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Objectives: Instrumental work diagnostic examinations can be used for capability assessment in evaluating work suitability, job selection, complex and occupational rehabilitation, and career counselling. According to the literature, assessments performed with work simulators and the International Classification of Functioning, Disability and Health (ICF) are suitable for monitoring changes in functional capacity. We propose that instrumental work diagnostic measurements - specifically, measurements conducted on the ErgoScope work simulator - along with the ICF, can be effectively used for the objective assessment of functional capacity and tracking changes over time.
Methods: At the request of an insurance company, a targeted examination was performed using the ErgoScope work simulator to determine the extent of force exertion. The measurement plan, evaluation of results, and ICF coding were prepared based on a methodology developed in our previous research with qualified assessors.
Results: The measurement results were recorded in an examination report. The examined individual was able to complete all tasks. If there was a difference in exertion between the two hands, the right hand/arm was always weaker.
Conclusion: Based on our experience, determining ICF qualifiers requires not only measurement data but also precise, documented observations from the examiner. Our study suggests that the measurement results obtained from ErgoScope work simulator examinations, along with ICF categories assigned by qualified assessors, are suitable for tracking changes in functional capacity. This methodology supports medical professionals in insurance medicine and occupational health services in making objective, data-driven decisions.

Objectives: No research among Finnish universities grouped students into clusters, based on their lifestyle behavioural risk factors (BRFs), and appraised relationships of the clusters with self-reported burdens, adjusting for confounders. The aim of the study was to undertake this task. Methods: Students (N = 1,169) at Turku University completed online questionnaire comprising socio-demographic variables (age, sex, income, social support), 18 burdens, and 4 BRFs (smoking, alcohol, drug use, food habits). Factor analysis reduced burdens into factors; cluster analysis of BRFs categorized students into clusters. Regression models appraised associations between socio-demographics and clusters with burdens. Results: Mean age was 23 ± 5 years, with 70.4% females, 23.4% smokers, 28.8% problematic drinkers, 21.1% illicit drug/s users, and mean dietary guideline adherence 4.84 ± 1.57 (maximum score of 8 points). Factor analysis of burdens generated four factors: 'Studies' - 3 items; 'Future' - 3 items; 'Relationships' - 7 items; and 'Needs' - 5 items. Cluster analysis produced four BRFs clusters with significantly different BRFs and socio-demographics. Cluster 1 exhibited less risk-taking behaviours, cluster 4 comprised more risk-taking, and the other two clusters fell in between. Regression showed that females were more likely to report all four burdens; higher social support was associated with less burdens generally; older age was associated with less 'Studies' + 'Future' + 'Relationships' burdens; and sufficient income was associated with less 'Studies' + 'Future' burdens. Compared to cluster 1, cluster 3 and 4 membership was more likely to feel 'Needs' burdens; cluster 2 and 3 was more likely to report 'Relationships' burdens (p-range: < 0.05 to < 0.001 for all).
Conclusion: Controlling for socio-demographics, cluster membership was more influenced by students' perceptions of 'Relationships' + 'Needs', rather than academic difficulties of 'Studies' or unsecure 'Future'. Risk taking was more likely with relationship difficulties, isolation, and day-to-day problems (housing, financial situation, health) rather than academic load or concerns for future prospects. Preventive and intervention efforts tackling students' lifestyle behaviours need to consider programmes aimed at better relationship building/maintenance to prevent isolation, while mitigating 'on-the-ground' everyday challenges that students face.

Objectives: Regular monitoring of health-related behaviours among vulnerable populations is of public health importance. This study examines recent trends in adolescent cigarette smoking in Czechia following the marked changes reported in the mid-2010s. Methods: Data from three recent rounds of the Health Behaviour in School-aged Children (HBSC) study conducted in Czechia in 2014, 2018 and 2022 were analysed. Temporal trends were assessed for two indicators of adolescent cigarette use: lifetime cigarette use and cigarette use in the last 30 days. Survey-adjusted binary logistic regression models were used to test changes between survey periods. In 2022, the prevalence of electronic cigarette use was additionally estimated using the same indicators. Results: A continued decline in adolescent cigarette use was observed for both indicators, extending the downward trends reported in the mid-2010s into the 2020s. The decline was most pronounced between 2014 and 2018, with smaller but persistent decreases thereafter, particularly among older adolescents. However, the findings also highlight the substantial prevalence of electronic cigarette use. In 2022, more than one-third of 15-year-olds in Czechia reported lifetime electronic cigarette use (35.1% among boys and 36.6% among girls), and approximately one in five reported use in the last 30 days (19.6% among boys and 23.0% among girls). Conclusions: While conventional cigarette use among adolescents continues to decline, electronic cigarette use represents an important component of contemporary adolescent smoking-related behaviour. In the long term, the phenomenon of electronic cigarettes may counteract intended trends in nicotine-related harms. These findings underscore the need for continued surveillance and prevention efforts in Czechia that address both conventional and emerging smoking-related products.

