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Objective: Drawing on qualitative analysis of selected historical documents, the paper seeks to provide a definition of the general characteristics of the first institutional alcohol treatment facilities in today's Czech Republic and Slovakia, taking into account the historical context of the first half of the 20th century. An additional aim was to point out the importance of archival research and its contribution to understand the determinants of alcohol-related agenda and alcohol treatment. Methods: The basic data platform was generated by analysis of historical documents pertaining to the subject matter under study and to institutional processes in different periods. The data was processed using the open coding method (as part of the grounded theory approach) and other specific methods based on the matching of data from scientific and professional literature and archives in different periods. Over 1,100 pages of text from relevant archival materials were analysed. This research is original, no such systematic analysis of historical documents on this subject matter has been conducted on such a scale with the intention of identifying the general correlates of the historical development of an alcohol-related agenda and alcohol treatment. Results: The establishment of the first institutional facilities intended to provide treatment for alcohol dependency was based on the notion of addiction as a disease, which needs to be treated in dedicated facilities applying an individualised approach. The circumstances of the establishment of the facilities under analysis were similar. Their existence was made possible by distinguished personalities rather than a general belief and social pressure that the issue of alcohol addiction should be addressed. This also explains the fact that the occupancy of these facilities never reached their full capacity, that they were not self-reliant in economic terms, and that they did not readily resume their operation after 1945. Conclusions: The analysis of the establishment, operation, and dissolution of these facilities at the time reveals the discontinuity in the approach to alcohol abuse and its treatment in the context of the historical development and perception of alcohol-related problems in Czech and Slovak society in the first half of the 20th century. Significant social changes occurred after 1948. New legislative instruments were used to enforce treatment based on a principle that was different from the previous approaches. The results of our study also make it possible to reveal the intensity of apparent individual and institutional motives in the process of the development of alcohol treatment in historical terms and its projection into different post-war periods. The understanding of these correlates will help in designing additional trajectories of research into the effects of social and political changes on addiction treatment and thus identifying the intensity of the historical development and its influence on the perception of addiction treatment at present. These findings will also be of great importance for a historical comparative analysis, including overlaps with the development of recent theories, and will support the emergence of new areas of study for the social sciences.

Letter to the Editor, in response to the paper “Reproductive health of Roma women in Slovakia”, Cent Eur J Public Health 2020 28(2):143–148.

Objectives: We examined the association between exclusive breastfeeding, early introduction of feeding formula, early weaning, and asthma in children aged six months to five years in a sample of non-institutionalized US children using a propensity score approach. Methods: Our study used data from the National Survey of Children's Health (2012-2018) of 3,820 children with physician-diagnosed asthma aged 6 months to 5 years. Propensity score matching (PSM) was applied to control selection bias with age, sex, race, birth weight, Federal Poverty Level, parent's education, and parent smoking history used as covariates in PSM. The total number in the matched sample was 6,904 (3,452 non-asthmatics; 3,452 asthmatics). Matched and unmatched samples were analysed using the χ² test and multiple logistic regression. Results: Exclusive breastfeeding was protective against asthma in the pre-matching (AOR 0.72; 95% CI: 0.54-0.97; p = 0.03) and post-matching (AOR 0.66; 95% CI: 0.55-0.81; p < 0.001) samples. Formula feeding before 6 months was associated with asthma in unmatched (AOR 1.38; 95% CI: 1.15-1.66; p < 0.001) and matched (AOR 1.31; 95% CI: 1.16-1.47; p < 0.001) sample. Early weaning before 6 months was associated with asthma in unmatched (AOR 1.62; 95% CI: 1.35-1.54; p < 0.001) and matched sample (AOR 1.37; 95% CI: 1.23-1.54; p < 0.001). Conclusion: Public health systems should continue to recommend the implementation of the World Health Organization exclusive breastfeeding guideline in developed countries. Asthma interventions in children under two years should continue to emphasize exclusive breastfeeding to reduce the incidence of infant asthma.

