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

Objectives: The Cervical Cancer (CC) Screening Programme in Georgia provides insufficient coverage of the target population. The aim of the study is to identify the barriers to cervical cancer screening for women in Georgia in order to plan and implement adequate measures to increase the screening effectiveness. Methods: The study is based on the results of a survey of 582 women aged 25-60 years (mean age 42.11 + 12.17). Respondents were selected in out-patient clinics. The questionnaire included questions related to the place of residence, ethnicity, religion, marital status, education, employment, cervical cancer awareness and screening, screening participation practices, and barriers to participation. Results: The following factors reliably increase the chance of participating in the screening: residing in Tbilisi, OR = 1.84 (95% CI: 1.10-3.07); higher education, OR = 1.87 (95% CI: 1.09-3.19); being employed as a nurse, OR = 3.42 (95% CI: 1.49-7.85); receiving screening-related information from medical staff, OR = 2.43 (95% CI: 1.42-4.15); and from television, OR = 2.57 (95% CI: 1.47-4.50). The chance of participating in the screening is reduced due to incomplete secondary education, OR = 0.10 (95% CI: 0.01-0.77); single marital status, OR = 0.49 (95% CI: 0.28-0.87); employment in public service, OR = 0.39 (95% CI: 0.17-0.89); and receiving screening-related information from friends, OR = 0.26 (95% CI: 0.09-0.77). Women with higher education are undoubtedly more informed about screening, screening procedures and free programmes than those without higher education. The common barrier to participation in the screening was "fear of the manipulation-related pain" but the most frequent answer was "I'm afraid that the test will detect cancer (36.3%)." Women with a lower level of education are more likely to believe that "Pap testing is appropriate for the women who have active sexual life", and/or "have multiple sexual partners", and/or "have children," and "it is not necessary if a woman has no complaints". Conclusion: Screening participation among women in Georgia depends on screening availability, formal education and awareness of CC, sources of information, and employment type.

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.

Objectives: Patients suffering from rheumatoid arthritis (RA) are repeatedly affected by oral diseases or problems, including dental caries and periodontal diseases (PDs). Periodontitis and rheumatoid arthritis are chronic inflammatory destructive diseases that share many similarities. The objective of this study was to assess oral health status including examination of hard dental tissues and periodontium in patients with rheumatoid arthritis and compare the results with healthy controls. We hypothesize some interlink between oral diseases and RA. Methods: The epidemiological case-control study involved a total of 64 subjects divided into an experimental group (14 rheumatoid arthritis cases) and a control group (50 healthy individuals). Disease activity in the subjects with RA was assessed by the Disease Activity Score (DAS28). The number of Decayed, Missing and Filled Teeth (DMFT) and Community Periodontal Index of Treatment Need (CPITN) as a basic epidemiological oral health indexes were recorded. Finally, the data were analysed statistically. Results: The RA patients (19.21, SD = 6.95) showed a higher caries index level measured by DMFT than the control group (17.72, SD = 6.19); the difference was not statistically significant (U = 387.5, p = 0.547). In terms of a mean number of teeth decayed (p = 0.078), teeth filled due to caries (p = 0.397), and missing teeth (p = 0.126), the two groups were not significantly different. In terms of periodontal health, a significant difference was observed between the two groups concerning the CPI maximum score (p = 0.003). The RA patients showed higher prevalence of periodontitis than the controls. Conclusions: A complete basic oral examination, along with an oral health instruction including adequate oral and dental hygiene, is crucial to prevent dental caries and periodontal diseases and associated complications in RA patients, since they appear to be more vulnerable than the non-RA population.

