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Objectives: This study aimed to investigate the acrylamide exposure of different children and adult population groups (10-14 years, 15-17 years, 18-24 years, 25-44 years, 45-64 years, and 65-74 years) resulting from the consumption of potato chips and wheat-based bread from Montenegrin market and to evaluate it in terms of health risk. Methods: The acrylamide content was monitored in 51 samples of bread and 20 samples of chips. The carcinogenic health risk in different population groups was assessed through the incremental lifetime cancer risk (CR) and total cancer risk (TCR). Results: The average acrylamide content in potato chips and bread was calculated to be 238 μg/kg and 30 μg/kg, respectively. Acrylamide content in a tested sample met the criteria prescribed by Commission Regulation (EU) 2017/2158 in 98% of the tested samples of chips and 85% of bread samples. The carcinogenic health risk of acrylamide exposure for the investigated population groups is of concern. The values of CR for all the investigated groups were in the range of 10^-6 < CR < 10^-4 and the values of TCR were 10^-5 order of magnitude, indicating a potential cancer risk. Conclusion: The youngest population (10-14 years) was exposed to the highest cancer risk through the consumption of both, chips and bread. For the population of 10-14 years, 15-17 years, 25-44 years, 45-64 years, and 65-74 years, a higher risk of cancer was found due to the consumption of bread compared to the consumption of chips. Only the population aged 18-24 years was faced with a higher risk of cancer due to the consumption of chips compared to the consumption of bread.

Objective: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. Methods: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N ~ 1.800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. Results: In comparison with women, men had a higher smoking prevalence (OR = 1.41, 95% CI = 1.09-1.84), higher consumption of cigarettes (B = 4.11, 95% CI = 1.97-6.26), and higher rate of smoking initiation (OR = 1.38, 95% CI = 1.10-1.74), but they did not differ in the quit rate (OR = 0.85, 95% CI = 0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR = 2.59, 95% CI = 1.36-4.97; OR = 2.23, 95% CI = 1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. Conclusions: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.

Objectives: Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. Methods: We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. Results: Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. Conclusion: Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.

Objectives: The aim of this study was to examine the prevalence of overweight/obesity in 15-19 years old adolescents in the Province of Vojvodina, Serbia, and to evaluate the association between obesity and socio-demographic factors. Methods: A cross-sectional study was conducted in high schools in the territory of Vojvodina, Serbia. The sample consisted of 986 high-school students (47.4% girls and 52.6% boys). Body height, body weight, and waist circumference were measured. Obesity was defined as a body mass index (BMI)-for-age value > x̅ + 2 SD, and overweight as a BMI-for-age value > x̅ + 1 SD and ≤ x̅ + 2 SD. Waist-to-height ratio (WHtR) of ≥ 0.5 was considered high risk. Socio-demographic data was collected using a questionnaire developed for this study. Univariate and multivariate logistic regression analyses were implemented. Results: The prevalence of overweight and obesity in adolescents was 19.6% and 10.1%, respectively. Boys were more likely to be obese than girls (OR = 1.87; 95% CI: 1.37-2.56). Adolescents living in suburban areas had a greater chance of obesity compared to those living in urban areas (OR = 1.84; 95% CI: 1.15-2.94), as well as those who attended trade schools compared to gymnasium students (OR = 1.92; 95% CI: 1.20-3.07). The lower level of the father's education was a significant predictor of obesity. Predictors of high-risk WHtR were gender, high school type, and the father's education level. Conclusions: Obesity and abdominal obesity are highly prevalent in adolescents in Vojvodina, more in boys. Gender, community type and the level of the father's education were confirmed as significant factors that influenced both obesity and abdominal obesity. This study could help to customize health promotion policies for adolescents in Vojvodina.

Telemedicine, as a health service provided remotely, is increasingly becoming a common part of health care. Telemedicine is defined as "an umbrella term for health activities, services and systems operated remotely through information and communication technologies to promote global health, prevention and health care, as well as education, health management and health research". It also describes telemedicine as "the provision of services where distance is a critical factor, using information and communication technologies to exchange valid information for the diagnosis, treatment and prevention of disease and injury, for research and evaluation, and for the continuing education of healthcare providers to improve the health of individuals and communities". Both definitions imply that two of the hallmarks of telemedicine include the use of communication and information technologies to overcome distance as a critical factor, a factor that is well known to us, not least from the recent months of the COVID-19 pandemic. Distance medicine can thus act as a tool for improving access to health care and also complement health care itself in a very appropriate way.

