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Objective: Obesity is a chronic disease in modern age and finding approach to the prevention, diagnosis and treatment of obesity has its place among the priorities of modern medicine and related fields. Important component in programmes to reduce overweight and obesity is regular physical activity (PA), which plays vital role in the comprehensive approach to the treatment of obesity. Primary objective of our study was to assess changes in somatic characteristics following eleven weeks of PA in overweight and obese women aged 30 to 60 years. Methods: Our research sample consisted of 221 women who were classified according to the level of PA carried out, namely 1^st, 2^nd and 3^rd category. STOB (STop OBesity) course participants underwent PA monitoring and diagnosis of the body composition, which is a modern multifaceted cognitive behavioural method. Results: Younger highly active women (PA 3) achieved higher average differences in body fat than did women with the typical daily activity (PA 1), however, significant differences have not been found. Statistically significant differences in visceral fat between the 1^st (PA 1) and 3^rd PA category (PA 3) have been observed in older women. Conclusion: Given the significantly higher increase of fat-free mass percentage in older highly active women (PA 3), we may assess the course results positively. Our study demonstrated positive correlation between carrying out the recommended level of PA and its impact on the body composition's health risk indicators. Obese women should walk at least 10,000 steps per day to improve their health.

In recent years increasing pressure to limit the powers of the Czech public health authorities in the field of food safety has been noticed. An approach to safe food production and official controls depends on diverse and complex socioeconomic factors in the context of political and legislative framework within which food producers and official controllers exist. Official controls are those activities carried out by the competent authorities (CA) or delegated bodies) in Member States to verify business compliance with the requirements set out in agri-food chain legislation. The presented text compares the effectiveness of national food safety systems in the Member States (MS) of the European Union (EU). Under the current EU legislation, each MS shall appoint the competent authorities responsible for the purposes of European legislation in the field of food safety and for performance of official controls. Member States shall ensure that official controls are carried out regularly, on a risk basis and with appropriate frequency to achieve the objectives set out in the European legislation. For evaluation were used the country profiles of Member States, as published in 2011-2015. From the perspective of the European Commission current system of official controls in the Czech Republic is rated as one of the most effective and least problematic. When comparing various systems in Member States it is not possible to decide which control system is more efficient, i.e. system based on one competent authority or relying on several competent authorities.

This special issue of the CEJPH focuses on selected non-communicable and communicable diseases in Eastern Slovakia. The country and its economy have gone through many important reforms since the Velvet Revolution in 1989 and the disintegration of Czechoslovakia in 1993. The Slovak Republic joined the EU in 2004, and in 2009 the country implemented the Euro currency. Slovakia has an advanced economy with one of the fastest growth rates in the EU and OECD, with a nominal GDP per capita of $35,094 (2018 est.). Slovakia is structured into 79 districts and eight administrative regions. There are considerable regional differences in the economy, employment and wealth between the western and eastern regions with an impact on the health status of population. Regional differences and different socioeconomic factors in Eastern Slovakia have an influence on the structure and frequency of important health determinants. Regarding non-communicable diseases indicators, our special issue is dealing with many key topics, such as the following: anthropometric impact on blood pressure in children, with important reproductive and pregnancy outcome in Roma and non-Roma mothers; cardiovascular risk in medical students; socio-demographic factors influencing compliance with a gluten-free diet among celiac children; and also with the validation of recommended questionnaires to screen the obstructive sleep apnoea syndrome. On the other hand, communicable diseases in Eastern Slovakia covered in this special issue include topic on tick-borne diseases – Lyme disease, tick-born encephalitis and its milk outbreak in Košice region. Also, the surveillance of Creutzfeldt-Jacob disease (2004–2016) in Eastern Slovakia showed an increased incidence. The special edition of the Journal also includes fungal infection analysis in the past three years and the treatment of hospital-acquired clostridia infections. Currently, the issue of health inequalities is only implicitly addressed by politicians, and falls within the broader efforts of the government to improve equity overall.

Letter to the editor, in response to the paper "Legionellosis: a walk-through to identification of the source of infection", Cent Eur J Public Health 2017;25(3):235-239.