Objectives: The aim of this study is to analyse Global Youth Tobacco Survey (GYTS) data on a prevalence of tobacco use, indicators of tobacco control and pro-tobacco activities in Czechia and Slovakia between 2002 and 2016. Methods: GYTS is a school-based survey of students aged 13-15 years carried out in Czechia and Slovakia in 2002/2003, 2007, 2011 and 2016. Standardized uniform questionnaires provided representative data. Results: Between 2002 and 2016 the current cigarette smoking declined both in Czechia and Slovakia (from 34.6% and 26.4% to 15.2% and 17.1%, respectively). Indicators of tobacco control activities either did not change (access to buy cigarettes by minors) or decreased (school-based and mass media interventions). Indicators of pro-tobacco activities declined (being ever offered by a free tobacco product and having something with a tobacco product brand logo on it). Conclusions: Tobacco use is on decline and the situation becomes similar to the most of European countries. Preventive activities are only partially responsible for the process. Rather effect of global trends accelerated by widespread use of social media can play a role.

Objectives: The study aimed to assess the attitudes of pregnant women toward vaccination against COVID-19. Methods: The research was conducted using a diagnostic survey with our original questionnaire among 283 pregnant women. The survey was carried out in Poland in the first quarter of 2022. Statistical analyses were performed using IBM SPSS 26.0 (p < 0.05). Results: It was shown that 140 (49.5%) pregnant women were vaccinated against COVID-19, of which 90 (64.3%) received vaccination during pregnancy. In the group of 143 (50%) unvaccinated people, only 11.9% of respondents expressed willingness to be vaccinated against COVID-19. The most frequently cited arguments for receiving the vaccine were fear of a severe course of the disease (37.5%) and the possibility of passing antibodies to a child (37.1%). Women who did not undergo vaccination believed that they did not want to put themselves and their babies at risk (39.9%) and were concerned about adverse post-vaccination reactions (35.2%) and the safety of the vaccine (32.5%). Women with higher education and professionally active (p = 0.004) were vaccinated more often than respondents with a lower level of education (p < 0.001). Age (p = 0.101) and place of residence (p = 0.179) did not indicate statistically significant differences in decision-making regarding vaccination against COVID-19. Conclusion: Pregnant women presented both pro- and anti-vaccination attitudes. Less than half of the respondents were vaccinated against COVID-19, and most of the women took the preparation during pregnancy. Selected socio-demographic factors determined women's attitudes toward vaccinations against COVID-19. Medical personnel should play a role in deciding whether a pregnant woman is vaccinated.

Objectives: The study aimed to investigate the use of electronic cigarettes (EC) among medical students, their knowledge and beliefs (opinion about harmfulness and addiction potential) on ECs, perceptions of the risk, as well as to assess the type of education and cessation training they received during their study at Faculty of Medicine, Comenius University in Bratislava, Slovakia. Methods: This cross-sectional, anonymous online e-mailed survey was conducted among medical students via the Study Department by sending e-mails containing the survey link. Participants completed the online questionnaire adapted from the American Survey on Tobacco and Alternative Tobacco Products. It included questions about the personal use of EC, perceptions about the harms and their role in disease causation, education and cessation training, and practices related to conventional cigarettes (CC), EC, and alternative tobacco products (ATP). The e-mailed questionnaire filled in 577 medical students (71.9% women) from Comenius University in Bratislava, the average age was 23 ± 2 years. The sample comprised 486 (84.2%) Slovak and 91 (15.8%) foreign students. The data were analysed using the Statistical Package for Social Science (SPSS) version 25. Results: There were 385 (66.7%) non-smokers, 111 (19.3%) ex-smokers and 81 (14%) current smokers in the study sample. EC currently use 13.5% of medical students, with a statistically significant intersexual difference (22.2% males vs. 10.12% females; OR = 2.53, 95% CI: 1.55-4.13), more foreign students than Slovak students (24.2% vs. 11.52%; OR = 2.44, 95% CI: 1.41-4.26), more smokers of conventional cigarettes than non-smokers (46.9% vs. 8.06%; OR = 10.07, 95% CI: 5.85-17.34). EC seems to be less harmful to 59.97% of students, mostly in the age group ≤ 24 (61.76% vs. 51.49%; OR = 1.46, 95% CI: 1.03-2.07), 41.25% of students consider EC to be less addictive, 55.6% think they do not get enough education on EC during their medical study. Conclusion: The results overall show the high consumption of tobacco products and the lack of knowledge and awareness among medical students, future health care providers. In health promotion and disease prevention, they should serve as a model for their patients and for the general public as well. Our study emphasizes the need for intervention in this field at medical faculties and for support of further monitoring in Slovakia and other countries and draws attention to the ongoing lack of EC regulation.