Objectives: The aim of the study was to determine the incidence of COVID-19 infection among healthcare workers (HCWs) at Reina Sofia University Hospital (RSUH) in Cordoba, Spain, from the first to the sixth wave of the pandemic. Additionally, we analysed the characteristics of infections across different age groups, genders, professional categories, hospital services, and COVID-19 vaccination status. Methods: An observational, longitudinal, analytical, and retrospective study was conducted, considering characteristics of person, time, HCWs category, and diagnostic test. The results of the tests of RSUH HCWs between March 2020 and March 2022 were analysed. Socio-demographic and clinical data were collected from the Alert Network of the Epidemiological Surveillance System of Andalusia. Results: The study included 6,794 HCWs, of whom 1,513 (22.3%) tested positive for COVID-19. The distribution of COVID-19 cases among HCWs across the six waves was as follows: first wave – 150 cases (9.9%), second wave – 597 cases (39.4%), third wave – 225 cases (14.9%), fourth wave – 24 cases (1.6%), fifth wave – 121 cases (8%), and sixth wave – 396 cases (26.2%). The mean age of confirmed cases was 46.32 years (SD = 11.53), with a lower infection risk among HCWs aged 61–70 years. Only 16.9% of cases had received two vaccine doses at the time of infection. Nursing was the most affected professional category (30%). Conclusions: COVID-19 infection risk varies by age and HCWs category, decreasing in older HCWs but increasing among residents and certain specialties. During the Omicron variant's dominance, vaccines seemed less effective in reducing transmission. Health education programmes for both patients and HCWs are necessary to limit the spread of the disease.

Objective: This study aimed to examine long-term trends in Czech adolescents' perceptions of school climate between 1994 and 2022, focusing on school satisfaction, perceived school pressure, and perceived social support from classmates and teachers. Methods: Data were drawn from eight cycles of the Czech Health Behaviour in School-aged Children (HBSC) study, encompassing responses from 63,252 students aged 11, 13 and 15 years. Binary logistic regression analyses were conducted to assess temporal trends and associations between school climate indicators and demographic variables, including gender, age, and family affluence. Results: Compared to 2022, students were significantly more likely to report liking school a lot in 2010 (OR = 2.14, 95% CI: 1.94-2.36) and 2014 (OR = 1.64, 95% CI: 1.52-1.76). Reports of school dissatisfaction were lowest in 2010 (OR = 0.53, 95% CI: 0.49-0.57) and 2014 (OR = 0.60, 95% CI: 0.57-0.63) relative to 2022. Perceived school pressure was highest in 2022, while in 2002 the odds of feeling pressure were less than half as likely (OR = 0.44, 95% CI: 0.41-0.47). Classmate support peaked in 2010 (OR = 2.04, 95% CI: 1.90-2.18) vs. 2022, and teacher support was highest in 2018 (OR = 1.32, 95% CI: 1.26-1.39). Girls and older students consistently reported greater school pressure and lower levels of support, while those from more affluent families reported more favourable perceptions of school climate. Conclusions: Czech adolescents' school climate perceptions have deteriorated over the past three decades, marked by rising demands and weakening support at school. These trends may contribute to reduced school engagement and heightened psychological distress, emphasizing the need for systemic interventions that ensure that high school expectations are coupled with relational and emotional support in schools.

Objectives: Planetary-health literacy (PHL), the knowledge, motivation and social support required to safeguard both human and environmental health, may help adolescents cope with climate-related distress and adopt sustainable behaviours. Evidence on the linkage between PHL and mental health from Central and Eastern Europe is lacking. The aim of the study was to describe PHL in Czech adolescents by sex, grade and family affluence, examine its association with mental-health indicators, and explore links with selected environment-relevant behaviours. Methods: Cross-sectional data were drawn from the nationally representative Health Behaviour in School-aged Children (HBSC) 2022 survey (n = 4,195, 50.8% boys, ages 13 and 15 years). PHL was measured with an 11-item HBSC optional package yielding three sub-scales (knowledge, action, perceived pro-environmental social norms). Outcomes were wellbeing (WHO-5), life satisfaction (Cantril's ladder), and psychological complaints (HBSC symptom checklist). Fruit and vegetable intake plus cigarette and e-cigarette use served as behavioural correlates. Results: Girls scored higher than boys on all PHL domains (Cohen d = 0.10-0.19). Thirteen-year-olds reported more action and stronger social norms than fifteen-year-olds (p < 0.001); socioeconomic gradients were small. In fully adjusted models, social norms were positively associated with wellbeing (β = 1.42, 95% CI: 1.12-1.72) and life satisfaction (β = 0.10, 0.08-0.13), and inversely with psychological complaints (β = -0.27, -0.33 to -0.21). Knowledge showed weak adverse relations with wellbeing and complaints, whereas action was associated with wellbeing only. Higher PHL related to daily fruit and vegetable consumption and inversely to intensive e-cigarette use; effect sizes were modest. Conclusions: Perceived pro-environmental social norms appear most tightly related to adolescent mental health, while overall PHL is slightly associated with sustainable dietary patterns and lower use of e-cigarettes. School curricula that combine climate education with collaborative, action-oriented projects may therefore deliver co-benefits for planetary and psychological health in Central and Eastern Europe.

Objectives: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected hundreds of millions of individuals globally. Vaccination has become a promptly effective preventive procedure. People living with HIV (PLHIV) are in increased risk of many infections including COVID-19. We aimed to analyse the first phase of vaccination (January 2021–June 2022) in the Czech Republic in PLHIV focusing on vaccination coverage, vaccine hesitancy and breakthrough infections. Methods: In this single-centre, open-label, prospective study we have enrolled 1,758 PLHIV with median age of 42.5 years and median CD4+ T cells count (cluster of differentiation) 800/µL. Results: Vaccination coverage was 84.7% and first booster dose was received by 71.7% of those who completed vaccination. Only 78 individuals (4.4%) have actively rejected vaccination. The most frequent vaccination scheme (60.3%) was Comirnaty vaccine plus booster of the same vaccine. There was a significant difference between vaccinated and unvaccinated individuals in age, CD4+ count, CD4/CD8 ratio, virological suppression on antiretroviral therapy (ART) duration of HIV and level of education (p < 0.001). Prevalence of breakthrough infection was seen in 21.4%. There was no significant difference among individual vaccines (p = 0.715). Individuals with breakthrough infections were statistically younger (p = 0.001) with some risk factors in 25.1%. Conclusion: In this prospective study we have seen higher vaccination coverage against COVID-19 in PLHIV in the Czech Republic in comparison with the general Czech population. Hesitancy, resulting in rejection of vaccination, was lower in our cohort as regards affinity to the HIV clinic, and breakthrough infections were noticed and occurred particularly in younger age groups.