Objective: Early morning shifts have a negative effect on the hypothalamic-pituitary-adrenal axis. The aim of this study was to comprehensively assess the extent of occupational stress in early shift workers of the car industry by using salivary cortisol as an objective marker during a workday and on a day off. Methods: For this cross-sectional epidemiological type of study, a survey included 55 suitable volunteers from the car industry. Five saliva samples were collected according to the following schedule: during one work day in the morning, during the morning shift from 6 a.m. - 2 p.m., then after the shift was completed, 3 hours after work and in the evening before going to sleep. Control samples were taken from the same participants on a day off. Radioimmunoanalysis was used as the main analytical method, and the effect of factors and between-factor interactions on the levels of salivary cortisol during the workday were assessed using an ANOVA model. Results: The cortisol diurnal rhythm was as expected, with the highest values in the morning and declining to the lowest values in the evening hours. Concentrations of salivary cortisol showed higher values during the workday, especially higher concentrations of evening cortisol and attenuated cortisol slope. Based on the results, irregular shift work has a greater increase in cortisol excretion after waking in the morning and a slower progressive recovery of the organism during the workday. In addition, cortisol levels were significantly higher in older women than in older men but did not differ in younger subjects. Conclusions: Salivary cortisol levels are a suitable objective marker of stress and can be used as a good predictor of occupational stress by public health services for the purposes of primary prevention.

Objective: The aim of the research was to assess the prevalence, effects and risk factors for motor vehicle accidents (MVA) in the years 2004-2017 in Poland. Method: We merged secondary data from the Prevention and Analysis Office of Road Traffic Headquarters of Police and Central Statistical Office of Poland. Results: Our results suggest that several thousand people are killed on Polish roads annually, and tens of thousands are injured. Road crashes represent the leading cause of death for Polish men up to 44 years of age. The most common causes of road crashes in Poland include failure to comply with the road traffic rules and low driving skills. We also found drivers who poorly assessed road situations, roads characterized by a lack of adequate road infrastructure, and many vehicles in poor condition. Road crashes have become a significant public health and social problem globally. Drivers caused most MVA in Poland in the years 2004-2017, whereas the underlying cause was inadequate speed regarding the road traffic condition as well as not respecting the right-of-way. Despite various measures that are being taken to improve safety on Polish roads, the number of the dead and wounded as a result of road accidents is still high and the losses to the society are considerable as well. Conclusion: It is necessary to continue multidirectional actions to improve safety on the roads in Poland resulting in a systematic increase in the level of road traffic security.

Objective: Obstructive sleep apnoea syndrome (OSAS) associated with daytime sleepiness (DS) contributes to a higher incidence of motor vehicle accidents. Validation of fitness to drive in driving license applicants, with special concern regarding OSAS accompanied by excessive DS, became mandatory under new EU legislation in January 2016. The aim of the study was to translate and validate the recommended questionnaire to screen for OSAS (Q-OSAS) in the Slovak population. No data on any Q-OSAS validation has previously been published. Methods: The translated Q-OSAS was administered to 311 Slovak patients prior to a planned overnight polysomnography. The diagnostic accuracy of the Q-OSAS in OSAS with an apnoea-hypopnoea index of 15 or more/h of sleep was evaluated by calculating the area under the ROC curve. Results: The sensitivity and specificity of the cut-off at 10 points for the Q-OSAS was 57% and 67%, respectively, with an increase of sensitivity and a decrease of specificity with a lowering of the cut-off values. Excluding the Epworth Sleepiness Scale (ESS) score from the final statistics yielded the best sensitivity (77%), specificity (50%), and an area under the ROC curve (0.637) for the cut-off value of 8 points (an equivalent of 10 points with the full version of the Q-OSAS). Conclusion: The Q-OSAS is an appropriate screening tool to facilitate the screening of subjects potentially at risk from moderate and severe OSAS. A modified two-step interpretation of the Q-OSAS in Slovakia yielded the best sensitivity, and in the future could promote evaluation of sleepiness in sleep and wake disorders other than OSAS for fitness to drive.

Objective: The present study examines the question as to whether the wellbeing of children and adolescents in Austria and the use of vaccination are influenced by migration background. Methods: The data was extracted from the Austrian Health Survey 2014 (ATHIS 2014). It contains health-related information of 5,277 children and adolescents aged 0 to 17 years. The analysis was based on logistic regression models. Results: To stem from a migration background had no influence on the assessment of health or the assessment of complaints. Regarding vaccination, the results showed that the children of study participants born in non-EU foreign countries had twice the chance of being vaccinated as the children of Austria-born parents. No difference existed between the children of Austria-born parents and the children of parents born in non-EU countries. Conclusions: The analysis suggests that children and adolescents with a migration background in Austria are not worse off in terms of their physical wellbeing and vaccination status than children without a migration background. Some thought should, however, be given to the fact that the notion of migration background refers to a heterogenic population. To analyse the risks and chances of children and adolescents from different migrant backgrounds, a more differentiated survey of their migrant background and social situation and a more differentiated survey of health parameters will be required.