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: Celiac disease (CD) is a chronic autoimmune disorder caused by a complex interplay between genetic and environmental factors. The main goal of our case-control study was to analyse the association of environmental factors with the odds of CD development in a sample of the Slovak population. Methods: Data were collected from 1,226 respondents (534 CD patients and 692 controls) by a questionnaire. The impact of analysed parameters on the chance of disease development was assessed by multiple regression analysis and expressed as odds ratios (OR). Values of p < 0.05 were considered statistically significant. Results: In the patient group, celiac disease was significantly more prevalent in women than in men (OR = 1.52, p = 0.010). Respondents with a positive family history of CD showed 2.9-fold higher odds of CD compared to others (p < 0.001), and respondents with coexisting autoimmune diseases had 2.6-fold higher odds of CD (p < 0.001). Subjects who had taken antibiotics at least three times a year during childhood had 1.95-fold higher odds of developing CD compared to those who took them less frequently or not at all (p = 0.022). Conversely, individuals who were breastfed in infancy had lower odds of CD compared to non-breastfed respondents (OR = 0.53, p < 0.001). The mode of delivery (vaginal vs. caesarean section), overcoming severe infections, and the timing of gluten introduction in childhood did not show a statistically significant effect on the odds of developing CD. Conclusion: Based on our data, being female, having a positive family history of CD, suffering from another autoimmune disease, and frequent use of antibiotics are factors associated with an increased chance of developing CD. On the other hand, breastfeeding in infancy seems to have a protective effect. Our findings highlight the importance of further research in understanding the complexities of this autoimmune condition and providing a foundation for prevention strategies.

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

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

Objectives: 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.

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

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

Objectives: The aim of our research was to investigate the self-rated health status, health behaviour and hygiene habits of pregnant women, and to explore the influencing factors during the pandemic. Methods: The sample included 1,200 pregnant women who gave birth in the most progressive institutions of the three examined counties in Hungary; 839 questionnaires were returned, based on which the willingness to answer can be said to be 69.9%. After data cleaning, 640 questionnaires were added to the database. Descriptive statistical analyses and correlation tests were performed, during which we used the Pearson's chi-square test and Fisher's exact test. Results: Socio-demographic factors show a significant correlation with the perceived state of health and the degree of responsibility for health, however, the existence of a chronic disease does not affect either the self-assessed state of health or hygienic behaviour. Factors influencing hygienic behaviour include residence, education, assessed income, and gestational age. We found no correlation between health status and hygienic attitude. Conclusions: Our results draw attention to the fact that among pregnant women - especially pregnant women with low socioeconomic status - education about hygiene habits is of particular importance. Teamwork is needed in this area, which should start during the period of preparation for pregnancy, but at the latest in the early stages of pregnancy.

Objectives: Previous studies have identified four distinct patterns of adolescent social media use (SMU): non-active users abstain from social media or engage in online interactions only once a week or less; active users connect with others online daily without any functional impairments related to their SMU; intense users frequently engage with others online but do not meet criteria for problematic use; problematic users report six or more addiction-like symptoms. The following study aimed to assess the prevalence of these SMU patterns among Czech adolescent, examine changes between 2018 (pre-COVID-19) and 2022, and explore age and gender differences to identify at-risk subgroups. Methods: Data were drawn from the Health Behaviour in School-aged Children (HBSC) study among 11-, 13- and 15-year-olds. The study analysed Czech data from the 2017/18 and 2021/22 waves (n = 26,450). Results: Findings revealed marked changes in SMU patterns between 2018 and 2022 among Czech adolescents, which varied by gender and age category. Girls and older adolescents reported higher rates of problematic SMU. The share of non-active users declined, most notably among 11-year-olds. Conclusions: The marked increase in both intense and problematic SMU among Czech adolescents highlights a growing public health concern. Given the established associations between problematic SMU and poorer mental health outcomes, these findings call for the integration of digital behaviour monitoring and education into school-based mental health and prevention programmes. Particular attention should be given to early adolescence and to gender-specific vulnerabilities.