Objective: Diabetes mellitus (DM) has been one of the leading chronic diseases worldwide over past decades. The objective of the study was to identify predictors associated with health-related quality of life (HRQOL) in diabetic patients. Methods: A cross-sectional questionnaire-based study was conducted at the General Hospital of the city of Leskovac, between June and November 2015. The Short Form-36 (SF-36) questionnaire, EuroQol-5D (EQ-5D) and EuroQol-VAS (EQ-VAS) questionnaires were used. Univariate and multivariate linear regression analyses were performed. Results: The total number of patients was 285, 112 men (39.3%) and 173 women (60.7%), average age 63.92 ± 1.07 years. The results of multiple linear regression of socio-demographic characteristics in relation to dimensions of the quality of life measured by SF-36 and EQ-VAS showed that age, country (rural) life, low level of education, retirement, and poor economic status are predictors of lower quality of life. Our results showed that employment has a significant association with higher Physical Component Score (PCS), Mental Component Score (MCS) and EQ-VAS score, which can be explained with higher incomes, improved economic status and less possibility for the occurrence of depressive mood. Patients without formal education have lower QOL. Univariate multiple regression analysis of the presence of micro- and macrovascular complications of DM showed that angina pectoris, heart failure, diabetic retinopathy, and diabetic nephropathy are the most important factors affecting the quality of life in our population. After including the multivariate model, all tested complications remained statistically significant. Conclusion: Our results showed that both socioeconomic and chronic complications are relevant factors of HRQOL in type 1 and 2 diabetes mellitus patients. Age, rural lifestyle, retirement, lower level of education and low socioeconomic status, as well as DM complications (angina pectoris, hearth failure, diabetes nephropathy, and diabetes retinopathy) were found to be independent risk factors for the component scores of SF-36 and EQ-VAS score. Taking into consideration the results obtained, health practitioners should be aware not only of the clinical parameters of patients with DM, but also of their educational level and working status.

Objectives: The purpose of this study was to assess the test-retest reliability of selected items based on self-reports, measuring problem behaviour in the Slovak and Czech version of the HBSC survey questionnaire. Methods: The data from test-retest study, based on an international Health Behaviour in School-aged Children (HBSC) study and consistent with its methodology, were analysed. A sample of 580 primary school pupils (51.2% of boys), grades five and nine participated in a test and retest with a four-week interval. Six items concerning problem behaviour were evaluated overall and stratified by gender and age. Results: Analyses of test-retest reliability indicated modest (0.30 to 0.49), moderate (0.50 to 0.69), or high (0.70 to 1.00) reliability across nearly all questions, with some reliability differences in analyses by gender and age. In general, findings of present study suggest the moderate reliability of measures of smoking, drunkenness, fighting and negative relationship to school, modest reliability of measures of bullying behaviour, and low reliability of measure of truancy. Conclusions: The overall findings of this study suggest that most of selected indicators in the HBSC survey questionnaire have satisfactory test-retest reliability. Further test-retest studies in a large and diverse sample, as well as validity studies, should be considered for the future HBSC study.

Objective: Lyme disease (LD) is chronic, multi-system zoonosis transmitted by ticks, and LD aetiological agents are spirochetes of the Borrelia burgdorferi sensu lato complex. The aim of the cross-sectional study was to analyze the LD incidence on the basis of the presence of specific antibodies in the serum of patients in Eastern Slovakia, and to compare the results of serological ELISA and immunoblot assays. Methods: Venous blood with questionnaires was obtained by field sampling of respondents from Eastern Slovakia. Overall, we examined 537 human sera by the ELISA and for confirmation we tested all positive IgG antibodies against the Borrelia immunoblot assay. Results: Our results confirmed the high serum prevalence of anti-Borrelia antibodies (17.9% for IgG), while the immunoblot seropositive test was confirmed in 69.8% of responders from ELISA IgG positive sera. Positive antibodies of the IgM class were found in 7.6% of the population under study. Most commonly found were antibodies against VlsE (80.2%), p41 (66.7%), p18 (56.3%), p100 (41.7%), p58 (31.3%), and p39 (30.2%). Conclusion: It should be noted that detection of antibodies against B. burgdorferi s.l. is only an indirect evidence of the presence of this bacterium in the development of clinical signs of LD in humans. Laboratory LD tests should be performed in accordance with valid standards, positive and uncertain results must be confirmed by the Western Blot/Immunoblot assay.

Objective: The study examined the links between pressure pain sensitivity (PPS) measured during preventive medical examination of men, their health status and occupation. Method: A one year (2015-2016) convenience sampling technique was used to gain primary data from actual medical examination, health records (personal and occupational history) and pressure pain sensitivity (PPS) measured by Ull Meter equipment during preventive medical examination of 371 men of different occupations (average age 43.6±10.4 years, range 19-66 years). Measured PPS values of 60 or more indicate high PPS, contrary PPS values to 40 indicate low PPS. Results: 345 men (93%) were considered healthy (without diagnosis of a disease), 26 men (7%) had positive personal history/symptoms of disease. The average of measured PPS values for the whole group was 36.6±9.5 (first measurement) and 36.7±8.5 (second, repeated measurement), suggesting a high reproducibility of the measurements (r=0.80). Decreased PPS values were measured in men without reported diagnosis of a disease compared to men with diagnosed diseases. Elevated PPS values were measured in men with symptoms of neurocirculatory asthenia (NCA) compared to asymptomatic men and also to men with different diagnosis. The group of men with other than NCA symptoms did not differ significantly in PPS values compared to group of asymptomatic men. Road drivers (177 men) did not differ significantly compared to other occupations (194 men). Conclusion: The increased neuropsychological load/stress is connected with increased pain sensitivity to pressure. The PPS method is objective, reliable, simple, and noninvasive evaluation of the impact of stress and may be helpful in assessing medical fitness to work.

