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Objective: Hepatitis E infection is one of the most frequent acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in recent years. Therefore, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the general population in Eastern Slovakia. Methods: Detection of anti-HEV total antibodies samples was done by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Results: Of 175 hospitalized patients included in the study, 76 (43.5%) showed positivity for anti-HEV total antibodies. No statistically significant differences were found in anti-HEV positivity between men and women or in the groups of different living areas (town/village - urban/rural). Conclusion: Prevalence of anti-HEV total antibodies of hospitalised patients was high. The risk factor significantly associated with antibody positivity was eating raw meat. Other factors, such as sex, age, living area and contact with animals were not associated with antibody positivity.

Objectives: Our study focused on the impacts on health among adolescents who became members of illegal armed groups in Colombia and their attention within the specialized government programme as seen by the professionals who work directly with them. Previous research indicates that those victims of armed violence are usually highly affected on their emotional and social health, but with appropriate and timely support more serious mental health problems can be prevented. Therefore, the care provided to them should be based on broader and holistic approaches. Methods: This cross-sectional study used the qualitative method based on semi-structured interviews with 42 professionals, and internal reports on the health condition of 165 adolescents, 57 (34.5%) females and 108 (65.5%) males, as a secondary source of information. All information was anonymous and confidential. Results: The interviews with professionals and their reports demonstrated that about a half of the 165 adolescents, 35 of 57 (61.4%) females and 48 of 108 (44.4%) males, suffered from serious symptoms requiring therapeutic and psychiatric attention. About 20% of the adolescents presented clinically important post-traumatic stress symptoms, 27% admitted sexual abuse and 29% psychoactive substance abuse. The professionals stressed various obstacles to the attention of these multiple impacts related both to the administrative and institutional issues and the particular characteristics of this population. Conclusions: Our findings show the complexity of the psychosocial impacts among adolescent victims of the Colombian armed conflict and their attention. Highly trained professionals and alternative strategies including active listening, observation and art therapy activities seem to be vital for an effective care. The lessons learned from the Colombian reintegration programme serve as important inputs to be considered when attending children and adolescents from conflict-stricken areas also in other contexts.

Objectives: About four million people are affected by rare diseases in Germany and 30 million in the EU. In 2013, a national action plan for people with rare diseases was adopted in Germany which is also aimed at improving the information situation and better gathering of information for affected patients and their families. Since then, various sources of information and medical care structures have been made available. The aim of this study was to evaluate the state of knowledge about information sources and health care centres for rare diseases among those affected. Methods: The study was carried out as anonymous survey among the member associations of the German Alliance for Chronic Rare Diseases (German acronym ACHSE e. V.). For this, a questionnaire was developed which in addition to questions on gender, age and disease comprised free text input referring to knowledge of health care centres or expert centres and source of information on rare diseases in Germany. Results: A total of 484 individuals suffering from 96 different rare diseases participated in the survey. Of these, 74.47% are aware of medical or dental care centres for treatment of their types of rare disease; 69.31% use self-help groups as a source of information, only a few respondents know government-sponsored "se-atlas" and "Orphanet". Conclusion: The majority of the respondents know medical care centres, most participants use self-help groups as information source, however, government-supported portals are largely unknown so that there is a need for further information in this regard.

The mandatory face mask wearing was implemented in the Czech Republic and Slovakia shortly after the COVID-19 outbreak in Central Europe. So far, the number of COVID-19-associated deaths per 100,000 individuals is far lower in these countries as compared with other neighbouring or close countries. The use of face masks in public may not protect the general public from contracting the virus, however, presumptively decreases the viral load and contributes to a favourable clinical outcome in COVID-19 disease. A certain time is required for antigen-specific T cells and B cells to fully develop. Obligatory face mask wearing in public favours the virus transmission through oral mucosa and/or conjunctival epithelium, which enables the adaptive immune responses to evolve. In the case of inhalation of high loads of SARS-CoV-2, the time for the development of fully protective adaptive immune responses seems to be insufficient. Then, a less specific and more damaging innate immune response prevails.