Objective: Pregnancy at advanced maternal age has become more common over the last decades. Therefore, the study aimed to describe the characteristics and maternal and perinatal outcomes of women giving birth at advanced maternal age and very advanced age. Methods: We conducted a retrospective cohort study of 2,300 singleton births that occurred in 2020-2021 at the Department of Gynaecology and Obstetrics of the Louis Pasteur University Hospital in Košice. The control (age 20-34 years), advanced maternal age (35-39 years), and very advanced maternal age (≥ 40 years) groups included 1,851, 382, and 67 women, respectively. Exclusion criteria were multiple pregnancies, maternal age less than 20 years, smoking and alcohol use, foetal malformation and intrauterine foetal death, and birth weight of 500 grams or less. Data on mothers and newborn infants have been reported from the birth book and the reports on mothers at childbirth. The data were analysed using IBM SPSS Statistics 23.0. Results: Our results confirmed statistically significant differences regarding the rate of preterm birth (p = 0.004), very preterm birth (p = 0.010), caesarean delivery rate (p < 0.001), very low birth weight (p = 0.027), extremely low birth weight (p = 0.001), and Apgar score at 5 minutes < 7 (p = 0.020) between newborns in the compared maternal age groups. Conclusion: Advanced maternal age is a prognostic factor for poor pregnancy outcomes. Women of advanced maternal age are at higher risk of adverse obstetric and perinatal outcomes.

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

Objectives: This study examines the prevalence of hand and wrist symptoms and diagnosed disorders in physiotherapists in Slovakia. The aim was to identify risk factors such as occupational settings type, number of patients treated per day and years of clinical practice, and to determine preferred methods of treatment. Method: The group of 107 physiotherapists (28 men and 79 women) participated in the study. All participants completed a questionnaire created for the purpose. It contained demographic data, years of clinical practice and the questions to determine the presence of various symptoms and injuries to the hand and wrist due to a long-lasting overuse of the hand musculoskeletal system. Results: Twelve (11.2%) physiotherapists of the observed group did not show any symptoms of functional impairment, and 32 (29.9%) were without any specific hand or wrist disorders. The results confirmed a significant prevalence of symptoms of functional impairment (mean 2.4) and disorders (mean 1.3) with an increased risk in the physiotherapists working in a combined type of occupational settings (outpatient physical therapy and hospital facilities). The most frequently reported symptoms were hand pain (70%) and reduced muscle strength (45.7%). The most frequently reported diagnosed disorder was hand tendonitis (26.2%). The results confirmed the statistically significant correlation (α = 0.05) between the years of clinical practice and the number of identified symptoms and disorders (p < 0.001) as well as between the number of patients treated per day and the number of symptoms (p = 0.007). Hand immobilization (28.6%) and manual therapy (24.4%) were preferred methods of treatment. Surgical intervention was required in 2.2% of hand injuries. Conclusions: In physiotherapists, long-term performance of manual techniques indicates the development of musculoskeletal disorders of the hand and wrist.

Objectives: Increasing tobacco excise tax is one of the most effective smoking-prevention tools. The aim of the study is to assess the use of this tool in the Czech Republic (CR) by studying trends in cigarette taxes, prices, tax revenue, and the affordability of cigarettes in the CR. Methods: Data on cigarette consumption, their tax rates, price, and tax revenue in the CR for 2004-2020 come from multiple sources. We used the consumer price index to convert nominal values to real values. Given an average daily consumption of 12.7 cigarettes per smoker, the affordability of cigarettes was measured as a percentage of the average monthly wage needed to buy 19 cigarette packs. Results: Despite recent increases in excise taxes, cigarettes in the CR are becoming more affordable. We found that the affordability of cigarettes was greater in 2020 than in 2008. The values of both the specific and the minimum excise taxes are currently being eroded by inflation. Cigarette consumption has declined from 2015 to 2020, and the government still received a bit more excise tax revenue due to its earlier tax policy. However, if taxes are not increased further, the revenue will start to decline. Conclusions: Despite the trend of increasing tobacco taxes in the CR, both the affordability of cigarettes and their use are still high in the country. This means that the CR is not using tax policy effectively enough to reduce smoking prevalence. It needs a substantial and sudden tax increase, in addition to the currently planned tax increases, to reduce smoking prevalence and lower the burden of tobacco use in the economy. Such a move would not only improve public health in the CR, but also increase government revenue.