Objectives: The aim of the study was to assess the factors determining the work of nurses in internal medicine departments. Methods: The study was multicentre, cross-sectional, and observational. The selection of the research group was intentional. The subject of the study were 209 nurses working in 11 internal medicine departments in 10 hospitals in the region of southern Poland. Results: The number of patients cared for by one nurse, nurses' participation in the decision-making process, and nurses' age were shown to be direct predictors of emotional exhaustion. The number of patients cared for by a single nurse, nurses' participation in the decision-making process, and age were direct predictors of depersonalization. It was shown that significant (p < 0.05) independent (multivariate analysis) variables of the job satisfaction subscale were information on support for nurses at work by managerial staff and nurses' participation in the decision-making process. After analysing the impact of socio-demographic factors on the nurses' working environment, it was found that the participation of nurses in the decision-making process was significantly lower in the youngest group than in the other age groups (p = 0.006). Conclusions: Participation of nurses in the decision-making process is a direct determinant of occupational burnout. A higher number of patients under the care of a nurse, lack of participation in the decision-making process and a higher age of nurses are predictors of emotional exhaustion and depersonalization.

Regarding the vaccination of children, it can be said that there are basically three vaccination policies in the world, one of which is usually used in particular country depending on the national legislation. These are the mandatory vaccination policy, mandatory vaccination policy for school entry and recommended vaccination policy. The mandatory vaccination policy and the mandatory vaccination policy for school entry face obstacles consisting of conflicts between fundamental human rights and freedoms. This is, for example, a conflict between the right to health and the right to life on the one hand and the right to protect the inviolability of the person and body integrity or the right to personal freedom, freedom of movement, residence, etc., on the other. Another issue is the right to undisrupted school attendance, based on both compulsory schooling and the right to education. This article looks at different approaches to the vaccination of children in different countries. It provides an illustrative comparison of approaches to vaccination of children in selected countries. It is obvious that the essential problems with organizing and ensuring the vaccination of children are and will be associated with the indicated conflicts of fundamental human rights. It is therefore necessary to search and try to find the optimal policy for undergoing the necessary vaccinations and thereby creating herd immunity, of course for those infectious diseases where this is possible. These efforts are necessary for sufficiently effective protection of individual and public health.

Objective: The primary objective was to comprehensively assess the association between single nucleotide polymorphisms (rs562556 and rs2479409) in the PCSK9 gene with biochemical parameters - C-reactive protein (CRP), glucose (GLU), triglyceride (TAG), low-density lipoprotein cholesterol (LDL CHOL), non-high-density lipoprotein cholesterol (non HDL CHOL), high-density lipoprotein cholesterol (HDL CHOL), cholesterol (CHOL), and anthropometric parameters (visceral fat), overweight/obesity and cardiovascular risk. Methods: A total of 71 women aged 23-64 years were divided into three groups based on body mass index (BMI). BMI ≥ 25/≥ 30 kg/m² was the criterion for assessment of overweight/obesity. Anthropometric, biochemical and genetic examinations were performed on the probands. Changes in markers in each group and their association with cardiovascular risk were monitored. Results: We can conclude that in our study population we observed differences between the BMI categories for biochemical markers (CRP, LDL CHOL, non HDL CHOL, HDL CHOL, LDL CHOL) and anthropometric marker (visceral fat). Atherogenic index of plasma (AIP), Castelli's Risk Index I (CRI-I) and atherogenic coefficient (AC) confirmed high cardiovascular risk for the obese women category (0.045); (< 0.013); (< 0.010). Genotype and allele frequencies for the PCSK9 gene in the overweight and obese groups showed higher allele frequencies of allele A for both polymorphisms of the gene. Conclusions: PCSK9 gene expression is associated with biological processes such as lipid metabolism and inflammation. Cholesterol-lowering therapies are the gold standard for reducing the risk of cardiovascular mortality and morbidity. Administration of monoclonal antibodies (mAbs) against PCSK9 is a novel lipid-lowering therapeutic approach in adults to reduce the risk of cardiovascular disease.