Objective: The aim of the study was to evaluate the knowledge and perceptions of the pregnant women presenting to our hospital for seasonal vaccination for influenza and to determine the factors associated with it. Method: In this cross-sectional study pregnant woman presenting to our hospital between October 2018 and March 2019 were evaluated. A non-validated, well-detailed questionnaire addressing the vaccination rates, participants' perceptions about the facts behind the vaccination for influenza and the factors associated with refusal of vaccination was performed. Women's knowledge level provided by their healthcare providers was also questioned. Results: A total of 250 participants were included in the study. The average age of the patients was 28.85 ± 5.42 years (range 18-43); and the average pregnancy week was 19 ± 9.75. It was determined that 98% (n = 245) of the participants did not have any vaccinations before, and 98.8% (n = 247) did not have any vaccination during their current pregnancy. 65.2% (n = 163) of the participants did not know that the vaccination for influenza was safe in pregnancy; and 64% (n = 160) did not know that the vaccination for influenza was recommended in pregnancy. The most frequent responses given by the participants to justify their refusal for the vaccination was "my doctor was against" and "it can be harmful to my baby" (25.6% and 24%, respectively). It was determined that 98.4% (n = 246) of the participants were not recommended about the vaccination for influenza by any healthcare centres; and 92.8% (n = 232) did not receive any information on vaccination for influenza. Conclusion: The knowledge of the participants on vaccination for influenza was inadequate and had misconceptions. The inadequacy of healthcare employees, government institutions and the media may have played roles in this outcome. The reasons underlying the inadequacy of the healthcare providers on vaccination for influenza may be questioned.

Objectives: The aim of this study was to gather information on demographic and health indicators, primarily vaccination status, of Syrians under temporary protection in five provinces of Turkey and to develop infrastructure for vaccination planning. Methods: The population under study consists of 89,986 Syrian children, 0-4 years of age, residing in Ankara, Mersin, Gaziantep, Izmir, and Bursa. Initially, we planned to evaluate 2,339 children, although a total of 2,827 children were evaluated by the end of the study. Results: Of these children, 74% were born in Turkey, while 20% were born in Syria. In addition, 22.4% (n = 634) of the children were never vaccinated, and of these, 67.0% (n = 425) were born in Turkey. In other words, one in five Syrian children born in Turkey (20.3%) had never been vaccinated. Of the Syrian children under temporary protection, the missing vaccinations were as follows: hepatitis B (54.7%); Bacillus Calmette-Guérin (62.5%); five-component combined vaccine (64.6%); conjugated pneumococcal vaccine (58.0%); oral polio vaccine (70.8%); measles, mumps, and rubella (76.6%); varicella (66.8%); and hepatitis A vaccine (76.0%). Conclusion: It is important to increase the immunization rates of Syrian children under temporary protection and establish regular vaccination procedures.

Objectives: The aim of this study is to determine the risk factors of childhood diarrhoea in Turkey throughout Turkey Demographic and Health Survey (DHS) 1998 and 2008 data. Methods: This study is a further analysis of the database of children under 5 years of age from the Turkey Demographic and Health Survey. Binomial logistic regression and Chi square analysis were used by weighted data of Turkey Demographic and Health Surveys. Results: In 1998 DHS there were 3,459 and in 2008 DHS 3,463 children under 5 years of age. Diarrhoea prevalence was 30.1% and 18.3%, respectively. Multivariate analysis revealed that household wealth status index, region, mother's education, mother's age (15-19 age), age (under 2 years of age), and sex (male) of the child were the risk factors for 1998 DHS. In 2008 significant risk factors were geographic region, education of the mother and father, breastfeeding status of the child (still being breastfed), mother's age (20-29 age group), and age of child (under 2 years of age). Conclusions: As a result, patterns of the risk factors of diarrhoea has changed from 1998 to 2008 DHS in Turkey. However, impact of factors related with socioeconomic environment such as region and mother's education persisted.

The main objective of this study is to describe the most common childhood diseases occurring in the Theresienstadt ghetto during the Second World War as well as applied anti-epidemic measures. A partial objective is to describe medical and nursing care of sick child prisoners. The data was obtained by the method of synthesis of primary and secondary data with the highest importance after adequate external source criticism using selected monographs, memoirs, survivor diaries, Orders of the day by the Council of the Elders and Reports of the Jewish self-government of the Theresienstadt ghetto from 1941 to 1945, the Archives of the Jewish Museum in Prague, the Ghetto Museum, the Museum of the History of Polish Jews in Warsaw, Post Bellum online electronic collection of oral historical interviews, and witness accounts. The validity of the presented conclusions is ensured by comparing data from several sources. The most common infections in Theresienstadt children were enteritis, scarlet fever, infectious jaundice, measles, mumps, rubella, varicella, black cough, pneumonia, otitis media, and typhoid fever. Most of these infections had entirely atypical symptomatology or complications. Children were hospitalized in children's hospitals, in children's rooms of hospitals for adults and infirmaries in children's homes. Albeit diagnostic methods had a high standard, options of treatment were very limited. The most common treatments included bed rest, diet and cold compress. Occasionally, chemotherapeutic agents (e.g. a sulphonamide drug Prontosil) and Aspirin were available. The anti-epidemic measures in the ghetto focused on hygiene, enhancing children's immunity, vaccination and pest control.