Objectives: Central obesity represents an increased risk to develop cardiovascular diseases. Guidelines of international societies suggest estimating central obesity by measuring waist circumference (WC). Robust statistical data in literature provide evidence on the superiority of waist-to-height ratio (WHtR) over WC and body mass index (BMI) for detecting cardiometabolic risk in both genders. Based on measurements of weight, height and waist circumference we compared the prevalence of central obesity using both the above mentioned criteria in the apparently healthy Slovak adults, and compared the prevalence of central obesity to that of general obesity (BMI). Methods: Data collected from 5,184 individuals (45% males) aged ≥18 years in four cross-sectional studies carried out between the years 2009-2012 were subjected to secondary analysis. Results: Waist circumference underestimated central obesity in males and overestimated in females: 37.3% of males and 41.8% of females presented central obesity according to WC, 54.2% males and 34.9% females according to WHtR. 17.3% of males centrally obese according to WC present WHtR < 0.5; while 7.8% of females centrally obese according to their WHtR do not display increased WC. The frequency of central obesity increased with age. According to BMI, the prevalence of overweight was 39% in males and 22% in females; that of obesity was 17% and 15%, respectively. Conclusion: The prevalence of central obesity estimated using WC vs. WHtR differs significantly in Slovak adults. WHtR is considered superior for detection of the risk of future development of cardiovascular afflictions. Thus, further studies addressing the gender-associated discordance of central obesity measures are required to determine whether our results are consistent across geographical regions and ethnic groups.

Background: Infant mortality rate (IMR) and neonatal mortality rate (NMR) are accepted as good indicators to measure the health status of a nation. This report describes recent declines in IMR and NMR in Turkey. Methods: Data on infants who died before 12 months of life were obtained from the Infant Mortality Monitoring System of Ministry of Health of Turkey between 2007 and 2012. A total of 94,038 infant deaths were evaluated. Results: Turkey IMR and NMR exhibited a marked decline from 2007 (16.4 and 12.2) to 2010 (10.1 and 6.6) and then plateaued in 2012 (9.7 and 6.3), despite regional differences. Prematurity, congenital anomalies and congenital heart diseases (CHD) were the three most common causes of infant deaths between 2007 and 2012. While the rates of respiratory distress syndrome (RDS), sudden infant death syndrome (SIDS), and metabolic diseases increased, the rates of congenital anomalies and birth injuries decreased. IMR and NMR significantly increased with the number of infants per paediatrician, per doctor, and per midwife, while was decreasing with the increased rate of hospital birth, caesarean delivery, antenatal care, infant follow-up, and staff trained within the Neonatal Resuscitation Programme (NRP). Conclusion: From 2007-2012, Turkey showed remarkable encouraging advances in reducing IMR and NMR. Any interventions aimed at further reductions in IMR and NMR should target the common causes of death and defined risk factors especially in socioeconomically disadvantaged regions.

Objectives: The aim of the serological survey of measles was to obtain information on the prevalence of antibodies against measles and to verify the effectiveness of vaccination in the Czech population in order to protect public health. Methods: The serological survey was carried out in the Czech Republic in 2013. Antibodies against measles were tested in 3,111 serum samples of participants aged 1-64 years. Serum samples were tested for the presence of immunoglobulin G (IgG) antibodies by enzyme immunoassay (EIA). The vaccination status assessment was based on the medical documentation. Seroprevalence differences were evaluated by sex and age using the Pearson's χ² test at 5% significance level. Results: The overall seroprevalence reached 93.0% (2,893/3,111) (95% CI 92.0-93.9). No statistically significant difference was found between men and women (p = 0.724). A lower seroprevalence was identified in the first age group (1-year old children) 62% (62/100), as the vaccination has not yet been completed in this age group. The second lowest seroprevalence 80.4% (160/199) was identified in the age group of 35-44 years. The highest seroprevalence 97.7% (387/396) (95% CI 95.7-99.0) was in the population with naturally-induced immunity (age above 45 years). In the individuals with two doses seroprevalence reached 94.1% (2,081/2,212) (95% CI 93.0-95.0). The level of IgG antibodies decreased in persons above 7 years of age. Conclusions: Based on the results of the serological survey carried out in 2013 in the Czech Republic, it has been decided to postpone the second MMR (measles, mumps and rubella) dose to the age of 5-6 years.