Objectives: Overweight and obesity are important concerns for global health. They are characterized by excessive fat accumulation that can harm health. Childhood obesity has reached alarming levels around the world due to urbanization and changes in lifestyle. This trend highlights an urgent need for effective public health strategies to promote healthier lifestyles, prevent chronic diseases, and support the wellbeing of future generations. This study aimed to monitor the impact of the risk factors on blood pressure and lipid profile parameters. Methods: Data were collected from 267 school-age children from Slovakia. The study assessed blood pressure using the sphygmomanometer technique, where systolic (SBP) and diastolic (DBP) blood pressure were measured in a seated position and repeated three times. The pulse rate was evaluated using Ruffier's physical fitness test. Anthropometric measurements included body weight, height, waist circumference, hip, and chest circumference, body mass index (BMI), and fat skinfolds measurement. The children's parents completed a comprehensive questionnaire. The data were statistically evaluated using IBM-SPSS version 19. Results: Our analysis showed a statistically significant difference in SBP between obese and non-obese children (p < 0.001), but no significant differences for DBP and total cholesterol. Similar results were found between normal-weight and overweight children for SBP (p < 0.001), with overweight children showing higher SBP. No significant differences were noted for DBP or total cholesterol. Among children with "bad fitness", 57.9% had elevated SBP, compared to 37.86% with "good fitness" (p < 0.01). Additionally, 41.67% of children with bad fitness had elevated DBP, versus 23.05% in good fitness (p < 0.001). Significant differences in total cholesterol were also observed in these two groups (p < 0.05). Conclusions: The results of this study confirm the importance of monitoring risk factors that significantly influence cardiovascular parameters.

Objectives: The Russian military aggression against Ukraine in February 2022 became the cause of the biggest humanitarian crisis. Postpartum depression (PPD) is a type of mood disorder of pregnant and postpartum women. It was earlier reported that depression of pregnant women is increased in a combat zone, while effects of war on pregnant refugee and displaced women are less studied. The aim of the study was to determine the features of emotional state of temporarily displaced Ukrainian women who gave birth in Lithuania in spring-autumn 2022, and compare it with the state of Lithuanian women who were not directly affected by war. Methods: The study was conducted by surveying a group of Ukrainian refugee women (UG) and a group of Lithuanian women (LG) who gave birth in maternity units of Lithuania, using Edinburgh Postpartum Depression Scale (EPDS), the questionnaire elaborated for evaluation of social and medical peculiarities of mother-child pair in early postpartum period as well as medical records of maternity unit. Results: The average mean scores of EPDS in UG were significantly higher compared to LG; 42% of UG exceeded the threshold for the high risk of PPD (> 13). UG, who arrived in Lithuania during the war because of close relatives legally working in Lithuania, had lower EPDS scores to compare to UG who came from combat zones and who did not have close relatives. Conclusions: Support of closest relatives and convenient surrounding is important for women's emotional state during the vulnerable period of maternity and especially during the crisis time.

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.

