Fulltext search in archive

Aim: The aim of the study was to estimate the possible risk of adverse birth outcomes of children born to mothers with rheumatoid arthritis (RA). Methods: The dataset of large population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities from 1980-1996 was evaluated including 22,843 cases with congenital abnormalities and 38,151 matched controls without any defect. Results: 36 cases (0.16%) had mothers with RA, while 68 controls (0.18%) were born to mothers without RA (OR=0.9, 95% CI=0.3-1.6). A higher risk for congenital abnormalities in the offspring of pregnant women with RA was not found. In fact there was a larger mean birth weight in the newborns without any defect of mothers with RA and it was associated with a somewhat lower rate of low birth weight. Conclusion: RA seems to have a beneficial effect not only for pregnant women but for their foetuses as well.

Objective: The study aimed to explore changes in the prevalence of psychological distress and co-occurring psychological symptoms among 19-34 years old Finnish university students between the years 2000 and 2012. Methods: The prevalence of perceived frequent psychological symptoms was compared in four nationwide cross-sectional student health surveys with random samples (N=11,502) in the following years: 2000 (N=3,174), 2004 (N=3,153), 2008 (N=2,750), and 2012 (N=2,425). Results: In the time phase from 2000 to 2012, the overall psychological distress (12-item General Health Questionnaire, GHQ-12) increased from 22% to 28%, while there was also an increase in the frequently experienced psychological symptoms (depressiveness from 13% to 15%, anxiety from 8% to 13%, concentration problems from 12% to 18%, and psychological tension from 13% to 18% with a peak prevalence observed in 2008). The co-occurrence of different psychological symptoms increased as well. Psychological distress was more common in females and in older students. Conclusions: The findings suggest an increasing trend of frequent psychological distress among Finnish university students over the years from 2000 to 2012, with the peak prevalence occurring in 2008, which may reflect the growing multifaceted environmental demands.

OBJECTIVE: The aim of the study is to examine cross-sectional time trends of life satisfaction and self-rated health in a representative sample of Czech children aged 11, 13 and 15 years using the Health Behaviour in School-aged Children (HBSC) study data from the Czech Republic.
METHODS: Data from survey years 2002, 2006, 2010 and 2014 was used. The sample consisted of 16,357 participants (48.5% of boys). Life satisfaction (LS) was measured by Cantril's ladder; self-rated health was measured through the simple item "Would you say your health is: excellent, good, fair, poor".
RESULTS: Most of the children were satisfied with their lives in all surveyed years (mean LS scores range from 7.21 to 7.51; maximum 10). LS was consistently significantly associated (p<0.001) with age and gender. Overall, children and adolescents in the Czech Republic also reported good health. In total, 87.6% of respondents from all samples reported their health as excellent or good. Gender was found to be significantly associated with self-rated health (p<0.05) in all surveyed years.
CONCLUSIONS: No permanent trends in both followed indicators have been seen in the examined period.

Objective: In Slovakia, thanks to a highly effective vaccination programme, no domestic cases of measles have been reported since 1999. However, there are several outbreaks of measles currently hitting some countries in Europe. Difficulties in reaching the goal of measles elimination make it necessary to monitor the status of the population susceptibility to prevent similar outbreaks in the future. We hypothesize that immunity wanes overtime, which can substantially impact the population susceptibility. This work introduces a model that estimates a proportion of individuals susceptible to measles in the Slovak population in 2015. Methods: Our analysis is based on an age-cohort model that incorporates waning immunity, vaccination schedule and changes in demographic structure. The inputs of the model are data on the vaccination coverage, last seroprevalence survey in 2002 and age structure of the population. Results: In a short-term horizon, waning immunity does not affect the estimated proportion of the susceptible population. However, in a long-term horizon, the antibody titers can fall below the level of protection, which would result in a substantial transfer of initially immune individuals to the compartment of the susceptible ones. Incorporating of waning immunity in the cohort model has indicated that the most susceptible cohorts are not-vaccinated youngest children and cohorts born between 1969 and 1986. Conclusions: Applying the model to the current situation shows that people aged 30-45 years and unvaccinated infants represent the most susceptible groups. Model partially replaces missing seroprevalence survey, but, because the parameters of model and phenomenon of waning immunity are not exactly known, we suggest reintroducing the regular national serosurveys in order to empirically determine the level of susceptibility for measles in Slovakia.