Introduction: The global burden of chronic diseases, including cardiovascular disease, remains a significant public health challenge. The Life's Simple 7 (LS7) score was developed as a tool to evaluate cardiovascular health behaviours and habits and identify high-risk individuals. The present study aimed to assess the distribution of LS7 scores among educational strata. Methods: The study population consisted of 3,383 asymptomatic individuals screened for colorectal cancer at a single centre in Austria. We split patients into lower (n = 1,055), medium (n = 1,997), and higher (n = 331) education, based on the International Standard Classification of Education (ISCED). Cox regression models were utilized to determine the association between education and mortality over a median follow-up period of 7 years. Results: Individuals with higher educational status had a significantly higher prevalence of ideal cardiovascular health metrics, as defined by the LS7 score, compared to those with medium and lower educational status: n = 94 (28%) vs. n = 347 (17%) and n = 84 (8%), respectively, (p < 0.001). In the Cox regression analysis, both medium (HR = 0.61, 95% CI: 0.43-0.84, p < 0.001) and higher educational status (HR = 0.44, 95% CI: 0.19-1.01, p = 0.06) were associated with all-cause mortality, as was the LS7. Conclusion: Our findings highlight a significant association between lower educational status and poorer cardiovascular health, as assessed by LS7, which persisted even after multivariable adjustment. Additionally, both educational status and LS7 were associated with increased mortality, underscoring the significance of our results. These findings have important implications for public health, as screening and prevention strategies may need to be tailored to meet the diverse educational backgrounds of individuals, given the higher prevalence of unhealthy lifestyle behaviours among those with lower educational status.

Objectives: Occupational allergic respiratory diseases frequently occur in individuals working in the agricultural and food production sectors, textile manufacturing, and industries involving exposure to isocyanates. The study aimed to describe trends surrounding the prevalence of occupational asthma (OA), occupational rhinitis (OR), and occupational hypersensitivity pneumonitis (OHP) in Eastern Slovakia between 1990-2021. Methods: All cases of OA, OR, and OHP registered in a database at the Louis Pasteur University Hospital in Košice, Slovakia, between 1990 and 2021, were divided into categories based on economic sector (agricultural, food production sectors, textile manufacturing, healthcare, industrial manufacturing, and tertiary sector) and causal agent. Changes in disease prevalence, causal agents, and economic sector association over time were analysed. Results: There were 287 occupational respiratory cases (179 OA, 65 OR, and 43 OHP cases). The annual prevalence of OA declined significantly over the study period (p < 0.05). Overall, there was a significant decrease in cases from the agricultural (p < 0.001) and an increase in the industrial manufacturing (p < 0.01). The number of cases due to farming agents fell markedly over the study period, while metalworking fluids (MWFs) were found to be the most common causes of allergic respiratory diseases since 2018. Conclusions: This study found a decrease in the number of OA cases, as well as changes in economic sectors and causal agents associated with OA and OHP, specifically, in the agricultural sector, with MWFs from the industrial manufacturing sector now being the most common aetiological agent.

Objective: The aim of the study is to assess the risk of malnutrition among institutionalized elderly individuals in North Bohemia and compare it to the risk of malnutrition in the capital city of Prague, Czech Republic. In the Czech Republic, very few studies have been conducted with the goal of describing and evaluating the nutritional status of the institutionalized elderly. Methods: In this study, data was collected from 254 elderly individuals (aged ≥ 65) residing in retirement homes in North Bohemia and then compared with similar data for the elderly living in retirement homes in Prague (the data from Prague were previously published in 2013). The data included an Mini-Nutritional Assessment (MNA) test; anthropometric measurements - Body Mass Index (BMI), waist circumference, triceps skinfold thickness; and biochemical parameters - albumin, prealbumin, transferrin, urea, and creatinine. Results: Mean BMI values were 27.4 kg/m² for females and 26.3 kg/m² for males. According to the MNA questionnaire, 10.4% of all tested elderly were malnourished and 50.8% were at risk of malnutrition; lager proportion of females were found to be malnourished than males. Biochemical indicators supported the MNA results. MNA categories correlated positively with independence (r = 0.56; p < 0.001), mental status (r = 0.54; p < 0.001), mobility (r = 0.46; p < 0.001), calf circumference (r = 0.42; p < 0.001), BMI, and the ability to self-feed (both r = 0.37; p < 0.001). The percentage of institutionalized elderly with malnutrition living in North Bohemia and Prague were about the same; however, the percentage of those at risk of malnutrition was higher in North Bohemia (p = 0.006). Conclusion: Study results confirmed that the institutionalized elderly face issues that lower their nutritional status and put them at increased risk; clearly these issues need urgent attention.