Objective: The study evaluates compliance with declared hygienic standards carried out by healthcare professionals in clinical practice within their scope of direct patient care and the maintenance of medical tools and devices in healthcare facilities in the Czech Republic. Methods: Cross-sectional questionnaire study focused on the standards of safe health care. All 80 addressed healthcare providers were also involved in the 2018 Adverse Event Reporting System (AERS) pilot project. Responses were scored on a 6-level scale, from "always" (100 points) to "never" (0 points). The evaluation was performed according to the frequency of responses and the average index (max. 100 points). Data analysis was performed using IBM SPSS Statistics version 22 (level of significance 1% and 5%). Results: There were statistically processed 2,016 questionnaires (100%). Most respondents stated their job classification as non-medical healthcare professionals (NHP) working at a patient's bedside (73%), physicians (16%), or other NHP (11%). As per their medical specialty, 43% of the respondents practice internal medicine, 28% surgery, 14% psychiatry, 9% long-term inpatient care, and 6% stated other fields of medicine. The lowest declared compliance was registered in the statement "I use a face mask when exposure to air-transmitted pathogens is anticipated" (rating index 80 points). The highest compliance (99.4 points) was registered in the statement: "I discard used sharp materials into sharps containers." Conclusion: In the surveyed healthcare facilities within the Czech Republic, overall compliance with hygiene standards is at a good level. Declared differences in compliance with hygiene standards in the selected items of the questionnaire are influenced by multiple factors. Generally, a higher level of compliance is linked to increasing age, years of practice, and a higher level of education. When comparing professional groups, a higher level of compliance with hygiene standards was registered in the NHP group.

Objectives: This study aims to identify the differences in the use of HPV vaccination between female medical students in the Czech and Slovak Republics and their possible causes. Methods: We performed a cross-sectional survey among female students of general medicine in all faculties of medicine in the Czech and Slovak Republics. Results: We obtained 630 questionnaires from the Czech Republic and 776 questionnaires from the Slovak Republic. In the Czech Republic, 65.4% of female medical students underwent HPV vaccination, while in the Slovak Republic, the figure was 21.1%. In the Czech Republic, residency and religion of students did not influence their rate of vaccination. However, in the Slovak Republic, village residency with less than 5,000 inhabitants lowered the probability of vaccination with OR = 0.56 (95% CI: 0.38-0.84), and the Catholic religion lowered the probability of vaccination with OR = 0.40 (95% CI: 0.28-0.57). Czech students were informed about the possibility of vaccination by a paediatrician in 55.7% of cases, while the figure for Slovak students was 26.8%. In the Czech Republic, 75.7% of students participated in regular cervical oncologic screening, while in the Slovak Republic, the figure was 57.7%. Vaccination of relatives would be recommended by 86.5% and 80.5% of Czech and Slovak students, respectively. Conclusions: The adoption of an oncologic prevention programme and the more extensive propagation by paediatricians are probably the medical reasons for the higher HPV vaccination among Czech students. Demographic factors - village residency and religion - are also important.

Objective: This study aimed to analyze the complications of planned home births treated at healthcare facilities in the Czech Republic. Methods: This prospective cohort observational study is based on analysis of women hospitalized with complications related to planned home deliveries in the Czech Republic between 2016 and 2017. The data were collected using an online form made accessible to the directors of all maternity hospitals in the Czech Republic. The results were statistically evaluated. Results: We identified 45 complications during planned home deliveries. Complications occurred most often among women living in largely populated cities with higher levels of education. Overall, 40% of patients did not receive routine antenatal care, and 38% of women gave birth after the 41st week of pregnancy. In 60% of cases, no professionals attended the birth. Hospital transfer frequencies were 42% after delivery, 36% at third-stage labour, 11% first-stage labour, 9% second-stage labour, and 2% before delivery. We recorded four neonatal deaths and one severe newborn morbidity. There was one maternal death unrelated to the home-birthing process and six cases of severe maternal haemorrhagic shock requiring intensive care. Conclusion: Complications of planned home births occurred more frequently in women living in largely populated cities and with higher education levels. Planned home births were also observed among women who were at a higher risk of complications. Risk factors included nulliparity, postdate pregnancy, and lack of prenatal care. Hospital transfers occurred most often in the third stage of labour and postpartum.

