beneficial for patients after stroke. Methods: Costs of early rehabilitation after stroke were calculated by the micro-costing method alongside a pragmatic study in three Czech hospitals. Patients were transferred to specialized early rehabilitation units usually on 7th to 14th day after stroke onset and received four hours of interprofessional rehabilitation per day. Results: The analysis of data collected during the prospective observational research of 87 patients proved significant differences between patients. The average costs of hospitalization were determined to be CZK 5,104 (EUR 194) per one day of intensive rehabilitation in seriously affected patients early after stroke. These costs differed significantly between hospitals (p-value < 0.001); the structure of direct costs was quite stable, though. About 60% of these costs were due to nursing and overhead, while no more than 15% were consumed by therapists. Conclusions: The treatment of patients after stroke in specialized stroke units proved to be beneficial for the patients increasing the number of those re-integrated in family and community life.

Objectives: Due to immunosenescence and presence of comorbidities, respiratory syncytial virus (RSV) disease burden is a major health concern in older adults, which is expected to increase with the life expectancy rise. Data on RSV burden are scarce in older adults residing in long-term care facilities, a vulnerable population living in crowded settings. Therefore, two independent prospective studies were conducted during the 2003-2004 and 2004-2005 RSV seasons to assess RSV acute respiratory illnesses (ARIs) and lower respiratory tract infections (LRTIs) in ≥ 65-year-old adults residing in long-term care facilities in the Czech Republic. Methods: RSV ARI episodes were confirmed by polymerase chain reaction in nasal swabs collected within 3 days of symptoms onset. The mortality and morbidity of RSV-confirmed ARIs, as well as the risk factors associated with RSV-confirmed ARIs were evaluated. Results: Among 1,251 participants in the 2003-2004 season (ARI surveillance between October and March), there were no RSV-positive cases in 255 ARI and 105 LRTI episodes. Among 1,280 participants in the 2004-2005 season (ARI surveillance between October and April), there were 39 and 26 RSV-positive cases in 335 ARI and 217 LRTI episodes, respectively, and RSV-positive ARI and LRTI episode incidence rates were 45.82 and 30.40 per 1,000 person-years. Among 290 RSV-negative and 39 RSV-positive ARI cases in the 2004-2005 season, 15 and 4 hospitalizations, 188 and 26 LRTIs, and 11 and 3 deaths were reported. Risk factors associated with RSV-positive ARI were female gender (odds ratio: 4.98), chronic heart failure class II (odds ratio: 2.31) and diabetes requiring insulin treatment (odds ratio: 9.82). Conclusions: These studies showed that RSV was an important cause of ARI in older adults living in long-term care facilities in the 2004-2005 season, with fluctuating yearly incidences.

Objectives: Influenza is a widespread respiratory disease with a potentially risky course. Vaccination is considered the most effective method of prevention. However, only a small portion of the population is vaccinated. Teachers work in a high-risk environment and they have a significant impact on the population through student education. Therefore, the aim of this study was to find out the knowledge and attitudes of pre-service teachers about influenza and vaccination. Methods: A questionnaire survey was conducted to find out what knowledge, attitudes and behaviour pre-service teachers (N = 373) show in relation to influenza and influenza vaccination. It was statistically tested whether there were differences between students with respect to their field of study. Results: The majority of pre-service teachers have a good knowledge of influenza symptoms, however, they often mistaken it for other respiratory diseases. The field of study plays only a partial role in the knowledge. The respondents perceive influenza as an easily spread disease, but they have negative attitudes towards vaccination, and most pre-service teachers think that its disadvantages outweigh the advantages. This was stated primarily by pre-services science teachers. These attitudes are also reflected in the low vaccination rate of the sample (6%). Conclusions: Relatively good knowledge of teachers is not reflected in their attitudes and behaviour. Negative attitudes towards vaccination are most held by pre-service teachers, whose field primarily includes teaching this topic. It can have a significant effect on students' attitudes not only toward influenza vaccines but also to other vaccinations.