Objective: As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts have been made to add a new item so that lumbar spine disease caused by overload may be recognized as occupational one, with adherence to the valid national rules, that is, clinical criteria are met and objective assessment confirms working conditions under which, according to recent scientific knowledge, such an occupational disease develops. The aim is to provide information on the use of a proposed method for working condition assessment in a real setting, based on the initial experiences gained from a pilot study carried out to validate the method. Methods: Working conditions were assessed in 55 individuals with chronic low back pain (25 males, 30 females; mean age 45.6 years; mean length of employment 15.6 years). The assessment was based on estimating compressive force on the L4/L5 intervertebral disc when performing potentially high-risk work tasks which were entered into four types of checklists throughout their work shifts. The compression values were calculated using a special module that was developed. Results: In 24 cases comprehensive assessment of all tasks performed showed fulfillment of the proposed criteria of working conditions needed for recognition of occupational disease. Those included healthcare, foundry and forest workers, production operators, cabinetmakers, locksmiths, bricklayers, etc. In all the cases, lumbar spine overload was associated with work tasks requiring combinations of manual handling of objects and trunk rotation or bending. The criteria were not met in 31 subjects. The mean length of employment was 15.4 and 15.8 years in patients who met and did not meet the proposed criteria, respectively. Conclusion: The proposed method proved to be applicable in occupational hygiene evaluation in a real setting.

Objective: Dental caries is an important public health issue worldwide. In developing countries preventive dentistry is not common; hence, oral and dental health problems continue to generate serious economic and social issues. The aim of this study was to assess oral health and the incidence of dental caries in systemically healthy children aged 3-14 years, provide education on oral hygiene motivation, conduct the necessary preventive and restorative procedures, and reassess caries development at the 6-, 12-, and 18-month post-treatment follow-up. Methods: Systemically healthy children aged 3-14 years who applied to the Paediatric Dentistry Clinic, Faculty of Dentistry, Adnan Menderes University (ADU) were included in the study. The subjects were evaluated for oral health status and incidence of dental caries based on surveys and clinical examination, motivation for oral hygiene with necessary training, completion of preventive and restorative treatments, and development of dental caries at the 6-, 12-, and 18-month post-treatment follow-up. Results: The study included 320 patients, aged 3-14 years (mean age 8.08 ± 3.45 years). In children included in the study, the average decayed (d), missing (m) and filled (f) primary teeth (dmft) value was 3.81 (min-max: 0-16), decayed (D), missing (M) and filled (F) permanent teeth (DMFT) value, 1.49 (min-max: 0-6), decayed (d), missing(m) and filled(f) primary teeth surface (dmfs) value, 10.11 (min-max: 0-40), and decayed (D), missing (M) and filled (F) permanent teeth surface (DMFS) value, 2.09 (min-max: 0-12). Conclusions: For the protection and maintenance of oral and dental health in dentistry, preventive approaches should be the first concern and conservative therapeutic methods should be given priority after occurrence of any dental pathology. In addition, one-time examinations are not sufficient, and children should be examined at least twice a year. This study showed that the incidence of dental caries declined in children who underwent periodical examination and preventive dental treatment.

Objectives: The aim of this study was to assess fractures of extremities, spine and pelvis in patients with respect to mechanism, time of the incident and demography of patients in order to propose preventive measures. Methods: A mono-centric (Level I Trauma Centre, predominantly urban population) prospective study was carried-out during the one-year period from 1 January to 31 December 2012. Patients with bone fractures of extremities, spine and pelvis were studied. Demography, mechanism and time of the injury were analysed. Results: The study group consisted of 3,148 patients, 53% being women and treated for 3,909 fractures. The mean age of patients was 53 years. The most traumatised patients were of the 3rd and 4th decade, a further increase in the incidence of fractures was seen in the 7th and 9th decade. Multiple fractures were significantly higher in men (p = 0.002). A car crash or fall from a height was more common cause of spinal fracture or pelvic fracture than fracture to the upper or lower limbs (p < 0.001). Most of the fractures occurred during the day between 9 a.m. and 6 p.m., on Saturdays and during the winter season. The bones most often broken were the radius (739 patients, 18.5%) and femur (436 patients, 11.1%). Conclusions: Our study highlights the need for injury prevention focused on sex, age and types of activities performed. Among younger individuals, such programmes should primarily be targeted toward men who, as observed in our sample, have a higher fracture frequency compared to women. Conversely, injury prevention programmes for individuals ≥ 60 years should primarily be targeted toward women, who have the highest fracture prevalence in this population.