Objectives: This study aimed to identify factors contributing to the early diagnosis of HIV in Turkey, with a particular focus on high-risk populations, comorbid conditions, and temporal trends. It also evaluated whether initial clinical findings could inform the expansion of screening strategies. Methods: A retrospective analysis was conducted on 1,703 individuals living with human immunodeficiency virus (HIV) who attended our clinic between 2004 and 2023. Patients were grouped into five-year intervals and assessed based on demographic characteristics, reasons for testing, and reported comorbidities. Results: Among the participants, 90.3% were males, with a mean age of 36.6 years. Of those who disclosed their sexual orientation, 46.8% identified as heterosexual. Common comorbidities included anal region disorders, cardiovascular and pulmonary diseases, diabetes, and syphilis. HBsAg positivity was 5%, and anti-HCV positivity was 0.86%. Nearly half of the patients (48.6%) were asymptomatic at the time of diagnosis. Physician-initiated testing and routine screenings played a significant role in early detection. Conclusion: Early diagnosis of HIV is essential for reducing transmission and improving patient outcomes. Screening programmes should be expanded to include not only high-risk groups but also sexually active individuals presenting with relevant clinical symptoms. Public health efforts must address stigma and improve access to HIV testing to optimize early detection and treatment.

Objectives: The aim of the study was to assess potential health risks associated with a large-scale environmental release of benzene following a railway accident in Moravia, Czech Republic, in 2025, with emphasis on differences between population and occupational exposure. Methods: An assessment of potential health risks associated with exposure was performed using available environmental monitoring data. Conservative exposure scenarios were defined for the general population and for remediation workers. Non-carcinogenic risk was expressed as the hazard quotient (HQ), and carcinogenic risk as excess lifetime cancer risk (ELCR). Results: Short-term peaks in ambient air benzene concentrations were observed in the period immediately following the accident and during remediation activities, with occasional hourly values reaching the order of tens of µg.m^-3. During the accident and its immediate aftermath, benzene concentrations at the accident site ranged from < LOQ-32.3 mg.m^-3 (LOQ – limit of quantification) in soil gas (March–April 2025), 0.0004-2.43 g.l^-1 in groundwater (March–May 2025), < LOQ-19.9 µg.l^-1 in surface water (March–June 2025), and < LOQ-849.7 mg.kg^-1 in soils (March–April 2025). Extreme values were confined to the immediate accident zone and represented the dominant exposure for workers rather than residents. For the general population, HQ values remained below 1 and ELCR ranged from 10^-6 to 10^-5. In contrast, remediation workers exhibited substantially higher risks, with HQ values reaching 10⁴-10⁵ and ELCR up to 10^-3, particularly for inhalation exposure. Conclusion: While population exposure remained within acceptable limits, occupational exposure during remediation represented the dominant health risk. Two workers involved in remediation activities were excluded from further work based on the results of biological monitoring of benzene exposure. The results highlight the need for strict exposure control and health surveillance of exposed workers.

Objectives: This paper deals with the characterization of outdoor swimming pool waters to study the occurrence of trihalomethanes (THMs) and to assess the health risk of THMs exposure for three population groups (male, female, and children). The concentration of total THMs and individual species (chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform) were monitored during the seven months of 2022 in outdoor swimming pools in the coastal area of Montenegro. Methods: A total of 73 water samples from outdoor swimming pools were collected and tested for the content of THMs using an Agilent 7890 A GC. Carcinogenic and non-carcinogenic health risks of total THMs and each species were assessed through lifetime cancer risk (CR) and hazard index (HI), respectively. Health risk assessment was assessed through the oral and dermal exposure pathways. Results: The concentration of total THMs in investigated water samples ranged between 0.19 and 237.18 μg/L when 26% of tested water samples had values above the maximal permitted value (100 μg/L) established by Montenegrin legislation. Chloroform concentration was in a range of 1.13-217.16 μg/L, while contents of BDCM and DBCM were in a range of 1.01-29.43 μg/L and 0.18-16.19 μg/L, respectively. Calculated values of dermal CR were higher than 10^-6, thus CR values of total THMs exposure were higher than 10^-6 for all population groups. On the other hand, CR via ingestion values were meagre, HI values of total THMs exposure for three population groups were calculated to be below 1. Conclusion: There is no non-carcinogenic risk for the children population while male and female populations were faced with non-carcinogenic health risk of total THMs exposure. On the other hand, all investigated population groups were faced with unacceptable cancer health risks and dermal contact was recognized as the main exposure route for all investigated populations.

Objectives: The objective of the present study was to explore whether gender differences exist in waist-to-height ratio (WtHR) values and to assess the correlation between WtHR and other obesity indicators after categorising older adults of Bosnian descent based on the presence or absence of abdominal obesity. Methods: The study included 151 inhabitants of the Geriatric Centre in Sarajevo, Bosnia and Herzegovina, aged 65 years and older (66 males and 85 females). Anthropometric indices and blood pressure values were measured by standard methods. WtHR was calculated using the following formula: waist circumference (WC) (cm)/height (cm). Differences between compared groups were analysed using the Student's t-test, Mann-Whitney U test or chi-square test. Correlations were assessed by Spearman's or Pearson's test. Results: Females had significantly higher WtHR values compared to males. Significant positive correlation was determined between WtHR and body mass index (BMI), WC, hip circumference (HC), neck circumference (NC), mid-upper arm circumference (MUAC), calf circumference (CC), and the weight-adjusted waist index (WWI) in both male and female elderly individuals. In elderly participants with abdominal obesity, there was a statistically significant positive correlation between WtHR and all of the tested anthropometric indices. Amongst elderly participants without abdominal obesity, a statistically significant positive correlation was observed between WtHR and BMI, WC, MUAC, and the WWI. However, no statistically significant correlations were observed between WtHR and HC, NC or CC in elderly participants without abdominal obesity. Conclusions: The results of this study imply that WtHR is a valid parameter for assessing abdominal obesity in elderly individuals. The observed WtHR values indicate that women are at greater health risk than men. Given the high prevalence of sarcopenic obesity in older adults and the demonstrated limitations of BMI, we propose that WtHR should be incorporated into routine clinical practice for obesity assessment in this age group.