Objective: Between February 2014 and September 2015 a large measles outbreak (5,084 cases) occurred in the Federation of Bosnia and Herzegovina (FB&H). The aim of this study is to assess the effectiveness of routine measles vaccination in the FB&H. Methods: We conducted an analysis of the resurgence period surveillance data and a retrospective cohort study involving primary school aged children in randomly selected schools. Results: Measles cases occurred among all age groups, mostly among the unvaccinated. Among fully immunized, 2.1% contracted measles. Measles vaccine effectiveness was high. The study indicates that one dose reduced the risk for measles by 91.9% (95% CI: 81.4-96.4%), two doses reduced the risk by 97.3% (95% CI: 95.5-98.4%). No evidence of waning immunity was found. Our survey reveals that a significant number of children had no immunization status registered. Conclusions: The results of this study suggest that the resurgence was likely caused by an accumulation of measles-susceptible children not being vaccinated. This vaccine effectiveness study does not support possible vaccination failure as a contributing factor.

Objective: Nanomaterials are materials consisting of particles having one or more dimensions smaller than 100 nm. Nanoparticles (NP) have different properties and effects in comparison with the same particle materials of larger size. They can penetrate through various membranes and get from the bloodstream to other organs in the body. Therefore, in our experiment we have dealt with the impact of nanoparticles TiO₂ instilled intravenously (i.v.) (to a tail vein of an animal) on the selected parameters of bronchoalveolar lavage (BAL). The aim of our study was to determine whether TiO₂ nanoparticles do pass through the vascular system to the respiratory tract, and if so, how they affect the selected inflammatory and cytotoxic parameters of bronchoalveolar lavage. Methods: Wistar rats were intravenously given a suspension of TiO₂ nanoparticles in saline solution. This suspension contained 10% volume of rat serum in dose: 1.0% from LD50 = 0.592 mg/kg of animal body weight. After the time intervals 1, 7, 14 and 28 days, the animals were sacrificed under anaesthesia; bronchoalveolar lavage was performed and the BAL cells were isolated. We have examined these markers: differential count of BAL cells - alveolar macrophages (AM), polymorphonuclear leukocytes (PMNL), lymphocytes (Ly); viability and phagocytic activity of AM; proportion of immature cells and cathepsin D enzyme levels. Results: Regarding the respiratory toxicity of TiO₂ nanoparticles we have found that TiO₂ nanoparticles are relatively inert. BAL examined parameters (except the immature form of AM) were not significantly changed after 28 days of instillation compared to the control group. We found that the TiO₂ nanoparticles used in our study were transferred from the bloodstream to the respiratory tract, but in a 28-day phase after i.v. instillation have been largely eliminated by the defence mechanism from the respiratory tract. Conclusions: We suggest low biopersistence and relatively rapid elimination of TiO₂ nanoparticles from the lung under used experimental conditions.

Objective: The aim of our study is to evaluate immune response after receiving the primary vaccination against tick-borne encephalitis (TBE), and to establish a link between seropositivity and selected factors in soldiers. Methods: Blood samples, questionnaires and vaccination records were obtained. TBE antibodies were detected using both ELISA and a neutralization test (NT). We used logistic regression for statistical analysis. Results: Overall, seropositivity (presence of IgG) was detected in 88% of participants. The proportion of seropositive subjects in relation to the number of doses of vaccine was 69% (2 doses) and 91% (3 doses). A statistically significant relationship was found between seropositivity and the number of vaccine doses. No statistical significance was identified in relation to age and sex. There was no statistical significance of seropositivity, depending on the time of the last dose of the vaccine. Conclusions: TBE immunisation should be targeted at individuals in the most affected locations and those at highest risk of exposure according to lifestyle and occupation.

Objective: The incorrect composition of a diet, its atherogenicity, is conducive to the occurrence of lipid disorders, arterial hypertension (HTN), diabetes, and metabolic syndrome (MetS). The aim of the study was to evaluate the prevalence of incorrect anthropometric and biochemical parameters as well as diet atherogenicity. Methods: The study group included 1,520 adults (880 women, 640 men). The nutritional status evaluation was based on respondents' BMI and waist circumference. The diet atherogenicity was estimated using Keys Index (KI) and P/S ratio. Total cholesterol (TCh), LDL cholesterol as well as triglycerides (TG) concentration in blood serum were also evaluated. Results: In 56.8% of women and 60.8% of men waist circumference exceeded referential values. The diets of 71.4% of women and 87.3% of men were atherogenic. HTN was observed in 64.1% of the study population. Hypercholesterolaemia was found in approximately 72% of the respondents. The increased LDL cholesterol concentration were found in 57.5% of women and 64.5% of men. Abnormal concentration of HDL cholesterol occurred among approximately 20% of respondents. Hypertriglyceridaemia was recognised in 26% of women and 44% of men. In the group of women and men with HTN, mean values, i.e. BMI, waist circumference and TG (with TCh concentration additionally noted in men) were found as significant. Normal lipid profile and arterial pressure values were observed in 6.6% of the population. Conclusions: In the diets of men with HTN were observed higher values of KI compared to group without HTN. No significant differences were found in the frequency of occurrence of the analysed parameters either among the group of women with HTN or without it. In the group of men with HTN, the abnormal BMI, waist circumference and TG occurred more frequently.