Objective: Period of elderly age preordains the occurrence of many health issues. People deported during World War II to concentration camps suffered from malnutrition, lack of sleep, physical and mental exhaustion. Recently, the health condition of Holocaust survivors is often complicated as a result of physical punishments and different torture methods as well as mental hardships which they had suffered during deportation. The consequences often have psychosomatic nature thus the survivors are often receivers of health care. The topic of bibliography review is based on the need to objectivize and systematically evaluate subjective health issues of Holocaust survivors in connection with trauma related to the stay in a concentration camp. The aim is to offer a review of effects of the Holocaust on health of different body systems for survivors in concentration camps and Jewish ghettos in the course of World War II. Methods: To map the subjective problems of Holocaust survivors, evidence-based medicine (EBM) method has been used with the help of scientific database PubMed, CINAHL Plus with full text, ProQuest and other sources with specific key words and Boole operators. Prognostic type of clinical/review questions has been selected for the bibliography review, which is trying to predict the probability of relation or output of illness/condition and based on diseases or symptoms seriousness to find out expectancy for treatment/improvement of care. Results: 175 studies have been found in basic search with the use of key words both in English and in Czech language. The search has not been time-limited. The advanced search has focused on different body systems and health damage due to Nazi experiments. Fourteen studies have been used to complete the study. The research results have confirmed the significant effect of Holocaust trauma on body condition of the survivors. The reasons of this condition were insufficient nutrition, unsuitable and harmful hygienic, living and working conditions and brutality of the guards. According to the research, these factors have impacted all organ systems, mainly locomotion and cardiovascular ones. The results have shown a more frequent occurrence of osteoporosis, fractures of long bones and corresponding chronical pain of people of Jewish origin who had gone through different forms of torture during World War II. Other present symptoms include gastrointestinal problems, tumors mainly in the area of colorectum and lungs. Moreover, the stay in concentration camps had influence on women's menstrual cycle. Conclusion: The studies of Holocaust effects are an example of the influence of an extreme mental and physical burden on the body condition of the survivors' health. The results of the studies have shown a wide range of the effects also in mental and social areas.

Objectives: The primary aim of a hospital is to promote/improve and restore health, thus smoking, whether in its passive or active form, should be banned in all hospital premises for the benefit of employees and patients alike. The Global Network for Tobacco Free Healthcare Services (GNTH) is an international non-profit association formed in 1999. The GNTH’s mission is to implement tobacco-free policies to create a healthy workplace and patients’ environment; help physicians, nurses, and other healthcare workers to stop smoking; and educate all caregivers about tobacco dependence treatment and support them in providing smoking cessation interventions. Methods: Implementation standards and a system of their self-audit for all participating hospitals were developed by the GNTH. We describe both the international and Czech networks, recommended methods for programme implementation and results of self-audit questionnaires completed by Czech participating hospitals. Results: Worldwide, there are 19 national networks with 1,672 members including 56 gold forum members. To date, the largest network has been formed in France (670 members), followed by Spain (580) and Taiwan (209). After the first Czech institution (Prague-based General University Hospital) joined GNTH in 2010, the Czech Republic established its national network in 2017 currently comprising 10 members, of this number 1 gold, 3 silver and 6 bronze national certification level members. The main barriers to better outcomes in the Czech Republic include smoking on outdoor hospital grounds, lack of pharmacotherapy reimbursement and time, and inadequate staff education in the field of tobacco dependence treatment. Conclusions: The Global Network’s mission is to advocate, recruit and enable healthcare services and professionals to implement and sustain effective tobacco management and cessation policies in accordance with the WHO Framework Convention on Tobacco Control (FCTC). A systematic approach supports the quality of care and treatment outcomes for patients as well as healthy workplace conditions for the staff.