Objectives: With increasing life expectancy, the prevalence of atherosclerosis and dementia is expected to rise in the future and as such represents a public health threat. This study focused on analysis of atherosclerosis risk factors and the protective factors of leisure-time activities in the development of dementia. Methods: The sample comprised 1,298 participants that were selected from university hospitals and outpatient clinics between 2019-2023. All participants completed a questionnaire and medical data were obtained. We used logistic regression to identify dementia risk factors and we also compared the leisure-time protective factors between four groups based on the presence of atherosclerosis and/or dementia. Results: Hypercholesterolemia (aOR = 3.25, p > 0.001), stroke (aOR = 1.43, p = 0.015), and carotid stenosis (aOR = 2.23, p > 0.001) were significantly associated with risk of dementia whereas age (aOR = 0.93, p < 0.001) and female gender (aOR = 0.70, p = 0.012) were negatively associated. The model of these factors demonstrated moderate discriminatory ability of AUC 0.737 (95% CI: 0.702-0.769). Higher education levels and regular cognitive and physical activities such as reading and exercise had positive effects against dementia. Conclusion: These findings accentuate the importance of cardiovascular health in reducing risk of dementia. Preventive strategies targeting hypercholesterolemia, carotid stenosis and inactivity, along with promotion of cognitive engagement and education, could substantially reduce the global burden of dementia.

Objectives: Clusters of human prion diseases have been reported in several endemic regions, notably in Slovakia, Italy, Chile, and Israel, predominantly linked to genetic forms (E200K mutation). Isolated temporo-spatial clusters that include sporadic forms are rarely documented and remain poorly understood. This report describes a unique cluster of prionopathies observed in northern central Slovakia. Methods: Between July 2021 and March 2022, three definitive cases of prion disease were identified in two neighbouring rural villages, Pribovce and Rakovo, in the Martin District of Slovakia. The villages, located within a radius of approximately three kilometres, have a combined population of 1,468. Clinical records, epidemiological data, and neuropathological findings were reviewed in all cases. Results: The cluster included one genetic Creutzfeldt-Jakob disease (gCJD) with the PRNP E200K mutation and M/M genotype at codon 129; one sporadic CJD (sCJD); and one sporadic fatal familial insomnia (sFFI), the first such case reported in Slovakia. The cases occurred sequentially within a ten-month interval. No familial, environmental, or iatrogenic links were identified. Conclusions: The coexistence of distinct prionopathies in such a confined population and period is exceptional. Despite comprehensive investigation, no explanatory factor was found, and this cluster likely represents a chance occurrence of epidemiological interest. The finding underscores the importance of systematic neuropathological confirmation, molecular testing, and regional surveillance in prion disease monitoring.

Objectives: Limited evidence exists on how working-age adults perceive the impact of ischaemic stroke (IS) during the first months post-event, and longitudinal data on health-related quality of life (HRQoL) are scarce. The aim of the study was to examine 12-month changes in HRQoL, functional outcomes, cognitive function, and psychosocial sequelae in working-age adults after IS, and to explore age-related differences (< 50 vs. ≥ 50 years). Methods: In this prospective cohort study, 220 patients aged 18-65 years with first-ever IS were assessed before hospital discharge, 3-, 6-, and 12-month post-discharge. Measures included the Stroke Impact Scale (SIS 3.0), Neuro-QoL, Fatigue Severity Scale (FSS), Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Brief Pain Inventory, and Multidimensional Scale of Perceived Social Support (MSPSS). Longitudinal changes were analysed using the Wilcoxon signed-rank, Bowker's test, and the Mann-Whitney U test with Bonferroni correction. Results: Significant improvements in HRQoL, cognitive function, and psychosocial outcomes occurred mainly within the first three months. FSS scores indicated clinically relevant fatigue. SIS domains - strength, emotion, communication, activities of daily living (ADL), mobility, hand function, and social participation - improved, while memory remained unchanged. Neuro-QoL T-scores increased for satisfaction with social roles, positive affect, and physical function. Changes after three months were generally not statistically significant. Post-stroke pain and perceived social support remained stable. Age subgroup analysis revealed no significant differences. Conclusion: Recovery in HRQoL, cognitive function, and psychosocial outcomes typically occurs within the first three months post-IS, with a subsequent plateau. Younger and older working-age adults exhibit similar trajectories, underscoring the importance of early comprehensive rehabilitation interventions adapted to the patient's condition and deficit.