Objectives: The study examined appearance and body satisfaction in adolescents. For these purposes, data from the European Longitudinal Study of Pregnancy and Childhood in the Czech Republic were used. Methods: The data were collected in 2010 and the sample comprised 3,105 18-year-old respondents. Results: The research found that the respondents who wished to reduce their weight were mostly women with BMI in the normal range. Based on the body cathexis scale, we found that women compared to men are more critical of stomach, hips, buttocks, and thighs, as well as overall weight and figure. The results showed that criticism of their weight from their immediate environment is unpleasant to both female and male adolescents to such an extent that it makes them try to reduce it. However, it is clear that girls are altogether less satisfied with their bodies than boys. Conclusion: For both genders, body dissatisfaction is most likely enhanced by critical comments from peers and parents about appearance, body weight etc.

Objectives: The aim of the study is to examine the physical activity (PA) of young children and their parents on weekdays and at the weekend, as well as possible associations between them. Methods: Fifty-eight children (29 boys), aged 5-8 years (mean age = 6.53 years) and the parent who spent more time with them (25 fathers, 33 mothers, mean age 40.67 years) wore Omron HJ-720IT pedometers for seven consecutive days. Two ANOVAs for repeated measures were applied to examine PA differences between genders and week phases (weekdays vs. weekend days) in children and parents. Moreover, one sample t-tests were used to compare participants' PA to the recommended PA, while linear regression analyses were utilized to examine whether parental PA in each week phase was associated with children's PA. Results: Children accumulated more steps on weekdays than at the weekend (F_1,56 = 18.58, p < 0.001, η² = 0.27), while boys presented higher PA than girls (F_1,56 = 12.42, p = 0.001, η² = 0.20), and accomplished the recommended daily PA, in contrast to girls. Mothers and fathers presented similar PA (p = 0.67, η² = 0.004), with more steps on weekdays than at the weekend (F_1,56 = 9.22, p = 0.004, η² = 0.16). However, their PA was significantly lower than the recommended. Finally, there were no statistically significant associations between parents' and boys' ambulatory activity either on weekdays (p = 0.938) or at the weekend (p = 0.095). On the contrary, parents' PA explained 47% of girls' PA on weekdays (R = 0.68, F_1,28 = 22.81, p < 0.001) and 23% at the weekend (R = 0.48, F_1,28 = 6.40, p = 0.02) Conclusions: Boys appear to be more physically active than girls in Greece, whereas mothers and fathers present similar ambulatory activity. Moreover, parents' PA is related to that of their daughters and not to that of their sons. Taking into account that both girls and parents did not meet PA recommendations, family-based interventions are needed for both children and parents benefit.

Objective: Tobacco related comorbidities and treatment of dependence are relevant to clinicians of all disciplines. Clinicians should provide a brief intervention about tobacco use with smokers at each clinical contact (success rate of 5-10 %). Intensive treatment (success rate >30%) should be available to those who need it. Brief intervention is not yet standard clinical practice. Our aim was to assess clinical practice guidelines (CPG) of selected medical professional societies to determine whether or not tobacco dependence treatment recommendations were included. Methods: Between October and December 2013, we conducted a keyword search of CPG for 20 medical professional societies in the Czech Republic. We searched for the keywords "smoking", "tobacco" and "nicotine addiction" in 91 CPG documents, which were freely available on the websites of selected professional societies. We focused specifically on CPG relating to cardiovascular and respiratory diseases as well as cancer. We excluded any CPG focused on acute conditions, diagnostics only, laboratory methods, or administration. Results: There was no mention of smoking in 27.7% (26/94) of CPG documents. Only 16% (15/94) of CPG documents listed smoking as a risk factor. 42.5% (40/94) mentioned smoking related phrases (e.g. "smoking ban"). Only 13.8% (13/94) of CPG included a section on tobacco dependence, referenced tobacco dependence treatment guidelines or mentioned specialized treatment centres where smokers can be referred. Conclusion: Nearly one third of CPG related to cardiovascular and respiratory diseases as well as cancer made no mention of smoking. Despite the clinical significance of smoking, the majority of CPG did not adequately address tobacco dependence and its treatment.