Background and Aim: Cardiovascular disease is a serious problem increasingly affecting young people worldwide. Cardio-metabolic risk factors include lipid profile parameters and atherogenic index of plasma (AIP), as well as basic anthropometric parameters such as the ratio of waist circumference to height (WHtR). The aim of our study was to determine WHtR. Method: WHtR was determined in a group of 500 clinically healthy young people aged 18-25 and, on the basis of measured data, a reference range for WHtR was designed. Results: The average WHtR value for the whole group was 0.45±0.06, with 0.46±0.06 for men, and 0.44±0.06 for women. WHtR values in respondents with all other parameters in normal range were from 0.41 to 0.52 for men and from 0.38 to 0.50 for women. Values are similar to those observed in other studies across diverse world populations. A positive correlation was observed between WHtR and atherogenic indices (AP1, AIP) uric acid levels and lipid profile parameters at p<0.001, with the exception of glucose and HDL. WHtR and HDL were negatively correlated at p<0.001. Conclusion: As WHtR can be easily determined, it can be used as another cardio-metabolic risk factor.

Objective: The study examined the links between health-related indicators, adult resilience, and burnout. Method: The data were collected during two waves of the longitudinal study (in 2004-05, N = 98, and 2011-12, N = 88, respectively). Health behaviour, self-rated health (SRH), Sense of Coherence Scale (SOC), and Shirom-Melamed Burnout Measure (SMBM) were measured. Results: The comprehensibility of SOC and physical fatigue of SMBM as measured in wave 2 were determined by SRH as measured in wave 1. In the cross-sectional part, the meaningfulness of SOC was related to SRH, and alcohol consumption in wave 1. The comprehensibility of SOC was related to SRH in wave 2. Conclusion: SOC is well known to have effect on health. However, the results show that self-reported health had effect on the comprehensibility of SOC. Our data also support the finding that the effect of SRH on burnout is stronger than the effect of burnout on SRH.

Objective: The aim of this study was to analyse differences in health, eating habits and social support in adolescents with type 1 diabetes mellitus (T1DM) in comparison to peers with another long-term illness or without any medical condition. Methods: We used self-reported data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents as well as data from adolescents with T1DM collected in outpatient settings (11 to 15 years old, N = 8,910, 50.3% of boys). Logistic regression models and general linear models were used to analyse differences between adolescents with T1DM and their peers with and without long-term illness in self-rated health, life satisfaction, health complaints, regular breakfast, sweets and soft drink consumption, and perceived support from family, teachers and classmates. Results: Adolescents with T1DM reported worse self-rated health and suffer from more health complaints, but they have lower chance of having breakfast irregularly in comparison to their peers with another long-term illness or without any medical condition. Moreover, compared with their peers, adolescents with T1DM perceived stronger support from teachers and classmates, but weaker support from their family. We did not confirm any differences in life satisfaction, sweets and soft drink consumption between adolescents with T1DM and their peers. Conclusions: Adolescents with T1DM reported more regular eating habits, no difference in life satisfaction and more social support outside the family in comparison to their peers. However, their worse self-rated health, more health complaints and weaker support from family should be considered in interventions targeting psychosocial adjustment of adolescents with T1DM.

Aim: The aim of our study was to find statistical associations including trends of standardised rate ratio of age-adjusted mortality rates for the male population as compared to the female population, in relation to available demographic factors (Chapter II - neoplasms vs. Chapter IX - Diseases of the circulatory system, Slovak region and calendar year of death). Methods: Dataset of individual cases of death in Slovakia with some demographic factors during 1996-2013 were provided by Slovak National Health Information Center. We used regression and correlation analyses, as well as analyses of variance and covariance along with descriptive statistics. Results: The standardised rate ratio of age adjusted mortality rates of men versus age-adjusted mortality rates of women differs between Chapter II and Chapter IX (mean 2.08 vs. 1.35, p < 0.001). There are also significant differences of standardised rate ratio among regions (p < 0.05). Trends show that the standardised rate ratio has significant regional decline for Chapter II: Košice (p < 0.01), Trenčín (p < 0.001) and Žilina (p < 0.05) whereas in Chapter IX Žilina region (p < 0.01) is implicated. In other Slovak regions standardised rate ratio stagnates. Conclusions: Standardised rate ratios of age-adjusted mortality rates for the male population compared to the female population are significantly dependent on chapter, sex and region. Standardised rate ratios either decline or stagnate.