Objectives: The impact of air pollution on gastrointestinal diseases remains unclear. This study examines the association between air pollutants and paediatric intussusception incidence. Methods: Using data from the Health Insurance Review and Assessment Service (HIRA), we analysed daily intussusception cases in Seoul (2009-2019). Air pollutants, including particulate matter (PM₁₀), ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO), and sulphur dioxide (SO₂), were assessed alongside temperature. A generalized linear model with a negative binomial link function evaluated the relationship between each pollutant and intussusception incidence, adjusting for long-term trends and seasonality. A distributed lag non-linear model (DLNM) examined non-linear cumulative lag effects. Results: In the model without lag and non-linear effects, NO₂ was significantly associated with intussusception incidence, while other pollutants and temperature showed no significant associations. DLNM analysis with a 3-day cumulative lag demonstrated a gradual increase in intussusception incidence with rising NO₂ levels, with significant rate ratio changes at lag 0 and lag 1 but not at lag 2 or lag 3. Extending the cumulative lag to 2, 4 and 5 days showed progressively decreasing significant intervals. Conclusion: These findings suggest a potential link between NO₂ exposure and paediatric intussusception. Further studies are needed to clarify underlying mechanisms.

Objectives: The study aimed to analyse trends in pathogen occurrence and antimicrobial resistance patterns in two long-term care (LTC) units operating within a Polish district hospital from 2017 to 2023, with a particular focus on changes across the COVID-19 pandemic. Methods: A retrospective observational study was conducted using epidemiological and microbiological data from two LTC units (nursing home and inpatient hospice) in Poland. Isolation rates (per 1,000 patient-days) for ESKAPE pathogens and Clostridioides difficile were analysed. The pre-pandemic period (2017-2019) was compared with the pandemic/post-pandemic period (2020-2023) using rate ratios (RR). Trends in the proportion of resistant isolates among the dominant Gram-negative bacteria (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii) were evaluated based on phenotypic surveillance criteria. Results: The inpatient hospice and nursing home exhibited different epidemiological profiles. In the hospice, ESKAPE pathogen isolation rates decreased significantly after 2020 (RR = 0.55, 95% CI: 0.37-0.81), whereas the detection rate of C. difficile quadrupled (RR = 4.39, 95% CI: 1.51-12.75). Isolation rates remained low and stable in the nursing home. Across both units, the proportion of antimicrobial-resistant isolates increased sharply during the pandemic period. Notably, in selected pandemic and post-pandemic years, all analysed E. coli and K. pneumoniae isolates exhibited the ESBL phenotype, while all analysed A. baumannii isolates were carbapenem-resistant. Conclusions: The COVID-19 pandemic was associated with substantial changes in pathogen occurrence patterns in long-term care units and with increased antimicrobial resistance among key Gram-negative pathogens. The emergence of resistant phenotypes among clinically important Gram-negative pathogens, including ESBL-producing Enterobacterales and carbapenem-resistant A. baumannii isolates, poses a significant public health concern. These findings highlight the need for strengthened microbiological surveillance, antimicrobial stewardship, and infection prevention and control measures tailored to the specific care profiles of hospices and nursing homes.

Objectives: This study aimed to systematically analyse original research publications to provide a comprehensive assessment of the transmission chain of healthcare-associated infections (HAIs). The review focused on identifying transmission routes, sources of pathogen detection, and the predominant microorganisms detected in healthcare environments. Methods: A systematic review was performed following PRISMA methodology. Relevant studies were searched in PubMed and Scopus databases using predefined keywords. Results: Forty-four original studies published in English between January 2015 and July 2025 were included. Indirect transmission was reported in 37 (84.1%) studies, while 27 (61.4%) studies identified it as the sole transmission route. Fomites were reported as the sole source of pathogen detection in 30 (68.2%) studies. Among studies investigating fomites or environmental contamination, stethoscopes were the leading contaminated item (n = 5, 13.5%). Among detected microorganisms, Gram-negative bacilli (n = 94, 51.1%) and Gram-positive cocci (n = 76, 41.3%) prevailed. The dominant bacterial genus was Staphylococcus spp. (n = 55, 29.9%), whereas Staphylococcus aureus represented the leading species (n = 25, 13.6%), followed by Klebsiella pneumoniae (n = 12, 6.5%) and Escherichia coli (n = 11, 6.0%). Multidrug-resistant strains, including methicillin-resistant Staphylococcus aureus (n = 11, 6.0%) were also observed. Conclusion: Indirect transmission through contaminated fomites represented the predominant transmission pathway, including medical devices such as stethoscopes. Staphylococcus aureus was among the most frequently detected microorganisms, while multidrug-resistant organisms were also reported. These findings emphasize the importance of infection prevention and control measures in healthcare settings.

Objective: Preventable medical errors are recognized as an important public health problem. The aim of this study was to evaluate the awareness of adults in the community about patient safety, medical errors and patient participation; and to determine their experiences of medical errors. Methods: Adults older than 18 years living in the Konya city centre in Türkiye were included in the study. The implementation of the questionnaire took approximately two months, and a total of 780 valid questionnaires were obtained. Participants were asked questions about their views and attitudes towards medical errors. In addition, participants' engagement in behaviours recommended by the Agency for Healthcare Research and Quality (AHRQ) to prevent medical errors was evaluated using a 4-point Likert scale. Results: Twenty-six percent of the participants stated that they or one of their family members had suffered a medical error. Those who were exposed to the error (n = 201) mostly experienced physical problems (44.3%). Other reported consequences included psychological problems (19.4%), disability (10.9%), loss of employment (5.5%), and death (2.5%). When the answers given to the questions about exposure to medical error and "whether the patients are responsible for preventing the errors" were compared with the socio-demographic characteristics, a statistically significant difference was found between age, education status, socioeconomic status, and experiencing with medical error (p < 0.05). Conclusion: A significant part of the participants were harmed while receiving healthcare services. In addition, their awareness of protecting themselves from this harm was low. The findings of this study can guide healthcare professionals for patient safety training for patients.