Objective: A three-year retrospective study of fungi isolated from samples of patients with suspected fungal skin infections in Eastern Slovakia is presented. Methods: A total of 11,989 samples were collected and investigated with direct microscopic examination using 20% KOH and cultivated in Sabouraud and Mycosel medium. Identification was based on macroscopic and microscopic characteristics. Results: Of the total samples, 61.76% (7,405/11,989) were completely negative and 38.24% positive (4,584/11,989). Dermatophytes accounted for 45.88% of isolates (2,103/4,584), yeasts for 26.79% (1,228/4,584), non-dermatophytes for 15.29% (701/4,584), and Malassezia sp. for 12.4% (552/4,584). Trichophyton rubrum was the most prevalent causative agent (79.08%) implicated in fungal skin infections, followed by Trichophyton interdigitale (10.60%). Less frequent isolates included Trichophyton tonsurans (5.13%), and Trichophyton mentagrophytes (3.14%). Other dermatophytes (Microsporum audouinii, Microsporum gypseum, Microsporum canis, Trichophyton violaceum, Trichophyton verrucosum, and Epidermophyton floccosum) were very rarely identified (each in less than 1% of all samples). The main clinical form of dermatophytosis in the sample was tinea unguium (42.61%), followed by tinea pedis (30.86%), tinea inguinalis (11.65%), tinea corporis (8.04%), and tinea manus (4.76%). Tinea capitis et faciei (2.08%) was more common among children and adolescents. Conclusion: The assessment of data has showed the predominance of tinea unguium among adult patients, tinea capitis et faciei among children, and the prevalent aetiological role of Trichophyton rubrum in fungal skin infections; findings that are in agreement with recent European studies.

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

Objectives: This study aimed to assess the predictors of allergic sensitisation to titanium and nickel in patients undergoing orthodontic treatment. Methods: A total of 250 patients undergoing orthodontic treatment were invited to participate, and 235 were analysed (67% females). A patch test was performed using nickel sulphate, titanium, titanium dioxide, titanium oxalate, titanium nitride, and petrolatum as control. In addition, clinical signs of the oral mucosa, gingiva, tongue, lips, and allergological history were assessed. Results: The predictors of metal allergic sensitisation in patients undergoing orthodontic treatment were adult age (OR = 2.6; 95% CI: 1.2-5.5; p = 0.016), female sex (OR = 3.0; 95% CI: 1.1-7.9; p = 0.025), exfoliative cheilitis (OR = 4.8; 95% CI: 1.9-12.4; p = 0.001), history of contact hypersensitivity (OR = 7.0; 95% CI: 1.3-35.4; p = 0.025), history of contact hypersensitivity to metals (OR = 8.3; 95% CI: 1.4-50.2; p = 0.021), and piercings (OR = 5.4; 95% CI: 2.1-13.9; p = 0.001). When predictors were analysed separately for these two metals, titanium sensitisation predictors were contact hypersensitivity to metals and piercing, whereas nickel sensitisation predictors were age and piercing. Conclusion: A positive patch test alone cannot draw definite conclusions regarding allergy. However, metal allergies in patients with orthodontic appliances could be considered in cases of previous contact hypersensitivity, previous reactions to metals, exfoliative cheilitis, and piercing.

Objectives: Although clinical research is still going on to determine any relationship between vitamin D and sleep regulation, only few studies have identified the role of vitamin D metabolism in sleep disorders. The current study aims to examine the incidence of vitamin D deficiency/insufficiency in the sample group and its effects on sleep quality and melatonin level. Methods: A cross-sectional study was designed. A total of 79 women aged 18-49 years who applied to the research and training hospital between 1 October and 30 November 2021 participated in the study. Data were collected using a socio-demographic questionnaire prepared by the authors and the Pittsburgh Sleep Quality Index (PSQI). Blood samples were taken from the participants, also, 25-OH-vitamin D3 and melatonin levels in serum samples were measured by ELISA. Results: The participants (n = 79) were aged 29.61 ± 11.14 years. The mean total PSQI scores of the participants were calculated as 5.77 ± 2.70. We determined that 64.6% of the participants had vitamin D deficiency, 21.5% had vitamin D insufficiency, and 13.9% of the participants were vitamin D sufficient. The mean melatonin level was found to be 24.77 ± 27.77 ng/L. We determined that an increase in the melatonin levels decreases the risk of vitamin D deficiency. Besides, our findings showed a good positive correlation between serum melatonin and 25 OH vitamin D3 levels (r = 0.544, p < 0.001). Conclusion: Our results indicate that the correction of vitamin D insufficiency can positively affect melatonin levels, therefore, it may positively contribute to the treatment of sleep disorders related to melatonin deficiency.