Increasing bacterial resistance to quinolone antibiotics is apparent in both humans and animals. For humans, a potential source of resistant bacteria may be animals or their products entering the human food chain, for example poultry. Between July 2013 and September 2014, samples were collected and analyzed in the Moravian regions of the Czech Republic to isolate the bacterium Escherichia coli. As a result, 212 E. coli isolates were obtained comprising 126 environmental isolates from poultry houses and 86 isolates from cloacal swabs from market-weight turkeys. Subsequently, the E. coli isolates were tested for susceptibility to selected antibiotics. Resistance of the poultry isolates to quinolones ranged from 53% to 73%. Additionally, the presence of plasmid-mediated resistance genes was studied. The genes were confirmed in 58% of the tested strains. The data on resistance of isolates from poultry were compared with results of resistance tests in human isolates obtained in the same regions. The high levels of resistance determined by both phenotyping and genotyping methods and reported in the present study confirm the fact that the use of fluoroquinolones in poultry should be closely monitored.

Objective: Vitamin D deficiency has been associated with cardiovascular disease. The aim of this study was to determine serum concentration of 25 hydroxyvitamin D (25(OH)D) in patients with acute coronary syndrome (ACS) and to assess the prognostic role of serum vitamin D level in ACS patients during 3-year follow up. Methods: The study included 60 ACS patients hospitalized at cardiology department for ACS between March 2012 and October 2012, and 60 age- and sex-matched control patients without ACS. Standard laboratory testing and vitamin D determination were performed in all study patients. In addition, ACS patients underwent coronarography and were followed-up for 36 months of ACS for major adverse cardiac events (MACE). Results: Patients with ACS had a statistically significantly lower mean 25(OH)D level as compared with control group (35.19 nmol/L vs. 58.08 nmol/L, p < 0.001). The lowest mean level of 25(OH)D was recorded in diabetic patients with ACS (30.45 nmol/L). ACS patients were divided into three subgroups according to coronarography findings: single vessel, double vessel and triple vessel coronary artery disease (CAD) with respective serum levels of 25(OH)D of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L. During 36-month follow up, the event-free survival rate was 60% in the ACS group. The ACS patients having sustained MACE during follow up had low serum level of 25(OH)D in the acute phase; however, the difference from ACS patients without MACE during follow up did not reach statistical significance (32.64 nmol/L vs. 37.01 nmol/L). Conclusions: Patients with ACS have low vitamin D level, which is lowest in diabetic patients with ACS. However, during 3-year follow up, vitamin D failed to prove useful as a prognostic biomarker in ACS patients.

Aim: Poverty and social exclusion is measured through different criteria and one of them is the health sector. The relationship between Roma population and the health sector is on the edge of researchers' interest in the Slovak Republic. The purpose of this paper is a quantification of the regional disparities in the development of mortality which is causally linked with selected infrastructural determinants - namely access to water and sewerage. These determinants differently participate in the structure of mortality in marginalised and segregated communities and they deepen regional disparities in health. Methods: It is a spatial analysis of the districts of the Slovak Republic. The data from the Atlas of Roma communities in Slovakia 2013 is applied. Through the multiple linear regression model the relationship between mortality of the Roma population and water and sewerage availability in the Roma settlements is examined. Similarity between the districts is measured by the Euclidean metric system. Results: The most appropriate district for representing the Slovak Republic average is the Dunajská Streda district in a field of arithmetic mean and the Veľký Krtíš district in a field of median value. The outermost district is represented by the Košice-okolie district, conversely, the Trnava district is the closest to the rest of the Slovak Republic. The highest statistically significant impacts on mortality are explored in public water supply extension plan and public sewerage supply extension plan. It seems that water play a greater role in determining health of Roma population. The highest number of inhabitants with supplied public water and public sewerage is kept by the Kežmarok district, the Košice district, and the Spišská Nová Ves district. Conclusions: Our results can be beneficial for health decision making, since in the Strategic Framework for Health of the Slovak Republic metrics for measuring and evaluating health aspects in Roma communities absent and that prevents them to be correlated with the planned interventions.

Aim: This study is concerned with environmental health studies conducted in Ostrava (Czech Republic) and the surrounding region since the early nineties. Methods: Various databases, journals and reports, including internal or unpublished reports, were reviewed to assess the individual publications. A brief description of the studies and main results were collated. Results: The city of Ostrava and the surrounding region is an important industrial centre in the Czech Republic with a long-term heavy environmental and occupational disease burden. In spite of the theoretically assessed decline of health risks related to decreasing concentrations of compounds in the environment in recent years, it still poses a disproportionally high risk for the city residents. There are a number of studies suggesting supportive evidence, but they are highly variable in their approach to this topic resulting in a high uncertainty of observed associations and consistency of results. Most of the studies were focused on specific contexts, without any relation to environmental factors. Conclusions: A more systematic approach is needed to assess environmental health burden of diseases especially in relation to air pollution, based on the prospective cohort study, that would lead to sufficient new evidence for accurate and updated description of the environmental health burden in Ostrava.