Objectives: In Ukraine, accurate HIV mortality data are lacking due to limited information on HIV-related deaths. This study focuses on Kyiv to track HIV-related deaths among undiagnosed individuals living with HIV and evaluate HIV programming for cause-of-death identification. Methods: Five mortuaries in Kyiv were selected to participate (July–December 2021) with cadavers from people aged 18+ years. HIV status was determined through serology; patient files were examined for prior diagnosis and treatment. Bivariate analyses were conducted to assess HIV status and select characteristics and chi-square or Fisher's exact tests were used, as appropriate, to assess statistical significance. Multivariable logistic regression explored correlates of HIV. Results: Of 1,513 cadavers, 39 (2.6%) tested positive for HIV, among whom, 31 (79.5%) had documentation of an HIV-positive status before death. Overall, medical records for 94% of all 1,513 cadavers did not contain information about HIV status at the time of death. Conclusions: HIV testing in cadavers can be used to understand burden of HIV disease; data from clinical record from the deceased can be used to assess morbidity and mortality associated with HIV.

Objectives: The main objective of the study was to adapt and verify the psychometric properties of the Illinois Bully Scale (IBS) in Czech adolescents. Methods: The analysis utilized quantitative data from 1,321 respondents, aged 12 to 14 years, who were enrolled in 7th grade of lower secondary or grammar school. Descriptive and inferential statistics, including chi-square tests and Mann-Whitney U tests, were used to examine group differences. Results: The IBS demonstrated strong internal consistency and construct validity across all subscales (Victim: 0.84, Bully: 0.80, Fight: 0.79, total IBS: 0.87). Boys and elementary school students reported significant victim and bully experiences. The supplemental cyberbullying scale showed significant correlations with the IBS subscales, supporting its criterion-related validity. Conclusions: Adaptation of the IBS confirmed that it is a useful tool for assessing the frequency and experience of different types and severity of bullying. Its Czech adaptation allows for population screening as well as identification of severe cases and planning of interventions.

Objectives: This study assessed perceptions of health and science students and academic staff regarding the health risks, environmental impact, and regulation of dental amalgam (DA). As DA faces increasing restrictions, understanding the views of students and academic staff is essential for evaluating educational and policy readiness. Methods: A cross-sectional survey was distributed to 1,230 participants in the Czech Republic. The questionnaire explored awareness of mercury exposure from DA, health and environmental concerns, and familiarity with regulations. Responses were statistically compared across disciplines. Results: Overall, 35.8% of respondents did not recognize DA as a mercury source, and 48.5% did not view it as a health risk. Most did not consider DA an occupational hazard for dental professionals. However, 55.3% saw it as an environmental pollutant. While 59.2% supported restricting DA use in pregnant women and 51.0% in children, only 22.0% supported a complete ban. Most respondents preferred composites for aesthetic reasons (88.5%) rather than health concerns. Dental students differed significantly from other groups in several key areas, particularly regarding perceived health risks and support for restrictions on dental amalgam use. Conclusions: Perceptions of dental amalgam differed according to educational background. While most participants supported restricting its use in vulnerable populations, dental students were less likely to perceive it as a significant health risk and were less supportive of a complete ban. These findings highlight the importance of evidence-based education and public health communication regarding dental amalgam and mercury-related issues.

Objectives: The aim of the study was to determine the probable places of coronavirus transmission in association with the work. Methods: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period March-December 2020. Results: 732,202 COVID-19 cases were officially confirmed, from them 64,587 (9%) represented work-related disease, 184,384 cases (25%) work-related contact, and 483,231 cases (66%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (42,072 cases), in descending order nurse, paramedic, teacher, machinist, clerk, social worker, physician, worker/agency worker, craftsman, policeman, manager, food worker, and miner; 150 cases of COVID-19 were recognized as an occupational disease in 2020, from them 148 cases in the health and social care economic activity sector. Conclusion: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which at least one third are related to work, so different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control.

Objectives: The ELITE study (German acronym for "Nutrition, lifestyle and individual information for prevention of heart attack, stroke and dementia") prospectively collects data on hypertension, cardiovascular risk factors (RF), dietary habits, physical activity, cognitive function, and quality of life in North-West Germany, which will then be improved through targeted individual information. The aim of the study is to improve the health of the participants in the long term and to identify reasons for a lack of implementation of prevention measures. Methods: Of 4,602 included subjects, 3,868 could be studied so far at one-year follow-up. Blood pressure (BP) was measured according to the guidelines at admission and blood pressure history, premedication, sports behaviour and BMI were recorded by means of questionnaires and compared with the data collected in the follow-up examination after one year. Results: The participants were evaluated in 4 groups (G): G1 - normotensive patients (n = 1,558), G2 - controlled hypertensive patients (n = 502), G3 - untreated uncontrolled hypertensive patients (n = 1,080), G4 - treated uncontrolled hypertensive patients (n = 728). In G1 blood pressure (RR) remained unchanged from 126.3/77.8 to 127.8/78.5, in G2 there was a significant (p < 0.001) RR increase from 128.1/77.0 to 134.9/79.8. In G3 and G4 RR decreased significantly (p < 0.001) from 149.9/90.0 to 143.5/86.9 and from 153.1/87.5 to 146.2 84.1 mmHg, respectively. In G3 and G4, RR decreased in 56.1% and 56.3% of subjects and increased in 18% and 21%, respectively. In contrast, RR increase was found more frequently in G1 and G2 (34.3% and 51%, respectively), and RR decrease less frequently (25.4 and 20.7%, respectively). The main reasons for RR decrease were weight loss, more exercise, and more antihypertensives. Frequently, improved compliance and dietary changes were given as reasons. As expected, the opposite often led to RR increase. Conclusion: 56% of the hypertensive participants succeeded in lowering their blood pressure, whereas there was a significant increase in blood pressure, especially in those who were well controlled with antihypertensives. This underlines the need to further motivate normotensive patients to maintain their normotension. The results show that the combination of individual written education and lifestyle interventions are an effective tool for the public health sector to combat hypertension. In our participants, lifestyle interventions have a significant impact on BP change. It should be noted critically that there are still too many patients who have not been reached.