The Northern Moravia Region is the most polluted region in the Czech Republic by particulate matter (PM_2.5) and carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) as benzo[a]pyrene (B[a]P) by heavy industry and local heating. This specific situation was used to study the impact of air pollution on newborns in the exposed Karviná district and control district of České Budějovice. Biological material from newborns and mothers was collected in summer and winter seasons. This project is highly detailed, analyzing the concentrations of PAHs in ambient air and diet, in human breast milk, in the urine of mothers and newborns, using biomarkers of genetic damage as DNA adducts and gene expression analysis, biomarkers of oxidative stress as 8-oxodG adducts and lipid peroxidation (15-F2t-isoprostane immunoassay). All 400 children, for whom the biomarker data at delivery were obtained, will be followed for morbidity up to 2 years of age. The Northern Moravia Region seems to be to be a model area for studying the long-term impact of human health exposure to c-PAHs. Our observations will indicate possible genetic and oxidative damage in newborns, which may significantly affect their morbidity.

Objective: As an excessive gaming is the addiction of the 21th century, purpose of our study was to investigate how sense of coherence interacts with gaming time, choice of various games types, age and gender characteristics. Our task was to evaluate relationship between computer gaming and an adolescent's sense of coherence. Methods: A cross-sectional study based on a self-reported questionnaire was performed among the representative samples of 1,806 adolescents aged 13-18 years. Adolescents reported the amount of time spent gaming computer games, types of games, as well as sense of coherence. The relations between the choice of computer games type, time spent gaming computer games and sense of coherence of respondents were assessed by odds ratio using multivariate regression analysis. Results: 32.9% of boys and 81.1% of girls reported gaming computer games less than 5 hours per day during the last month (p < 0.001). 30.9% of boys and 4.1% of girls reported gaming computer games more than 10 hours per day during the last month (p < 0.001). Boys and girls aged 13-15 with a weak sense of coherence had significantly higher probability to play action or combat computer games for 5 or more hours per day in comparison to the respondents who had a strong sense of coherence. Also, this probability was 2 times higher among boys than among girls. Conclusion: Sense of coherence is a useful tool to identify adolescents who are at risk of excessive gaming. Game playing time is linked to the sense of coherence. Adolescent with a weak sense of coherence had a higher probability to play more times, especially in younger age.

Objectives: The aim of the study was to understand determinants of ageing in relation to future cardiovascular disease (CVD) events at population level, and to explore determinants of healthy ageing and its relation to 10-year CVD incidence among apparently healthy individuals. Methods: In the context of the ATTICA study 453 apparently healthy men (45 ± 13 years) and 400 women (44 ± 18 years) with complete psychological evaluation were studied and followed during 2002-2012. Healthy Ageing Index (HAI) (range 0-7) was calculated based on socio-economical, bio-clinical, psychological, and lifestyle characteristics (i.e. dietary habits and physical activity) of the participants during the baseline examination. CVD incidence during the follow-up period was defined according to ICD-10 criteria. Results: Healthy Ageing Index was inversely associated with higher 10-year CVD risk (OR per 1/7 (95% CI): 0.47 (0.28, 0.80). Age and sex-adjusted determinants of healthy ageing were abnormal waist to hip ratio (p < 0.001), increased coffee consumption (p = 0.04), reduced basic metabolic rhythm (p < 0.001), increased triglycerides (p = 0.003), and C-reactive protein levels (p = 0.02), as aggravating factors, while moderate alcohol consumption (p = 0.002) was identified as a positive influential parameter. Conclusions: Understanding healthy ageing, as a dominant factor of CVD development, provides a new direction for better prevention efforts focused on healthy ageing at both population and individual level.

Objective: Hepatitis C virus (HCV) infection is a major public health problem and affects large populations all over the world. Serum anti-HCV level is a valuable marker to determine HCV infection. Anti-HCV testing has been recommended for high-risk population. The Center for Disease Control (CDC) and Prevention in the United States proposed a new high-risk population group - adults born between 1945-1965. Under this perspective, we designed a multicentre retrospective study to determine the seropositivity of anti-HCV among adults born between 1945 and 1965 and adults born after 1965 in Turkey. With the data collected, we aimed to determine whether there was a need for anti-HCV testing especially in people born between 1945 and 1965. Methods: We requested data from ten different medical centres in ten different provinces. Each medical centre collected the anti-HCV test results of adult patients for five-year period between 2009 and 2014 from hospital records. Results: A total of 974,449 anti-HCV test results were included in this study. When the seropositivity rates in the two groups of adults were compared, anti-HCV seropositivity rates were higher in nine medical centres out of ten. Anti-HCV seropositivity in adults born between 1945-1965 was significantly higher than in adults born after 1965 (p < 0.05). Conclusions: We determined that the anti-HCV seropositivity rate is significantly higher in adults born between 1945-1965 compared to the younger adults as indicated in the literature. According to data from this study together with the WHO and CDC suggestions, we believe that it is appropriate to offer anti-HCV serology testing for people over 50 years of age since the anti- HCV seroprevalence in this age group is relatively high.