Objectives: Our research aimed to examine children's sleeping habits from preschool to the end of elementary school age. Developing proper sleeping habits in childhood is essential, as it is decisive for the rest of our lives. Methods: A total of 339 children (160 males and 179 females) took part in the research, of which 145 were preschool-age children (3-7 years old), 72 lower-grade elementary school children (6-11 years old), and 122 upper-grade elementary school children (12-16 years old). The questionnaire was completed in a paper form (elementary school students) and online (kindergarten children). Results: The research results show that most of the children spend enough time sleeping following the recommendations. In case of the kindergarten children, the younger ones also sleep in the afternoon on weekends (average of 3.66 years, 28.3%), and the older ones do not sleep in the afternoon either in kindergarten during the week or at home at the weekend (average of 5.22 years, 46.2%). The use of blue light typically increases with age; 39% of the preschoolers, 61% of the 6-11-year-olds, and 67% of the 12-16-year-olds use it before falling asleep. Sleep aids and rituals are used by 87.6% of the preschoolers, 67.4% of the 6-11-year-olds, and 34.4% of the 12-16-year-olds, because significantly more preschoolers find it more difficult to fall asleep than older children. At night, 40% of the preschoolers wake up at least once (due to biological needs - 46.3%), 32% of the 6-11-year-olds wake up at night (due to nightmares - 42.3%), and 41% of the 12-16-year-olds also wake up all night (due to biological needs - 31.9%, and due to noise - 29.8%). Conclusion: Although the children get enough sleep, significantly more upper-grade school children feel tired in the morning. It is essential to help sleep and eliminate factors that prevent falling asleep to create a healthy circadian rhythm in the life of children.

Objectives: The global situation concerning the incidence of infectious diseases emphasises the need for increased health literacy, particularly after the COVID-19 pandemic. A large part of this need relates to the area of education. The aim of this study was to analyse health literacy in relation to the cognitive dimension in the field of knowledge about the COVID-19 disease in the post-pandemic period among future teachers. Methods: The research sample comprised 286 female students in the first year of Bachelor's teacher training courses at the Faculty of Education in the Czech Republic. The research study was conducted during the academic year 2022/2023. To explore the level of health literacy, the present research used the standardized HLS-EU-Q86 questionnaire designed by the World Health Organization. For the purposes of this study, the original 'structured interview' method was changed to an online questionnaire. An additional online questionnaire was attached to explore participants' knowledge related to the COVID-19 disease. Results: The average score for general health literacy was 34.1, placing it within the 'sufficient' category. A total of 14.0% of the students showed an excellent level and 38.1% a sufficient level of general health literacy. Relatively the most favourable results were observed in the dimension of health promotion literacy. The threshold for successful completion of each knowledge test related to the COVID-19 was set at 80% of correct answers. Only 14.0% of the future teachers met the criteria for inclusion in the overall excellent level of the knowledge test. Conclusions: The level of knowledge of future teachers associated with COVID-19 is inadequate. Therefore, it is desirable to strengthen education in the field of prevention of infectious diseases. The results indicate the need for some action, e.g., expanding the portfolio of compulsory courses in all branches of teacher training in order to increase the level of health literacy among future teachers.

Objectives: The aim of this study was to evaluate the relationship between internet addiction, substance use and alexithymia among students of education faculty and medical faculty. Methods: This cross-sectional analytical study included 1,257 faculty students aged 18 and over, studying at Meram Medical Faculty and Ahmet Keleşoğlu Faculty of Education. Young's Internet Addiction Scale, Toronto Alexithymia Scale, Fagerström Tobacco Addiction Test and CAGE alcohol use tests were applied to collect data. Results: The mean age of the participants was 21.12 ± 1.96 years, 71% (n = 893) of them were females and 29% (n = 364) were males, 37.9% (n = 477) were training at medical faculty, 62.1% (n = 780) were training at the faculty of education. Of the students, 1.5% were internet addicts, 15.3% were possible addicts, and 22.8% had alexithymia. Internet addiction was higher in those with higher alexithymia scores (p < 0.001). Internet addiction was significantly higher in male students, the third grade, ones with lower academic success, students who work their lessons less than 2 hours a week. Internet addiction was also significantly higher in smokers and alcohol users (p < 0.001). While there was a low negative correlation between the first internet using age and internet addiction (p < 0.001), there was a moderately significant positive correlation between spending uninterrupted time on the internet and internet addiction (p < 0.001). Conclusion: In this study, it was determined that the teacher and doctor candidates, who are studying at the faculties of education and medicine, were at risk of internet addiction. A teacher or a doctor who cannot develop social skills due to excessive internet use will not be a good model to communicate correctly with the target population.