Objectives: Since 2009 the number of unvaccinated children in Poland has been regularly increasing. The purpose of the study was to learn what parents who decide to vaccinate their children feel and believe about their children's vaccines and in particular to find out how these sentiments and beliefs affect their attitude and decision-making with reference to vaccinations. Methods: The interviews were conducted during an immunization visit of parents whose children are covered by immunization schedule; 53 parents aged 23 to 48 years took part in the study. Most study participants were high school or university graduates living in rural areas. Children were 1 week to 5 years old. Thematic analysis was used to analyse interview data. Results: Identified factors shaping the parents' positive attitude to vaccination included conviction of necessity of vaccines (effective disease prevention, safety, favourable benefit-to-risk ratio, and concerns about the child). The general anti-vaccination belief was that vaccines are unnecessary. External factors, mainly authority figures and media broadcasts, affect parents' beliefs and decisions. Conclusions: Various factors affect parents' decision concerning immunization of their children. Both compulsory and recommended vaccines should be provided free-of-charge. Choice overload should be reduced. Paediatricians should address parental vaccine hesitancy.

Objectives: Breast cancer is the leading cause of cancer mortality among women in Serbia and accounts for 22.8% of total cancer mortality in 2018. This study assessed the knowledge and barriers to early detection of breast cancer in women. Methods: In March 2019, at the Primary Healthcare Centre Kikinda, Serbia, a 22-item questionnaire was distributed to a series of patients (N = 403, response rate 91.8%) to assess the odds ratio (OR) and 95% confidence interval (CI) between variables explaining knowledge of breast cancer symptoms and risk factors and barriers to screening, and four types of early detection of breast cancer. Results: The majority of patients (85.4%) know that a lump in a breast is a common symptom of breast cancer and that a family history of breast cancer is a risk factor (80.1%); 63.8% of respondents aged ≥ 30 years self-examined their breasts in the past month, 39.1% of patients aged ≥ 40 years had clinical, while 34.4% had ultrasound breast examination in the past year, and 51.1% of patients aged ≥ 50 years had mammography once in the past two years. Patients aged ≥ 40 years retired and those with a positive family history were 84% and 63% less likely not to undergo a clinical breast examination in the past year. Participants over 40 years of age who reported a lack of funds were 2.46 times more likely to miss a clinical breast examination than those who did not have that barrier. Among participants aged 50-69 years, the likelihood of not receiving the mammography increases by 2.82 with an increase in wealth status and it was 65% lower for those who lack information about the available treatment. Conclusion: Women under the age of 50 rarely practice breast cancer screening. Study findings can be used to improve breast cancer screening at the primary level.

Objectives: Our survey aims to highlight parents' and healthcare workers' opinions and hesitations regarding children's vaccination, identify the main factors influencing these opinions, and assess the impact of hesitations on immunisation for children, included in the National Immunisation Programme in Lithuania. Methods: We used the questionnaire developed by the European Academy of Paediatrics Research in Ambulatory Settings Network (EAPRASnet). This questionnaire is designed to assess attitudes toward vaccination. The study involved parents raising children aged 1-4 years and primary healthcare providers (paediatricians, family doctors and nurses). Results: We analysed the completed questionnaires from a total of 329 parents (142 fathers, 187 mothers) and 386 medical personnel (150 physicians, 236 nurses). Most parents expressed positive opinions about vaccines (> 8 points out of 10 possible), with older parents exhibiting more favourable attitudes. Compared to mothers, fathers showed more criticism regarding the information provided by physicians (p = 0.04). Family doctors and paediatricians were more supportive of vaccination than nurses and homoeopaths (p < 0.001). Parents and healthcare providers with higher education showed statistically significantly stronger opinions about the benefits of vaccines than those with lower education levels (p = 0.01 for parents, p < 0.001 for physicians and nurses). The Internet was identified as the primary source of negative information for both parents (69.6%) and healthcare providers (86%). However, verbal information received from medical staff during patient consultations or informal conversations among colleagues had the greatest impact on parents' opinions (17.3%) and medical personnel (35.5%). Conclusions: Confidential conversations with physicians and nurses remain the most trustworthy sources of information and influential factors shaping opinions. The Internet serves as the primary source of inaccurate information about vaccinations for both parents and medical professionals, although verbal information from primary healthcare providers has a more significant impact on vaccination attitudes. Discrepancies in basic education and specific knowledge about vaccination within the same family can pose additional obstacles to child vaccination.

Objectives: The growing popularity of diets that restrict the consumption of animal-based foods is an important new challenge for the public healthcare system in Czechia. While the environmental and health-related benefits of plant-based diets are widely discussed in the media, people who follow these diets may lack professional support in terms of nutritional advice and even access to healthcare. The present study aims to map the nutritional practices and experiences with the healthcare system of people in Czechia who follow vegan diets. Methods: In a qualitative study we conducted semi-structured interviews with twenty-one self-reported adult vegans (14 women and 7 men; 18 with university education) who were on a vegan diet for at least a year. We were specifically interested in their motivation for why and how they became vegans; their everyday diet and eating routines; their use of health care and experiences with medical professionals; their nutritional knowledge and use of supplementation; and their perception of their health and embodiment. Results: The primary motivations for going vegan are ethical, environmental and health-related. Vegans see themselves and their diet as generally healthier, but for this to be true they must spend a considerable amount of time researching nutritional requirements and what dietary supplements they need. To this end, they tend to rely mainly on non-medical sources of information. Because of the lack of acceptance of veganism among primary-care physicians, vegans tend not to seek out medical advice or tell their doctor about their eating habits in order to avoid conflicts and negative experiences. Conclusions: We identified a perceived lack of accessible educational materials and potentially limited access to primary healthcare recommendations for people who eliminate the consumption of animal-based foods. These findings deserve further research and public health risk-mitigation strategies.