Aim: Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. Methods: A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupational diseases and possible awarding compensations to the patients. Results: In 13 countries out of the 23 countries studied, LBPD caused by overload can be recognized as occupational, providing that the diagnosis is sufficiently proven and exposure criteria and/or listed occupation are met and duration of exposure is confirmed (Belgium, Denmark, France, Germany, Hungary, Italy, Lithuania, Macedonia, Netherlands, Romania, Slovakia, Sweden, and Switzerland). LBPD due to vibrations can be also recognized as occupational in 14 countries. In 8 countries LBPD are not accepted as occupational unless they are caused by an injury at work. Specific criteria to evaluate occupational exposure of patients with LBPD were set in Belgium, Denmark, France, Germany, Lithuania, Macedonia, Netherlands, and Slovakia. In other countries, the evaluation is done at an individual basis. Conclusions: In practice, the assessment of occupational overload and its contribution to the development of LBPD as well as its inclusion in the compensation system are important for several reasons. Firstly, it may be considered essentially preventable. Secondly, cases with a significant contribution of occupational aetiology may be viewed as occupational diseases for which compensation may be claimed, as it is the case in many European countries. Importantly, inclusion of LBPD in the list of occupational diseases or another system of compensation may be viewed as a preventive measure as it increases the visibility of this problem not only for the workers, but especially for the employers.

This article considers developing trends in self-perceptions of health among the Czech population. Its conclusions are based on data from the European Union Statistics on Income and Living Conditions (EU-SILC) conducted from 2005-2011. The data analysis suggests that the compression of morbidity is present, but the Czech Republic continues to lag behind Western Europe. In addition, among males the difference in health expectancies between the Czech Republic and the EU-15 is due to a change in mortality at higher ages, rather than in self-perceived health. Among females the opposite is true. Demographic categories, such as "attained education" and "age-group" proved to be significant factors in influencing self-perceived health in the Czech population for the year 2011. Gender and marital status seem to be less important.

OBJECTIVE: Due to the importance of surveillance of injuries and accidents in the Czech Republic, the purpose of this study was to report the temporal trends of injuries of Czech adolescents between 2002 and 2014.
METHODS: Adolescents (N=20,038) from the Czech Republic, that took part in the 2002, 2006, 2010 and 2014 HBSC study, reported the frequency of medically attended injuries in the past 12 months. Repeated binary logistic regressions with different years as reference categories were performed.
RESULTS: Less than half (44.7%) of all Czech adolescents reported they had experienced at least one medically attended injuries in the past 12 months, with boys experiencing more injuries than girls (p<0.001), and the injuries were more common in older adolescents. Fewer boys reported injury in 2014 when compared to 2002 (OR, CI: 0.81, 0.72-0.90), there was also a significant decrease in injuries among girls between 2014 and 2006 (OR, CI: 0.77, 0.69-0.86).
CONCLUSIONS: The trend was not linear amongst boys. Along with improved safety promotion education, the rate of injuries decreased among adolescents between the years 2002 and 2014.

Nanoparticles exist for a long time as both inorganic and organic parts of nature. Recently, massive expansion of nanotechnologies is evidenced, together with intentional production of new nanoparticles which have not been in contact with living organisms until now. Besides obvious positive aspects, potential threats related to their exposure should be taken into consideration. Unique physical-chemical properties of nanoparticles cause a high bioactivity following their intake (through air, ingestion and skin) and unrestricted spread in exposed organs. Primary effects of nanoparticles on cellular level represent oxidative stress and reactions leading to apoptosis, autophagocytosis and necrosis. Number of studies indicating contribution of nanoparticles to numerous disorders has been recently increasing. However, detailed mechanisms of health effects are not well known. Similarly, there is insufficient information on life cycle of nanoparticles in the environment. Research in this field as well as legislation is behind rapid development and use of nanotechnologies. Considering absence of mandatory exposure limits and other protective measures, nanomaterials represent a potential threat for population health. Recommendations and guidelines of international institutions can contribute to deal with situation, however, passing of effective legislation both on national and European level is urgently needed.