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

Objectives: No previous research of university students in Finland assessed lifestyle behavioural risk factors (BRFs) and categorized students into clusters, explored the associations of the clusters with self-reported health complaints (HCs), whilst controlling for potential confounders. The current study undertook this task. Methods: Students at the University of Turku (1,177) completed an online well-being questionnaire that assessed socio-demographic variables, 5 BRFs - problematic alcohol consumption, smoking, illicit drug use, food consumption habits, moderate-to-vigorous physical activity (MVPA), and 22 HCs. A food frequency questionnaire assessed students' consumption of a range of foods, and a dietary guideline adherence score was computed based on WHO dietary recommendations for Europe. Three separate regression models appraised the associations between the cluster membership and HCs factors, adjusting for sex, income sufficiency and self-rated health. Results: Mean age was 23 ± 5.2 years, 77% had never smoked and 79% never used illicit drug/s. Factor analysis of HCs resulted in four-factors (psychological, circulatory/breathing, gastro-intestinal, pains/aches); cluster analysis of BRFs identified two distinctive student clusters. Cluster 1 represented more healthy students who never smoked/used illicit drugs, had no problematic drinking, and undertook MVPA on 4.42 ± 3.36 days/week. As for cluster 2 students, half the cluster smoked occasionally/daily, used illicit drug/s, and > 50% had problematic drinking and students undertook MVPA on 4.02 ± 3.12 days/week. More cluster 2 students adhered to healthy eating recommendations, but the difference was not significant between clusters. Regression analysis revealed that females, those with sufficient income, and with excellent/very good self-rated general health were significantly less likely to report all four HCs. Cluster 2 students were significantly more likely to report psychological complaints, circulatory/breathing and gastro-intestinal complaints. There was no significant association between BRFs clusters and pains/aches factor. Conclusions: Risk taking students with less healthy lifestyles and behaviour were consistently associated with poorer psychological and somatic health.

Objective: This study aims to describe the outcomes of COVID-19 patients treated with molnupiravir and to explore the associations with various risk factors. Methods: We conducted a single-centre, descriptive, retrospective study without a comparison group. Results: Out of 141 patients, 70 (49.7%) required follow-up outpatient care. In the subgroup of 66 (46.8%) hospitalized patients, 28 (19.9%) developed interstitial viral pneumonia, with 6 (4.3%) deaths. Unvaccinated patients had a higher incidence of pneumonia (p = 0.020), and obesity was a significant risk factor for both pneumonia (p = 0.001) and mortality (p = 0.011). Patients over 60 years (p = 0.040) and those with cardiovascular diseases (p = 0.026) also had increased pneumonia risk. Male sex was associated with a higher risk of death (p = 0.020). Conclusion: Molnupiravir treatment was linked to reduced risks of hospitalization and death, particularly in high-risk patients. Vaccination provided additional protection, and obesity obstructive pulmonary disease and autoimmune diseases were significant risk factors for severe outcomes.

Objectives: This systematic review seeks to present and compare data from studies evaluating the success of medium-term inpatient treatment of alcohol-dependent patients in the Czech Republic. Another aim was to identify the problems that make such comparisons difficult. No previous review comparing the efficiency of various therapeutic programmes has been published in the Czech Republic. Methods: Bibliographia medica Čechoslovaca and PubMed were used to find studies published in professional medical journals since 1970 evaluating the abstinence of patients who voluntarily completed medium-term inpatient treatment of alcohol dependence. Results: Medium-term inpatient treatment of alcohol addiction leads to one year of abstinence in 34% to 76% of patients. Such variance in value is largely caused by selection bias, differences in the definition of abstinence, and differences in data collection methods. Conclusion: The comparison of studies presented many challenges. Further steps should be taken to help compare treatment programmes in the future, as the programmes provide different therapeutic interventions of different intensities and lengths to different patients. Adequate demographic and other pretreatment characteristics data collection, detailed descriptions of therapeutic interventions, and identification of effective components of the therapeutic programme could support further research in this area, optimize existing programmes, and increase the overall treatment efficiency.