Objectives: The health of the Roma population is relatively poor and indicators on municipal level are needed to inform authorities to improve it. The aim of this study was to compare the rate of low birthweights (LBW) and mean birthweight (BW) in municipalities with minor Roma population (MMR) and municipalities with large Roma population (MLR) in Slovakia. Methods: A population-wide, ecological level, cross-sectional study was conducted using data from 2009-2013. Data on proportions of newborns with LBW, on mean birthweight of newborns and on mean ages of mothers at birth were obtained from the National Health Information Centre of Slovakia. Rates of LBW and mean BW were compared between the MMR and MLR groups. Mean age of mothers and rates of unemployment were considered possible confounders. Results: The mean BW was by 183 g higher in the MMR group compared to MLR; the rates of LBW were 4.2% and 8.9%, respectively. Increasing proportions of Roma were significantly associated with increasing rates of LBW and decreasing mean BW, one percent increase in the proportion of Roma was associated with an increase in LBW rate of 0.15% and a decrease in mean LBW of -4.9 grams. Conclusions: Our findings could be used as a proxy for the purposes of policy making, replacing individual level studies with more resource-demanding design.

Objectives: The pathophysiology of tinnitus is not clearly understood, but its prevalence is relatively high. Persistent symptoms of tinnitus are linked to various mental health conditions, and in particular, tinnitus prevalence is high in Korean adolescents. Accordingly, this study aimed to reveal the associations between tinnitus and mental health in Korean adolescents using a nationally representative sample. Methods: Original data from the Korea National Health and Nutrition Examination Survey were analyzed by logistic regression analysis. The sample consisted of 1,587 adolescents aged 12-18. We examined demographic variables; tinnitus measured by health examination; and stress, depression, and suicidal ideation measured by health interview. Results: The prevalence of tinnitus was 18.0%. Tinnitus severity was directly related to level of stress (p = 0.023), depression (p < 0.001), and suicidal ideation (p < 0.001). In comparison with Korean adolescents without tinnitus, the odds ratio (OR) of having depression and suicidal ideation was 2.27 (95% CI: 1.47-3.50) and 1.96 (95% CI: 1.35-2.84), respectively, in univariable analysis. The OR of having depression and suicidal ideation in multivariate analysis was 2.00 (95% CI: 1.28-3.13) and 1.73 (95% CI: 1.13-2.62), respectively. Conclusions: Tinnitus prevalence in Korean adolescents is relatively high, and thus, intervention may be necessary to prevent or reduce depression and suicidal ideation to ensure that other areas of life are not negatively affected. Further, individuals with tinnitus may be in need of intervention to prevent or reduce depression and suicidal ideation.

Objective: Besides irreplaceable role in health, vitamin B₁₂ is proposed to have cytoprotective role in colorectal cancer (CRC). So far, studies are inconclusive on the role dietary intake of vitamin B₁₂ has in CRC. The aim of this study was to determine whether total dietary intake of vitamin B₁₂ and contribution from its food sources relates to a low-risk diet and lifestyle in a population at high risk for CRC. Methods: An observational study on 200 healthy adults from Eastern Croatia was conducted during April-May 2013. A typical diet of this population in this region is characterized with all known major dietary risk factors for CRC placing the population at high risk for CRC, yet the incidence of CRC remains relatively low. Results: Diet and lifestyle characteristics of 52.2% of participants can be classified as the high-risk for CRC. Women, people in lower BMI category, and urban residents have significantly lower risk of the high-risk diet and lifestyle. Higher intake of vitamin B₁₂ shows positive association with the low-risk diet and lifestyle. Intake of vitamin B₁₂ from milk, dairy and fish represent independent factors for the low-risk diet and lifestyle in this population at high-risk for CRC. Conclusions: Higher intake of vitamin B₁₂, especially intake from milk, dairy and fish are associated with the low-risk diet and lifestyle in a population at high risk for CRC. Further studies should focus on interplay between vitamin B₁₂ and other nutrients that share the same food sources to elucidate their role in the aetiology and pathology of CRC.

Objective: Celiac disease (CD) is a chronic long-term disease with autoimmune disorder connected to an allergic reaction to the molecule of gluten. CD is manifested in persons who are genetically predisposed. The only therapy for CD is a strong gluten-free (GF) diet. The aim of our study was to follow the adherence to the gluten-free diet in the selected group of parents and caregivers of children with CD, and to compare factors influencing the adherence to GF diet and therefore influencing also clinical symptoms of CD. We compared and examined important food-related activities as well, by using a personal questionnaire in the group of CD children's parents or caregivers. Methods: We designed a cross-sectional study; 325 parents or caregivers of children with CD were recruited in the sample. CD was confirmed by the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) criteria. The anonymous questionnaires were collected at summer camps within period data 2012-2016 and followed factors which might have an influence on compliance with GF diet, according to parents' opinions. Results: Adherence to GF diet was statistically significantly higher among girls compared to boys. Parents' questionnaires confirmed that younger group of children and children with the family history of CD had statistically higher compliance with GF diet. Parents with higher education confirmed better adherence to GF diet, statistical analyses confirmed higher adherence in mother´s education compared to father's education. Duration of CD, socio-demographic factors of parents - age of parent, gender of parent, and residency were not statistically significant in terms of compliance with the diet. Conclusions: Our study confirmed important factors influencing adherence to the GF diet, which are connected to the symptoms and consequences of CD. The assessment of parents' opinions and burden on the families of children with celiac disease should be also reflected in the evaluation of patient's status. Important is also the role of parents in order to facilitate and support clinical interventions and prevention of CD.