Objective: The aim of the presented cross-sectional seroepidemiological study was to determine the current presence of antibodies against B. burgdorferi s.l. in the groups of Slovak population, and to identify potential risk factors to Lyme borreliosis. Methods: A group of 261 adults (patients from the Neurological Clinic with possible symptoms of LB and healthy persons with possible working exposure to tick bite: gardeners and soldiers working in afforested areas) were examined in order to assess the seroprevalence of anti-Borrelia antibodies. Sera were screened by commercial enzyme-linked immunosorbent assay (ELISA). The respondents completed questionnaires with general demographic, epidemiological and clinical data. Results: We detected 17.2% presence of positive IgG and 5.7% presence of positive IgM antibodies in all investigated groups. Our results confirmed that the following risk factors such as age and gender are significantly associated with the presence of positive specific antibodies against investigated disease. Conclusion: The results of seroprevalence obtained in the present study confirm the possibility of infection with B. burgdorferi among respondents exposed to contact with ticks.

Objective: The aim of the study was to estimate changes in the prevalence of respiratory diseases and disorders between 2003/2004 and 2011/2012 in 13-16 years old children living in Bytom, one of the biggest cities in the Silesia agglomeration and provide the evidence for local policy makers. Methods: Data from two cross-sectional surveys, based on the Polish version of the International Study of Allergy and Asthma in Childhood (ISAAC) questionnaire, conducted in 2003/2004 and 2011/2012 was used. Response rate in the first and the second survey was 68% and 35%, respectively. The number of analyzed observations was 4,041 and 707 from the first and the second survey. The selection bias was controlled with the propensity score matching and potential determinants of analyzed respiratory diseases and disorders were controlled in the multivariable logistic regression model. Results: We found statistically significant increase in asthma ever diagnosed by medical doctor (4.5% vs. 9.6%; p < 0.01), seizures of dyspnea (8.2% vs. 27.7%; p < 0.01), and chest wheeze (9.6% vs. 19.2%; p < 0.01). Conclusion: Our study revealed significant increase in the prevalence of respiratory diseases and disorders after 8 years in adolescents living in the Upper Silesian Industrial Zone. This is a relevant finding which provides the evidence for decision makers in the scope of local public health policies.

Objective: The marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) exert numerous beneficial effects on health, but their potency to defend against development of peripheral insulin resistance of healthy person with overweight remains poorly characterized. We aimed to evaluate the effect of a combination intervention using EPA + DHA and the lifestyle modification (LSM) in women with overweight. Method: In a parallel-group, three-arm, randomized trial (UMIN Clinical Trials Registry - R000031131), 34 women were assigned to a 12-week-intervention using corn oil (1.5 g/day; placebo); LSM and corn oil (1.5 g/day; LSM); or LSM and EPA + DHA concentrate (1.5 g/day, containing ~ 0.6 g EPA + DHA; LSM & n-3). At baseline and after intervention, anthropometric measurements including bioelectrical impedance analysis, spiroergometry, 24-hours dietary recall, and various metabolic markers, adiponectin and cytokines were evaluated in serum using standard procedures. Data from 29 women were used for the final evaluation. Wilcoxon two-sided rank-sum test was used to inspect the differences between LSM and LSM & n-3, and placebo groups, with a p-value of ≤ 0.05. All computations were performed with MATLAB Statistics Toolbox. Results: In comparison with placebo, LSM and LSM & n-3 decreased body weight, waist circumference, and body fat, and increased VO₂max/kg. LSM & n-3 increased adiponectin levels in comparison to LSM. Fasting insulin, IL8, and cholesterol were decreased by LSM, but were unchanged by LSM & n-3. IL6 was not affected in LSM & n-3, while it was increased in LSM. Other inflammatory markers, as well as leptin, LIF, follistatin, BDNF, and fasting triacylglycerol were not significantly affected by any of the interventions. Conclusion: Besides preventing a modest negative effect of LSM on IL6 and adiponectin level, the combination of LSM and EPA + DHA supplementation could be probably used to improve the functional capacity of adipose tissue in women with overweight.