Objective: Recent experimental studies point to a high reactivity of nanoparticles and the potential of sunscreens to penetrate the skin. We measured 20 markers of oxidative stress and inflammation to find out whether skin exposure to nanoTiO₂ sunscreen may elevate the level of the markers in exhaled breath condensate (EBC) and urine of exposed subjects, as was suggested by our earlier study. Methods: Six volunteers (3 males and 3 females), with a mean age of 48.0 ± 6.7 years, used commercial sunscreen for three days continuously. The first samples were collected before the test. The second samples were collected on day 4, before the sunscreen was washed off, and the third samples on day 11. The following biomarkers were measured: malondialdehyde, 4-hydroxy-trans-hexenal, 4-hydroxy-trans-nonenal, aldehydes C6-C12, 8-isoProstaglandin F2α, o-tyrosine, 3-chlorotyrosine, 3-nitrotyrosine, 8-hydroxy-2-deoxyguanosine, 8-hydroxyguanosine, 5-hydroxymethyl uracil, and leukotrienes B4, C4, D4, and E4, using liquid chromatography-electrospray ionisation-tandem mass spectrometry. Results: In the urine, 4-hydroxy-trans-hexenal was significantly higher in post-exposure sample 2, and the same trend was seen in all urinary markers. In EBC, no difference was seen between the mean values of 20 post-test markers as compared with pre-test samples. Conclusion: This study suggests potential side effects of the sunscreen - borderline elevation of markers of oxidative stress/inflammation - which may relate to the absorption of the nanoTiO₂, and the non-significant difference may be explained by the small number of subjects. The effect was not seen in EBC, where nanoTiO₂ was not found. A larger study is needed, as according to our previous study, the beneficial effect of the sunscreen to suppress oxidative stress caused by UV radiation may be questioned.

Objectives: Smoking at the workplace has a negative impact both on employers' economic interests and employees' health. The aim of this study is to describe the current situation, mainly barriers in implementation and resources in the Czech Republic as an example of a Central European country. Methods: We synthesised relevant review papers with our knowledge of the local situation based upon professional experience of both authors. Results: Despite smoke-free laws, some EU workers are still exposed to passive smoking during working hours. The main barriers towards smoke-free workplace implementation are the lack of resources, perception of smoking as a norm, and exceptions for leading personalities and their smoking. Social support increases smoking cessation effectiveness. Low availability of local smoking cessation services is an overall problem in Central Europe. Conclusions: The working environment influences smoking habits. Smoking cessation support is cost-effective not only for the smoking employee but for employers as well. Smoking cessation resources should be available during the working day. No exceptions should be made as they serve as barriers to a smoke-free working environment.

Objectives: Asbestos-related diseases are still a current problem worldwide. What is their occurrence in the Czech Republic? The answer is the subject of this study, which aims to provide a general and regional overview of the situation over the last 20 years with a more detailed focus on mesothelioma, the development of which is highly associated with asbestos exposure and the issue of their recognition as an occupational disease. Methods: In its retrospective reviews, the study is based on analyses of data from the Institute of Health Information and Statistics of the Czech Republic and data from the Czech National Cancer Registry, which also interconnects. Results: In the last 20 years, 512 new cases of occupational diseases from asbestos have been reported, namely 228 cases of pleural thickening, 133 mesotheliomas, 92 asbestoses, and 59 cases of lung cancer. In the last 5 years, mesotheliomas (n = 39) predominated among the reported diseases with a 45% proportion in the total number of 86 cases. The trend in their incidence, as the only one among asbestos-related diseases, is not declining. There was a significant difference in the overall incidence of mesothelioma in a general population and the incidence of occupational mesotheliomas. At the national level, occupational aetiology was acknowledged in only 11.3% of cases of mesothelioma on average. The highest proportion of occupational mesotheliomas and the highest incidence of all asbestos-related diseases were found in regions where the largest asbestos processing plants were located. Conclusion: The authors emphasize the importance of work history for the diagnostic process of asbestos-related diseases and also the need to perform follow-up examinations for their early detection.

Objectives: Acrylamide is a toxic compound that can be found it both occupational and non-occupational environments. This study focuses on its sources and health effects of its exposure. Methods: Adverse effects of acrylamide, especially carcinogenic, genotoxic, and teratogenic were reported in many studies conducted on animals. Neurotoxicity was reported in workers exposed to acrylamide in the occupational environment. Another important source of populations' exposure to acrylamide is their nutrition. Results: This study focuses on humans' exposure to acrylamide from various sources and its harmful effects on their health. Conclusions: Dietary intake of acrylamide, as well as occupational exposure, cigarette smoking, cosmetics usage and other environmental sources could have a significant effect on human health.