Objectives: The aim of the study was to establish frequency, severity and circumstances of alcohol and drug intoxications in adolescents admitted to inpatient wards in the Czech Republic. Methods: Chief physician of each participating ward (or their designated deputy) searched the patient records for required information. The data was then statistically processed. Results: Thirty inpatient paediatric wards participated in the study (27 district wards and 3 university hospital wards), amounting to more than a third of all paediatric wards in the country. The total number of intoxications reported was 2,176, the majority of which were alcohol-related (84.5%), followed by cannabinoids and, to a lesser degree, amphetamines. The number of alcohol intoxications increased by 22% during the 5-year observation period, whilst the frequency of illegal drugs intoxications remained the same. We also observed an increase in the percentage of alcohol intoxications in girls - from 42% to 45.5%. The mean age at intoxication was low - 15.5 years. The Glasgow Coma Scale in individual episodes of intoxication increased during the study duration/follow up period. The proportion of alcohol intoxications originating in pubs, clubs or other public institutions was 25%. Conclusion: The number of alcohol intoxications has risen during the observation period. The age at which these intoxications occurred is very low. Of serious concern is the fact, that 25% of alcohol intoxications originated in places where alcohol is sold, despite the fact that majority of the adolescents were under the legal drinking age limit of 18 years.

Objectives: The aim of the study is to describe current prevalence of selected risk factors in the Czech general population in a particular region and to compare the data with recently published results in the selected population of Czech soldiers. The work also deals with the advantages and disadvantages of methods determining overweight and obesity. Methods: Within medical preventive examinations the data of 1,051 individuals (482 men, 569 women) were obtained. In this group anthropometric parameters such as height, body weight, Body Mass Index (BMI), and waist circumference were monitored. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Demographic data such as age, gender and achieved education were processed. Results: Average BMI values in men were in the overweight range. Monitored average BMI values in women were up to standards. Monitored anthropometric parameters significantly increased with the age of examined individuals. The highest values of BMI and waist circumference were found in the over-50 age group. Selected biochemical parameters also increased with the age of examined individuals. Education did not have significant influence on the values of selected parameters. A statistically significant positive correlation was found between the values of BMI and waist circumference. The correlation coefficient in men was r = 0.804, p < 0.001, and in women r = 0.858, p < 0.001. Conclusion: The work confirmed differences in anthropometric parameters between the civilian and military Czech male population due to a higher muscle mass percentage in the military population. The work also confirmed the significance of further anthropometric methods in diagnostics of overweight and obesity. The number of individuals with anthropometric and biochemical parameters out of the physiological range is increasing in the over-50 age category.

Objective: The purpose of this study was to examine stress, depression and suicidal ideation in Korean adolescents according to their sexual behaviours, such as experience of sexual intercourse, time of first sexual intercourse, and sexual intercourse after alcohol drinking. Methods: This study was conducted as a secondary data analysis using the raw data of the 9th Korea Youth Risk Behaviour Web-based Survey (KYRBWS-IX) conducted in 2013. The survey sampled 75,149 secondary school students, and 72,435 of them were included in this analysis. Results: Stress level, depression and suicidal ideation were significantly higher in adolescents with experience of sexual intercourse than in those without it. Adolescents with experience of sexual intercourse after drinking had a 1.415 times higher odds ratio depression than those without it. When the time of first sexual intercourse was delayed by one year, the odds of stress increased by 1.022 times and the odds of suicidal ideation increased by 1.014 times. Conclusions: Adolescents with experience of sexual intercourse showed significantly higher stress, depression and suicidal ideation, the latter of which was particularly higher among low-grade female students that had experienced first sexual intercourse at a young age. Suicidal ideation was more common when first sexual intercourse was early. Adolescents with experience of sexual intercourse after drinking showed higher stress, depression and suicidal ideation than those without drinking.