Objectives: An extraordinary incidence of genetic Creutzfeldt-Jakob disease (gCJD) appearing in clusters in the Slovak Republic was described in the 1990's. The aim of the study was to analyse data of CJD cases obtained from surveillance in Eastern Slovakia (ES) (2004-2016), the region outside the described geographical clusters. Methods: The database set in the project was the source for epidemiological and clinical analysis of CJD cases. Results: The incidence of CJD in ES (2004-2016) was 1.7/million person-years (95% CI 1-2.4); the incidence increase in the last five years (2012-2016) was comparable to the whole country. Twenty seven of 29 reported CJD cases were available for analysis (mean age 59 years, F/M 15/12). The proportion of gCJD (E200K mutation) cases remained dominant (78%), with 9 familiar cases originating in 4 families. Analysis of the clinical features revealed shorter duration of the symptomatic phase in sporadic CJD (sCJD) (3.4 months) versus gCJD (5.15 months). Cognitive/behavioural changes, insomnia, and sensory disturbance were more pronounced in the early symptoms of gCJD. Periodic EEG discharges were more frequent in sCJD (83%) than gCJD (56%), all 19 available MR findings were CJD specific and localisation of abnormalities varied amongst the CJD forms. Conclusions: The surveillance of CJD in ES (2004-2016) showed an increased incidence of CJD in ES, reaching the incidence rate of the whole country, with a permanent proportion of 70% gCJD cases based on the E200K mutation. Clinical, electrophysiological and MR features of sCJD and gCJD cases were in conformity with already published data. Epidemiological analysis of CJD in ES shows increasing detection of CJD but also suggests that current routine surveillance systems for CJD may underestimate the true burden of disease, especially sporadic cases in Slovakia.

Objective: The current study investigated how adolescents perceive their own health risks and compare their own likelihood of health risks with that of others of the same age. Moreover, the study identified the differences in health risk perceptions between males and females. Methods: A total of 625 adolescents (314 males and 311 females) from the Nowon district, geographically located in northern Seoul, voluntarily participated. In order to measure health risk perceptions a Korean version of self-other risk judgments profile was used. Results: The findings indicated that study participants, regardless of gender and age, tend to underestimate their vulnerability to majority of health risk events. Furthermore, there were significant gender and age differences in health risk perception and perception bias in all health risk domains. Conclusion: The present study suggests that further research is needed to identify realistic and unrealistic perception mechanism for a large number of people from different demographic and socioeconomic backgrounds.

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: HIV testing among people who inject drugs (PWID) in Russia has been documented to be low; however, few studies have been conducted outside of the major metropolitan cities. The aim of this study was to determine how many PWID were aware of their HIV serostatus and what motivators were associated with getting tested for HIV. Methods: Our analysis describes HIV testing behaviours among 593 PWID in Ivanovo and Novosibirsk, Russia. Participants completed a questionnaire and consented to HIV testing. We used logistic regression modelling to determine demographic and behavioural correlates of HIV testing. Results: Self-reported history of HIV testing was 52% in Ivanovo and 54% in Novosibirsk. Prior knowledge of serostatus was very low among PWID who tested positive (3 of 102 in Ivanovo and 0 of 11 in Novosibirsk). The most common reason for testing was doctor referral, and the most common locations were government HIV/AIDS centres and prisons. HIV testing was rarely client initiated or led by a personal motivation for being tested. Conclusions: HIV testing in Ivanovo and Novosibirsk is suboptimal, resulting in poor knowledge of HIV serostatus. More programmes to promote HIV testing among PWID are urgently needed in both cities.