Objectives: Low cardiorespiratory fitness (CRF) is related to higher risk of cardiovascular diseases, increase in all-cause mortality and higher risk of different tumors. The reverse is also true; improvement in CRF is related to decrease in mortality. Cardiopulmonary exercise testing (CPET) is a standard and also the most precise test for determination of CRF - the best possibility is the maximal test measuring different parameters including maximal oxygen consumption. Healthcare professionals throughout the developed world have markedly high rates of sickness absence, burnout, and distress compared to other sectors and this leads to higher risk factors. The study aimed to assess CRF in a group of nurses in a big hospital and compare it with population norms and available published results. Methods: Nurses over 50 years of age working in one faculty hospital were gradually included in the study from the beginning of 2018. These nurses work in physically demanding positions. A CPET was carried out following the Bruce protocol. Results: 90 nurses (84 females and 6 males), mean age 55.7 years, were evaluated by CPET. The resting blood pressure was within the norm in 58 persons (64.44%), maximal oxygen consumption in 61 persons (67.8%), W/kg in 25 persons (46.2%). We detected a hypertension reaction in 28 persons (31.1%), some types of arrhythmia in 17 persons (18.9%) and signs of ischaemia in 8 persons (8.9%). The result of CPET led to further examination in 42 persons (46.6%). Detailed examination resulted in change of medication in 21 nurses (23.3%). New diseases were diagnosed in 15 nurses (hypertension, atrial fibrillation, mitral valve prolapse indicated for cardiac surgery, coronary artery stenosis, and lipid disorders). Conclusions: It was concluded that the usage of CPET during the regular medical check-ups significantly increases detection of hidden diseases and thus improves the care for nurses.

Objective: Acrylamide is a toxic compound found in occupational and non-occupational environment. It originates from industrial use, technological processes in construction as well as food production, water purification, and laboratory use. Adverse effects including neurotoxicity, probably carcinogenicity, genotoxicity, teratogenicity, and reproductive toxicity were reported in many studies. Our study is focused on acrylamide content in selected food products in the Czech Republic. Method: In this study, we determined acrylamide content in selected samples of commonly consumed food products (potato chips, biscuits, popcorn, corn flakes, breakfast cereals, and baked muesli). Results: The concentration of acrylamide in most samples of potato chips, biscuits and popcorn exceeded the benchmark limits. The acrylamide content in samples of potato chips from one manufacturer in 4 cases out of 5 analysed samples exceeded benchmark limit. On the other hand, no corn flakes sample acrylamide content from the same manufacture exceeded the benchmark limit. With 20 of all analysed samples exceeding the benchmark levels for acrylamide, it can be concluded that 47.6% of samples did not comply with the benchmark level. Conclusion: Dietary intake of frequently consumed food products with the acrylamide content exceeding the recommended comparative value could have adverse effects on the human health. Our study confirmed high amount of acrylamide in some selected food samples. The reduction of dietary burden with acrylamide is possible by complying with the correct technological principles in food preparation.

Objective: The study examined the fatty acids composition and main nutrients composition in two freshwater fish species in the Czech Republic during one year. Methods: Samples of common carp and rainbow trout were taken from a market chain during a year. All samples were homogenized and analyzed for lipid, protein, water, and ash contents. Energy value (E), sum of polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA) and saturated fatty acids (SFA), atherogenic index (AI) and thrombogenic index (TI) were then calculated. Results: The freshwater fish on the Czech market chain have beneficial average value content of unsaturated fatty acids, Σ MUFA+PUFA in carp is 69.46% of all fatty acids, similar average value of Σ MUFA+PUFA - 70.83% is in rainbow trout. The calculated average value of AI in carp is 0.52 (SD = 0.06), AI in rainbow trout is 0.63 (SD = 0.07), the average TI in carp is 0.63 (SD = 0.09), TI in rainbow trout is 0.49 (SD = 0.05). Conclusion: Freshwater fish in the Czech market chain have beneficial value of PUFA, so AI and TI indices are low in both species of analysed fish. Regular consumption of fish meat is important in the prevention of cardiovascular diseases.