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

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: Socioeconomic status (SES) and lifestyle have impact on recovery after ischaemic stroke (IS) and on risk of recurrent ischaemic stroke (RIS) in elderly patients. With regard to currently available limited data on young people, we aimed to assess SES and parameters of lifestyle and evaluate their relationship to stroke recovery and risk of RIS in young patients. Methods: We analysed consecutive young IS patients < 50 years enrolled in the prospective HISTORY (Heart and Ischaemic STrOke Relationship studY) study registered on ClinicalTrials.gov (NCT01541163). Data were acquired from structured a self-evaluating multiple-choice questionnaire. Clinical outcome was assessed using the Modified Rankin Scale (MRS) after 3 months with score 0-1 for excellent outcome. Results: Data were obtained from 297 (163 males, mean age 39.6 ± 7.8 years) young patients. Patients with MRS 0-1 (237, 79.8%) did not differ in SES except university education (21.1 vs. 3.3%; p = 0.001), less smoked (16.5 vs. 58.3%; p < 0.001), more of them did regular sport activities (79.1 vs. 51.6%; p = 0.02) and passed regular preventive medical checks (45.6 vs. 24.2%; p = 0.01). Twelve (4%) patients suffered from RIS during a follow-up with median of 25 months. They did not differ in SES but had higher body mass index (31.6 vs. 26.7; p = 0.007), reported less regular sport activities (16.7 vs. 73.0%; p < 0.001) and less regular medical checks (8.3 vs. 40.0%; p = 0.001). Conclusion: In young patients, SES had no relationship to clinical outcome after IS and to risk of RIS except education level. Some parameters of health lifestyle were presented more in patients with excellent outcome and without RIS during the follow-up.

Objective: The aim of this study was to reveal pregnant women's beliefs about third-hand smoke and their exposure to tobacco smoke. Methods: The population of this cross-sectional study consisted of patients attending the obstetrics and gynaecology outpatient clinic of the hospital in Samsun, a province of Turkey on the Black Sea coast (annual average 4,000 pregnant women). The minimum sample size of the study was determined as 350 at a confidence interval of 95%, prevalence of 50% and margin of error 0.05. The study data were collected with the personal information form used to determine the personal characteristics of the participants, and the Beliefs about Third-Hand Smoke (BATHS-T) scale. The data were analysed in the SPSS 25.0 program using the descriptive statistics and multiple regression analysis. Results: The mean age of the participating pregnant women was 26.84 ± 4.372 years. Of them, 48.4% were high school graduates and 86% did not work. Their mean gestational age was 29.85 ± 9.238 weeks, and 69.8% of them were in the third trimester. Of them, 9.8% were smokers, and the average number of cigarettes they smoked per day was 6.97 ± 4.931. The mean score they obtained from the BATHS-T scale was 3.79 ± 0.859. There was a significant relationship between the mean score obtained from the BATHS-T scale and the variables such as education and smoking status. As the level of education increased, exposure to third-hand smoke decreased (p < 0.05). The mean score the smoking pregnant women obtained from the BATHS-T scale was lower than that of the non-smoking pregnant women. Conclusion: High level of education decreases exposure to third-hand smoke. Belief in third-hand smoke is an important factor affecting pregnant women's smoking habit.

Objectives: Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. Every day, approximately 800 women die from causes related to pregnancy and childbirth worldwide. Maternal ill health increases the risk of LBW. This study seeks to investigate determinants and incidence of LBW. Methods: This study was conducted based on the medical records of mothers and their 1,946 infants born in 2016-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants were obtained from the Reports on mothers at childbirth. The inclusion criteria were singleton births and birth weight > 500 g. The exclusion criteria were twins or multiple births, congenital anomalies and stillbirths, birth weight ≥ 4,000 g or ≤ 500 g, and Roma ethnicity. Roma children are more likely to be born prematurely, with low birth weight. Roma mothers have different lifestyle. Univariate analysis was employed to evaluate the association between the independent variables and LBW. Variables that were found to be statistically significant were then further analysed using multivariable logistic analysis for each dependent variable. The implementation of the research was approved by the Ethics Committee. Results: Of 1,946 newborns, 271 (13.90%) have low birth weight. The mean of birth weight at delivery was 3,068.62 (SD 671.16) grams. Factors that were associated with LBW were primary maternal education (OR = 2.98, 95% CI: 1.08-8.21, p = 0.034), marital status single (OR = 2.88, 95% CI: 1.68-4.94, p < 0.001), number of prenatal care visits less than 8 (OR = 1.62, 95% CI: 1.01-2.61, p = 0.047), and preterm birth (OR = 74.94, 95% CI: 45.44-123.61, p < 0.001). Conclusion: The reducing of LBW requires strategies to improve maternal lifestyle, maternal care before, during and after birth and to strengthen social support.

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

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.