Objectives: The aim of this study was to confirm the relevance of knowledge a dentist has regarding obstructive sleep apnoea (OSA), considering the fact that based on specific risk factors a dentist may be the first clinician to identify patients who are at risk of being affected by this serious condition. Methods: The cohort consisted of 53 subjects who underwent a routine dental examination. Anthropometric data and data on tongue size (Mallampati classification), tonsil size (Friedman classification), daytime sleepiness (Epworth Sleepiness Scale) and systemic risk factors were recorded in a record sheet. On the basis of the monitored parameters, selected subjects underwent polysomnography in order to objectivise the parameters observed. Results: Polysomnography confirmed a 96% success rate in our identifying subjects as being at high risk of developing OSA. This indicates that the parameters monitored during a routine dental examination were properly selected to identify patients with this condition in advance. Conclusion: The relevance of information dentists have about the early identification of patients with OSA may be crucial in the management of further therapy to be provided to these patients.

Objectives: The aim of the study was to assess the effectiveness and safety of dupilumab therapy in patients with moderate-to-severe atopic dermatitis (AD) in a real-life Czech bicentric cohort. Methods: We retrospectively analysed 50 patients with moderate-to-severe AD treated with dupilumab in two centres in the Czech Republic. Baseline characteristics, the Eczema Area and Severity Index (EASI) score and Dermatology Life Quality Index (DLQI) were collected at baseline and each 3 following months. The proportion of patients achieving EASI50, EASI75, EASI90 and EASI100 were analysed. Levels of immunoglobulin E (IgE) were collected before and after 6 and 12 months of therapy. Adverse events were recorded as well. Results: Thirty-two men and 18 women with mean body mass index (BMI) of 25.7 were enrolled in our analysis. The mean age of the patients was 37.6 years and the mean time from diagnosis until the initiation of dupilumab therapy was 35.0 years. After 4 months, EASI75 was achieved by 75.7%, out of which 40.5% achieved EASI90 and 10.8% achieved complete clearance. Improvement continued with time, and the proportion of patients with EASI90 increased to 71.4% at the 6th month and at the 12th month of therapy the EASI90 was 65.2%. EASI100 was achieved by 14.3% and 13.0% at the 6th and 12th month, respectively. A marked reduction was observed in the DLQI and also in IgE levels. EASI responses were independent of BMI. No new safety issues were identified. Adverse events were experienced by 44% (22/50) of the patients and they were all mild in intensity. Conjunctivitis and herpes simplex virus infection were the most common adverse events. Conclusion: Our results confirmed the effectiveness and safety of dupilumab in a real-life setting in adult patients with moderate-to-severe AD in the Czech Republic. Dupilumab was well-tolerated and resulted in a significant clinical improvement in combination with improvement of quality of life.

Objectives: The overall aim of the research is to gain insight into the lifestyle and health behaviour of young people with disabilities aged 12-18 years, and to learn about the factors shaping their health. In this study, our aim was to investigate the eating habits and physical activity of adolescents with disabilities and the influencing factors. Methods: The study's source population was young people aged 12-18 with disabilities in the Szabolcs-Szatmár-Bereg County. A total of 239 completed questionnaires were processed and analysed. Boys were overrepresented in the study. Results: The results show that inadequate eating habits also exist in the population we studied, the consumption of certain foods correlates with the education level of parents. A more secure social background is a protective factor in terms of physical activity. The survey was made with the aim of intervention much needed. With precise knowledge of the health behaviour of the target group, our goal is to develop a complex intervention programme adapted to the needs of children with disabilities. Conclusion: The eating habits of adolescents with disabilities in the Szabolcs-Szatmár-Bereg County are unsatisfactory. Experience and results show that differentiated health promotion of young people with disabilities is necessary.

Objectives: The Lombardy Region, Italy, was the most severely affected by the COVID-19 outbreak. In absence of effective treatments and with basic hygiene measures made mandatory, Lombardy response to COVID-19 relied on its healthcare system characteristics, the administered competition or "quasi-market" model. The aim of the study was to review the strengths and weaknesses of Lombardy's response during the first wave of the COVID-19 epidemic, to explore whether the healthcare model influenced crisis management and describe which policies could help to contain future outbreaks. The results are expected to provide similar healthcare systems with lessons to avoid mistakes and learn from best practice. Methods: Data for quantitative analyses on the performance of the Lombardy and Veneto Regions healthcare systems were derived from existing government sources including the Italian Civil Protection Agency and the Ministry of Health. Results: Lombardian quasi-market model, traditionally characterized by a strong hospital network, was held responsible for many suboptimal outcomes. According to critics, years of disinvestments in community care resulted in a hospital overload. However, the same model was responsible for other positive outcomes which have been substantially neglected, such as the opportunity to test for effective containment treatments in a safe environment and rapidly extend the number of beds. Conclusions: The performance of a quasi-market model against public health emergencies largely depends on integration between policy-makers and balance between healthcare providers, which require clear regulation. Reducing institutional fragmentation between levels of governance, improving the coordination of healthcare facilities and adopting telemedicine technologies are means by which healthcare networks could strengthen their resilience against future outbreaks.