Objectives: Determinants of health in Central and Eastern Europe (CEE) have been discussed primarily in relation to the transition of the 1990's and early 2000's, citing lifestyles as the main culprit. This paper tries to draw a bigger picture of the health determinants in CEE in the first decade of the 21st century. To do so, the two main analytical approaches to health are united in one setting. One of them is based on the definition of health as a personal commodity relying mostly on micro-level subjective data. The other views health as a public commodity analysing objective societal characteristics and health care interventions with often a macro-level perspective. The current study incorporates these different approaches (subjective and objective) in a multi-level setting in CEE. Methods: The analysis concentrates on health care, social, political, and economic factors as determinants of self-rated health. Multilevel analysis is carried out on a dataset of Life in Transition Survey (LiTS), conducted in 2006 and 2010, pooled cross-sectional data on 46,546 individuals in 27 CEE states. They are accompanied by macro-level data. Results: The findings demonstrate that a complex mix of determinants influences subjective health in CEE. There are clear differences in the way objective and subjective indicators influence self-rated health. While societal economic prosperity does not influence health, there are strong country-specific differences in the effect of individual prosperity on health. Conclusions: The study adds to the recent literature on health in CEE by introducing an encompassing systematic approach to analysing health, as no leading cause for self-rated health variation was found. This paper also contributes to research on the determinants of health by fusing objective and subjective determinants in a hierarchical setting. Both subjective and objective determinants matter for health.

Trends in dietary nutrition and their personalization are progress in medical science and point out the necessity of adaptation and development of innovations in health system. The main objective of this article is to review the role of dietary fibre as prebiotics in nutrition with different functionality, its influence on modulation of intestinal microbiota, which has an essential role in maintenance of healthy organisms in people of all ages.

Objective: The aim of this study was to examine subjective sensitivity to noise of the citizens of Niš and its impact on their non-auditory health effects. Methods: This study was designed as a cross-sectional questionnaire survey among 908 adult residents of Niš, Serbia, of whom 387 were men (42.6%) and 521 women (57.4%). Streets with day L_eq ≥ 55 dB(A) and night L_eq ≥ 45 dB(A) were regarded as noisy and those with day L_eq ≤ 55 dB(A) and night L_eq ≤ 45 dB(A) were regarded as quiet, in accordance with WHO recommendations. Noise sensitivity was measured with the Weinstein's Noise Sensitivity Scale. Logistic regression analysis was used to assess the impact of noise sensitivity on non-auditory health effects. Results: The study showed that the values of the Weinstein's Noise Sensitivity Scale were significantly higher for those surveyed in the noisy zone. Multiple regression analysis revealed a significant impact of noise sensitivity on night-sleep duration (p = 0.04), subjective assessment of sleep quality (p < 0.01) and daily rest disruption (p < 0.001). Conclusion: Based on the study results, it can be confirmed that noise sensitivity has an important role in causing non-auditory health effects among adults.

This study presents the results of pilot measurement, where the exposure of fine and ultrafine particulate matter was monitored. The measurement was performed in welding workplace, where these particles are produced unintentionally. The measurement consisted of collecting information and measuring the concentration of particles in the workplace, where data collection was focused only on inhalation exposure. During welding, primarily 300 nm size particles are produced, and their concentration is strongly influenced by the welding material, type of welding and suction. The particles are amorphous in terms of morphology and contain manganese, iron and silicon, which can cause neurodegenerative diseases. Furthermore, the results indicate the importance of monitoring oral exposure.

Objectives: The study presents the findings of a quantitative research conducted among people aged over 90, who live in a large town of Hungary, Debrecen. The aim of the research was to examine the lifestyle, attitudes, values, and physical and mental condition of old and long-lived people. We laid a special emphasis on the exploration of the life perspectives, mood and mental youth, and their interconnections. Methods: The sociological questionnaire used for data collection (159 questions) was intended to inquire socio-demographic characteristics, dietary habits, health condition, physical activity, and identity features. Further examinations were conducted in order to measure the level of depression using the Geriatric Depression Scale (GDS) and mental condition using the Mini-Mental State Examination (MMSE). We managed to reach out to the elderly living in the town on the basis of family doctors' districts (N = 212). We dealt with a subsample of 115 people since we got answers for all questions from them. During data processing, we applied multivariate statistical methods, first of all linear regression analysis and cluster analysis. We examined the differences between clusters using variation analysis. Results: According to our results, the extremely low educational level of the elderly belonging to the target group did not decrease their life perspectives, but it had a significant impact on the age when their illness begun. We revealed a connection between the mental condition and the level of depression. Better mental condition (higher MMSE) resulted in lower depression level (low GDS). One of our main finding is that the change in the level of depression (GDS) is 13.4% due to the change in the mental condition (MMSE). Conclusions: Physical and mental activity, personal autonomy, a wide range of activities, and avoiding isolation and solitude allow people to experience quality ageing; all these factors can be substantially influenced by the status acquired at a younger age. We believe that it is extremely important for the society to develop guarantees for active old age, which would ensure the optimal balance between the possibilities of physical and mental health, social participation and safety.