Objective: Forced migration caused by wars has led to regression in health parameters, including tuberculosis. This study aims to determine the relationship between living area, family type and the number of contacts among refugees and Turkish citizens diagnosed with tuberculosis. Method: This study was designed using retrospective file scanning. A total of 194 patients with diagnosed TB were included in this study. In addition, patients' addresses were visited and their family lifestyles and living areas were recorded. Results: Of 194 patients in the age range of 1-72 years (mean = 31.15, SD = 15.16), 98 patients were refugees. The number of contacts among refugees was 549, and their total living area was 7,740 m². A total of 57 refugees lived in a communal living situation, and their average living area was significantly lower than that of Turkish citizens. Statistical significance was observed between family lifestyle and habitats. This was found due to the difference between nuclear families and communal living situations. Conclusion: Tuberculosis was found to infect more people in war-related living conditions. This situation is caused by communal living, which refers to people who are not blood relatives living together; this is new information. Communal life should be taken into account in the contact examination of refugees for tuberculosis, and the obstacles to reach health services for refugees living outside of camps should be examined.

Objective: The aim of the study was to determine the prevalence and severity of early childhood caries (ECC) among different social groups of preschool children in ethnic and multilingual diverse community such as South Backa District (SBD), Republic of Serbia. Methods: This survey was a cross-sectional analytical study and sample type has been projected by simple random choice of 13-71 months old children together with their parents of varied socioeconomic status (SES) and nationality in SBD. Preschool children were randomly selected through a two-stage cluster sampling procedure and parents were invited to answer the questionnaire regarding SES, native language, education, and income issues. The WHO caries diagnostic criterion was used and the severity of ECC was defined by Wine's modified criteria. The data was further analyzed using the SPSS for Windows Microsoft Excel, version 21. The percentage of caries-free children was compared using the χ² test, and one-way ANOVA was used to compare the mean disease indices at the 5% significance. Results: A total of 341 children were examined and the prevalence of ECC was 30.5%. "White spot" initial caries lesions were the most prevalent form and the highest disease frequency was found in male children (p = 0.038), who did not speak official Serbian language (p = 0.009), in children of the part-time employed parents (p < 0.001), with elementary education (p = 0.001), in low monthly income families (p = 0.023), and Roma ethnic group. Conclusions: The complex interaction of risk factors like social environment along with ethnicity and Serbian language ignorance had a significant influence on the prevalence and severity of ECC in preschool children of this multi-ethnic region.

Objective: The aim of the study was to determine the associations between recreational screen time and dietary habits and lifestyle factors in a representative sample of schoolchildren. Methods: Observational, cross-sectional study data were derived from 177,091 children aged 8 to 17 years participating in a health survey. Recreational screen time, physical activity (PA), and sleeping hours were assessed through self-completed questionnaires. Dietary habits were evaluated via the Mediterranean Diet Quality Index for children and adolescents (KIDMED) test. Anthropometric and physical fitness (PF) estimations were obtained by trained investigators. Results: Binary logistic regression comparisons between screen time levels (e.g. < 2 vs. ≥ 2 - < 3 h/d, < 2 vs. ≥ 3 - < 4 h/d and < 2 vs. ≥ 4 h/d) and dietary habits showed that the longer the screen time the increased the odds of unhealthy dietary habits such as skipping breakfast, consuming fast food frequently, and eating sweets frequently, and the decreased the odds of healthy dietary habits such as consuming a second fruit every day, consuming fresh or cooked vegetables or/and fish regularly, in both genders, after adjusting for several covariates. Furthermore, the longer the screen time the increased the odds of total and central obesity, insufficient sleep (< 8-9 h/d), and inadequate PA, and the decreased the odds of healthy PF. Conclusions: The longer the screen time the unhealthier dietary habits and lifestyle profile among schoolchildren, after adjusting for several covariates.

Objectives: The availability of information on healthy products does not ensure the empowerment of people with the knowledge on how to choose or avoid food products or dishes depending on unhealthy factors. Public knowledge and beliefs of unhealthy food effects on health needs to be evaluated so that appropriate measures can be taken to properly inform people and relevant socio-demographic groups. Methods: The original survey questionnaire containing questions about specific food groups and various health effects was compiled. A total of 1,007 respondents, Lithuanian residents aged 18-75 years, were surveyed in March 2019. Multilevel stratified probability sampling method was used for data representativeness. Results: Almost half of respondents (46.2%) knew that deep-fried food could cause cancer. The majority of respondents (68.4%) were aware that sugar causes obesity and 61.7% were aware that sugar increases the risk of diabetes mellitus; 41.6% (more often those living in non-rural areas) know that grilled meat may cause cancer. More than half of respondents (57.2%) (more likely those living in non-rural areas and those with a university degree) were aware that smoked meat products may cause cancer. Only 46.4% were aware of the fact that salt raises blood pressure and the risk of cardiovascular diseases. Conclusion: Only about half of Lithuanian residents aged 18-75 were aware of the scientifically proven harmful effects of unhealthy food groups. Socio-demographic factors influence the knowledge and beliefs of the population.