Objectives: Different psychoactive substances are widely used in today's society. So far limited data are available on the use of psychedelics in the general population. The main aim of this study is to estimate the numbers of users of substances with psychedelic properties (classical psychedelics, cannabis, ecstasy, and ketamine) in the Czech Republic. Methods: Data from two samples enrolled in representative cross-sectional questionnaire surveys in the Czech adult population in 2016 (n = 2,785) and 2018 (n = 1,665) were analysed. Prevalence rates were extrapolated to estimate numbers of current, i.e., last-year, users of psychedelics, and their socio-demographic profiles were compared with non-users and users of cannabis. Results: An estimated 5-6% of the Czech adult population (350-430 thousand people) used classical psychedelics (LSD, psilocybin mushrooms, ayahuasca) in their lifetime, increasing up to 28-30% when cannabis is included (1.9-2.1 million users). Current use of classical psychedelics reached 0.7-1.9% (50-130 thousand people), and 9-11% (590-750 thousand users) when cannabis was included. Users of psychedelics were more often males, of younger age and single. Conclusions: No significant socio-demographic differences were found between users of classical psychedelics and recreational cannabis users, however, differences were significant when compared to non-users and users of other illicit drugs. Findings should further serve to inform drug policy and social and healthcare systems in respect to the use of psychedelics.

Objectives: The purpose of this quantitative study is to assess the impact of fine particles air pollution in major cities of Slovakia. The study aims to estimate number of premature deaths from long-term exposure to fine particles PM_2.5 in eight regional capitals of Slovakia in the period 2016-2020. Consequently, the study aims to conduct a comparative analysis using secondary derived indicators. Methods: For calculations of estimated premature deaths from long-term exposure to fine particles PM_2.5 air pollution we used standardized methodology developed by the World Health Organization and the European Environment Agency. Results: The annual average of estimated premature deaths from PM_2.5 air pollution in the studied period was in Bratislava 353, Košice 219, Prešov 84, Žilina 90, Banská Bystrica 76, Nitra 73, Trnava 59, and Trenčín 52. In relative terms per 1,000 inhabitants Bratislava had annual average 1.14 of estimated premature deaths, Košice 1.32, Prešov 1.38, Žilina 1.61, Banská Bystrica 1.35, Nitra 1.35, Trnava 1.27, and Trenčín 1.31. Bratislava as the largest city in Slovakia recorded the smallest relative number of estimated premature deaths. The worst results were recorded by the city of Žilina. Conclusions: The estimated number of premature deaths from long-term exposure to particulate matter air pollution in the regional capitals decreased in the given period. The most of the regional capitals with the exception of Bratislava and Žilina, showed similar levels of estimated premature deaths. However, the current geopolitical situation and rising energy prices threaten return to solid fuel burning which is the largest source of particulate matter air pollution in Slovakia and thus reversing positive trends.

Objective: Our research was focused to find a relation between the occurrence of spondylodiscitis and occurrence of chronic diseases. We were trying to discover some new risk factors and relations between chronic disorders in our research group. This analysis was also focused to detect factors that prolong the hospitalization of patients and worsen their prognosis. Methods: A study was carried out involving patients with spondylodiscitis treated between 2013 and 2022. A statistical analysis expressed by several coefficients was calculated in software IBM SPSS 21. Results: The study group comprised 32 (53.3%) females and 28 (46.7%) males. During the period the overall incidence of spondylodiscitis was increasing (except the year 2020 where only 2 patients were treated) with a peak in 2019. The average age of patients was 69.3 (±12.3) years, and the highest incidence was in the age group 60-69 years (n = 19, 31.7%). The most impacted vertebral region was lumbar (n = 29, 48.3%). The most prevalent associated comorbidity was some cardiovascular disorder (n = 39, 65%) followed by diabetes mellitus (DM) (n = 23, 38.3%). Genitourinary system was the most common source of primary infection (n = 22, 36.7%). Average length of stay was 34.3 (±14.5) days and surgery prolonged hospitalization period. Mortality rate was 1.7%. Conclusion: The results of our study are confirmed by the data of other European and non-European studies. We confirmed diabetes mellitus and hypertension as the most common non-infectious risk factors of spondylodiscitis and the presence of pathogens in genitourinary system as the most frequent source of primary infection.

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.