Objective: Worldwide, primary schools are the most important segment of childhood education. The main disturbing source of noise in schools is human speech, the primary component of the learning process. School noise has a negative impact on information processing, teachers and pupils, and communication in the classroom. The study aimed at assessing A-weighted sound pressure levels in primary school classrooms. It was concerned with A-weighted sound pressure levels and their fluctuation during various classes. Methods: The noise was measured with the static calibrated Brüel and Kjær 2260 Investigator sound level meter. The sound pressure levels were measured twice in 12 classes as 11 different subjects were taught to reduce the uncertainty of results due to their potential variability in time. From the instantaneous values, L_A (t), equivalent continuous A-weighted sound pressure levels (L_Aeq,T) and L_Amax were calculated. Results: The mean equivalent A-weighted sound pressure level during lessons irrespective of age and subjects taught was 68.0 ± 3.4 dB (uncertainty of measurement). The highest levels of noise were in physical education and arts; the lowest levels were found for English taught as a foreign language. There were no statistically significant differences in L_Aeq,T depending on the numbers of children in the classes. The main source of noise is pupils. Attention should be paid to negative feelings of noise to reduce L_Aeq,T in schools. Conclusions: Continuous noise pollution, in combination with stress and the mentally demanding nature of the teaching profession, may lead to numerous negative effects on human personality.

Objective: The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a novel coronavirus circulating in the Arabian Peninsula since September 2012. It leads to significant respiratory disease and among patients with co-morbidities is associated with high mortality. This research studied the mortality rate of MERS-CoV among intensive care unit (ICU) patients and the correlation of mortality with different co-morbidities. Methods: This was a retrospective observational study conducted at the Intensive Care Unit of the King Fahad Hospital, Jeddah, Saudi Arabia. Data was obtained through patient chart review. Results: The total sample consisted of 52 laboratory-confirmed MERS-CoV infection patients. 39 patients died, with a 75% case-fatality rate. Many patients had underlying co-morbidities, including diabetes mellitus (51.9%), hypertension (46.2%), and chronic renal disease (21.2%). Conclusions: MERS-CoV ICU mortality remains markedly high due to a combination of factors; the disease process of MERS-CoV leads to multiple organ failure, particularly respiratory and renal failure.

Objectives: The aim of this study was to investigate the associations between urinary arsenic, oxidative stress, assessed by thiol/disulphide homeostasis, and lung diseases in firefighters. Methods: The study conducted among the municipality-based male firefighters (n = 100) who were admitted to occupational diseases clinic for periodic medical examination. The control group consisted of non-exposed male office workers (n = 50). Urinary arsenic levels, thiol/disulphide homeostasis parameters of participants were determined. Also, lung diseases were assessed by chest X-ray and pulmonary function tests. Results: The mean age and work year did not differ in the study and control group. The median urinary arsenic concentration of firefighters was significantly higher than in the control group: 15.65 (2.5-246) μg/L and 3 (0.10-6) μg/L, respectively (p < 0.001). The parameters of pulmonary function tests (PFT) FVC (%), FEV1 (%), FEV1/FVC ratio and FEF 25-75 (%) were all significantly lower in firefighters compared to controls. A significant increase in mean serum disulphide concentration (17.10 ± 8.31 μmol/L vs. 7.48 ± 5.91) (Fig. 1) and disulphide/native thiol % ratio: 3.63 (0.53-11.43) vs. 1.51 (0.03-7.65) (p < 0.001) were found between exposed group and controls. The Spearman's correlation analysis revealed a positive correlation between urinary arsenic and disulphide (r = 0.422, p < 0.001), disulphide/native thiol % ratio (r = 0.409, p < 0.001). Nevertheless, urinary arsenic correlated negatively with all PFT parameters including FVC (%), FEV1 (%), FEV1/FVC and FEF 25-75 (%) (p < 0.001). Conclusion: We showed the arsenic-induced oxidative stress in firefighters with impairments of several lung functions determined by thiol/disulphide homeostasis using a novel method.

Objective: The aim of the study was to analyse the frequencies of rs1229984 genotypes within the alcohol dehydrogenase (ADH1B) gene in a Gypsies/Roma population and compare them with other populations and with ethanol consumption. Methods: We analysed the ADH1B (rs1229984; Arg47→His; c.143G>A) genotype using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) in two ethnically different groups - Gypsies/Roma (N = 301) and Czechs (N = 300) where one day alcohol consumption was recorded. Results: ADH1B genotype/allelic frequencies did not significantly differ between the populations (p = 0.32). The frequency of minor A allele carriers was slightly higher in Gypsies/Roma (14.7%) than in Czechs (11.9%). The prevalence of subjects reporting alcohol intake on the previous day was non-significantly lower in Gypsies/Roma (10.5% vs. 16.4%), as was the amount of alcohol consumed the day before the examination in ethanol consumers (36.1 ± 18.3 g vs. 43.0 ± 27.2 g). Conclusions: The frequency of rs1229984 genotypes in the ADH1B gene within the Gypsies/Roma population corresponds with frequencies obtained in North India/Central Asia, the putative country of this ethnic origin. Our results suggest that the minority Gypsies/Roma population consume slightly less alcohol than the Czech majority population.