Objectives: This paper explores education-, income- and occupational class-related inequalities in risky health behaviours including into models all three factors together as well as their interactions, which has not been undertaken by previous studies analysing socioeconomic status (SES) related differences in risky health behaviours. Methods: Our data source is the special module "Social Inequalities in Health" included into the European Social Survey Round 7 (ESS R7) and conducted in 20 European countries. We run nine separate multilevel binomial logistic regression analyses for all the risky health behaviours with all our independent and control variables including country as the second level random intercept. Into all the models we also included interaction terms to consider possible moderating effects of separate independent variables. Results: Education and income emerged as factors most consistently related to risky health behaviours, but occupational class differences were also found to be significant: eating vegetables or salad less than once a day and being daily smoker is positively related to lower SES as measured by all three indicators; eating fruits less than once a day is related to lower income and occupational class, while drinking alcohol at least several times a week is positively related to higher education and higher income; being physically active for less than 3 days per week is positively related to lower education; patterns of heavy smoking and binge drinking are inconsistently related to SES variables. We also found considerable regional variation, especially in fruit and vegetable consumption, being physically active and alcohol consumption patterns. Conclusions: Without careful theoretical consideration linking SES and risky health behaviours, education, income and occupational class cannot substitute each other in the study of SES-related differences of health behaviours, as assumed in the larger part of research on the subject.

Growth references are important for paediatric health monitoring. It is critical to understand differences in growth interpretation and potential consequences when using available growth references. This study compares the growth of Czech breastfed children with the current WHO growth standards 2006 and the Czech references 1991, 2001. A total of 960 infant/parent pairs in the Czech Republic were recruited through paediatric practices. Anthropometric data were collected during infants' first 12 months of life and parent questionnaires were gathered during a preventive visit at 18 months. Czech breastfed infants were longer with a greater head circumference at all percentiles compared to the WHO standards and were similar to the national references. The percentile weight-for-age and weight-for-length values of infants (≤6 months) were lower, and higher (6-12 months) compared to the WHO standards. The infant growth in the sample differed from both the WHO standards as well as the national references. Our findings indicate that the growth of Czech breastfed children differs from the current national references. These discrepancies were smaller compared to the WHO standards. The results of the study were used for new growth assessment guidelines to optimize feeding recommendations for Czech infants. The adoption of the WHO standards in the Czech Republic is not recommended.

Objectives: The aim of this paper is to present the Child Safety Reference Frameworks (CSRF), a policy advice tool that places evidence-based child safety interventions, applicable at the sub-national level, into a framework resembling the Haddon Matrix. Method: The CSRF is based on work done in previous EU funded projects, which we have adapted to the field of child safety. The CSRF were populated following a literature review. Results: Four CSRF were developed for four domains of child safety: road, water and home safety, and intentional injury prevention. Conclusion: The CSRF can be used as a reference, assessment and comparative tool by child safety practitioners and policy makers working at the sub-national level.

Objectives: The aim of this study was to verify the Effort-Reward Imbalance (ERI) model, which served as the basic concept of mapping workplace stress, on the sample of Czech professional caregivers. ERI model examines the relationship between the long-term subjectively perceived level of workers' effort and rewards and analyses the physical and psychosocial consequences of the (im)balance. Methods: The verification of ERI model in combination with well-being (and its psychosocial consequences) was conducted on a sample of Czech professionals caring for older people in 2014 (N = 265). The survey included 12 facilities providing health and social care services for older people. Facilities were chosen through purposive sampling and snowball technique. The sample was divided into the following subgroups: professionals working in residential or field services and medical or social workers. Results: Results showed that the majority (57%) of professional caregivers in both residential and field services suffered from imbalance caused by higher effort and lower rewards. Subgroup of medical workers in long-term care institutions formed the most demanded group with the highest imbalance between work effort and rewards (68%). This discrepancy was reflected in a reduction of their well-being. This effect was most evident by the medical workers in home care. Well-being within this group was more than five times lower compared to other groups with ERI imbalance. Also, a group of social workers in institutions came out as a high-risk group in this regard. Discussion: The level of imbalance differed among the defined groups. The data obtained verified the known facts about the adverse work situation of professionals in long-term care in the contemporary Czech environment. The outputs correspond to foreign studies and confirm the validity of ERI model on the sample of Czech professionals in the long-term care.