Objectives: This study aims to assess the frequency of smoking cessation and to identify the factors affecting smoking cessation success among individuals seeking assistance at a smoking cessation centre. Methods: This cross-sectional study included 1,570 individuals who applied to the smoking cessation centre in Izmir, Turkey, between 2009 and 2018, and completed three follow-ups. Data were obtained from the centre's records. Factors affecting smoking cessation success were analysed using logistic regression in multivariate analysis. Results: The median age to start smoking was 19 (17-22), and the median number of cigarettes consumed per day was 20 (20-30). Among the participants, 59.9% exhibited a high/very high level of nicotine dependence, and 79.6% had attempted to quit smoking previously. The median number of patient follow-ups was 7 (5-10). Of the patients, 34.0% successfully quit smoking for one year. According to the multivariate analysis results, smoking cessation success increased with being married by 2.26 times (95% CI: 1.51-3.38, p < 0.001), the absence of other smokers in the household by 1.38 times (95% CI: 1.01-1.88, p = 0.04), having a low level of nicotine dependence by 1.75 times (95% CI: 1.23-2.48, p = 0.002), and more patient follow-ups by 1.61 times (95% CI: 1.52-1.72, p < 0.001). Conclusions: Smoking cessation success is increased by the support and follow-up provided by healthcare professionals, the absence of other smokers in the household, and a low level of nicotine dependency.

Objective: The main objective is to confirm a hypothesis that atherosclerosis, through various mechanisms, considerably influences cognitive impairment and significantly increases the risk for developing dementia. Complete sample should be 920 individuals. The present study aimed to analyse epidemiological data from a questionnaire survey. Methods: The work was carried out in the form of an epidemiological case control study. Subjects are enrolled in the study based on results of the following examinations carried out in neurology departments and outpatient centres during the project NU20-09-00119 from 2020 to 2023. Respondents were divided into four research groups according to the results of clinical examination for the presence of atherosclerosis and dementia. The survey was mainly concerned with risk factors for both atherosclerosis and dementia. It contained questions on lifestyle factors, cardiovascular risk factors, leisure activities, and hobbies. Results: Analysis of the as yet incomplete sample of 877 subjects has yielded the following selected results: on average, 16% of subjects without dementia had primary education while the proportion was 45.2% in the group with both dementia and atherosclerosis. Subjects with dementia did mainly physical work. Low physical activity was more frequently noted in dementia groups (Group 2 - 54.4% and Group 3 - 47.2%) than in subjects without dementia (Group 1 - 19.6% and Group 4 - 25.8%). Coronary heart disease was more frequently reported by dementia patients (33.95%) than those without dementia (16.05%). Conclusion: Cognitively impaired individuals, in particular those with vascular cognitive impairment, have poorer quality of life and shorter survival. Risk factors contributing to such impairment are similar to those for ischaemic or haemorrhagic stroke. It may be concluded that most of the analysed risk factors play a role in the development of both atherosclerosis and dementia.

Objectives: The main objective of the questionnaire survey conducted by the National Institute of Public Health in Prague was to determine the level of knowledge and attitudes and to identify changes since the previous survey in 2015. A secondary objective was to gather more detailed information on how HIV/AIDS topics are taught in schools, as reported by school prevention coordinators. Methods: The questionnaire was distributed to 48 randomly selected educational institutions and the humanitarian organization MRIYA UA z.s. between October 2022 and January 2023. Data on 21 questions focusing on HIV/AIDS issues were collected anonymously from Czech and Ukrainian students. The survey included a representative sample of students from the 7th, 8th, and 9th grades in primary schools and multi-year grammar schools. Each institution received a questionnaire for the prevention coordinator, who answered 12 questions. Results: A total of 3,011 students completed the questionnaire. The average score for HIV/AIDS knowledge was 13.5 points out of a maximum of 22 points. Students' knowledge gradually increased with higher grades: students from multi-year grammar schools scored an average of 15.9 points, while primary school students scored an average of 13.2 points. Czech students scored an average of 13.6 points, whereas Ukrainian students scored an average of 12.4 points; the 1.2-point difference was statistically significant (p = 0.004). Compared to the 2015 survey, there was a slight overall decline in adolescents' knowledge levels. Students' attitudes towards people living with HIV/AIDS positively correlated with their knowledge about HIV/AIDS: the better their knowledge, the more favourable their attitudes toward people living with HIV/AIDS. Students' main sources of information about HIV/AIDS were school (37.1%) and the Internet (36.6%). According to school prevention coordinators, 95.7% of the surveyed schools address the topic of HIV/AIDS, most commonly in biology or health education classes, dedicating an average of 8.7 instructional hours to the subject. The most frequent teaching method is video lessons, used by 87.2% of the surveyed schools. Schools expressed a preference for improving the quality of education by utilizing presentations with professionally approved content, with 74.5% of schools supporting this option. Conclusions: The survey highlighted a gradual increase in HIV/AIDS knowledge with advancing school grades, a significant disparity in knowledge between Czech and Ukrainian students, and a slight overall decline in knowledge compared to 2015. The Internet and schools were the main information sources, though the role of schools declined significantly. It also underscored the need for enhanced educational programmes and continuous professional development for educators to improve health literacy and HIV/AIDS prevention among adolescents.