Aim: This study investigated the cumulative incidence of Chlamydia trachomatis infection in women treated in gynaecology departments of healthcare facilities in two towns in Serbia and one town in the Former Yugoslav Republic (FYR) of Macedonia, including their medical records in public health reports. Methods: A cross-sectional observational research design with retrospective data collection during a five-year period (2008-2012) originated from women treated as in- and out-patients. The data included the results of cervical and urethral swab testing on Chlamydia trachomatis infection and women's gynaecological diagnoses in Pomoravlje County (the Institute of Public Health Cuprija "Pomoravlje" in Cuprija, Alba outpatient clinic, Paracin) and in Skopje (Clinic for Obstetrics and Gynaecology, "Mikrolab" laboratory). Results: The incidence of positive ELISA assay from samples from the Institute of Public Health "Pomoravlje" Cuprija and polyclinic Alba was 6.5% and 12.5%, respectively (p<0.01). The incidence of positive DFA test from samples from the Clinic for Obstetrics and Gynaecology, Skopje and "Mikrolab" laboratory was 18.8% and 15.2%, respectively (p=0.20). In Pomoravlje County and in Skopje 7.5% and 17.6% of urethral swab samples were positive for Chlamydia trachomatis, respectively (p<0.01). The rate of microbiological samples tested for Chlamydia trachomatis in Pomoravlje County and Skopje was 48.4% and 21.2%, respectively (p<0.01). One-year incidences of Infectio sexuales chlamydiales (A56) from 2007-2011 were significantly different among three data settings relating to Serbia, the FYR of Macedonia and Pomoravlje County (p<0.001). Conclusions: The incidence of Chlamydia trachomatis positive cervical and urethral swabs in our study were highly variable between countries and within individual hospitals and caused by many factors.

Objective: The aim of the study is to comprehend results of the influenza lab surveillance system in the Republic of Macedonia after the 2009 pandemic and to determine the main characteristics of four consecutive epidemic seasons (from 2010/2011 until 2013/2014). Methods: As part of the universal surveillance system, nasal and throat specimens were collected from patients. After extraction of RNA, the CDC real-time RT-PCR assays for the detection of influenza types and subtypes were performed. Results: Out of 920 tested samples, 406 (44.1%) laboratory confirmed cases of influenza were found. Influenza activity begins as early as December and continues until the end of April with peaks in January or February with predominant influenza A and A/H1N1pdm. Influenza A viruses start their activity at week 49 to 52 and subside at week 17. Usually two peaks appear, the first one between week 2 and 4 and the second one between week 6 and 9. Subtype A/H1N1pdm was dominant among influenza A types in the 2010/2011 and 2012/2013 seasons. A/H3N2 was the only circulating influenza virus in the 2011/2012 season. Influenza B season is shorter and has only one peak, between weeks 2-5. Usually the influenza B viruses emerge in later stages than influenza A viruses, except for the first post-pandemic season. Conclusion: Results revealed that post-pandemic influenza seasons in Macedonia were rather different. Although the influenza season pattern is similar to patterns in some countries of the WHO European region, some unique characteristics were observed.

Aim: The aim of the study was to analyze accessibility of medical assistance in Russian polyclinics (a case study of the city of Ekaterinburg). Methods: The research included an anonymous survey of patients in five polyclinics of Ekaterinburg (N=500) conducted by applying a specially developed standardised interview. Results: The following factors of medical care accessibility were analyzed: the patient's financial status and administrative and managerial resources of medical institutions. Medical aid in polyclinics is provided within the framework of the Compulsory Medical Insurance Programme. 72% of the patients polled, however, had to pay for medical services. In order to pay less for medical services and to obtain services faster patients use informal payments: they either pay their doctors directly (4%) or make gifts (58%). Low-income population groups refuse to pay for medical services or to make gifts to the medical staff. They also tend not to follow their doctors' recommendations. The most significant indicators of the organizational and managerial work of a medical institution which limit accessibility are the following: queues in front of doctors' offices (41%) and difficulties with making appointments (17%). Conclusions: To solve the problem of medical aid accessibility in the Russian state healthcare system, it is necessary to develop information and reference materials for patients available in every polyclinic listing the terms of provision of free medical aid and types of free medical services. The difficulties to obtain medical services could be resolved at the management level by using the material and human resources of the administration of medical institutions.

Objective: The aim of this study was to determine the effects of a nurse-led school-based sun protection programme in Turkey. Methods: A randomized controlled trial was performed at two public schools between February and October 2014. Children with written consent from their parents were screened by nurses for skin type, and 80 children at moderate to high risk for skin cancer were included in the study. The sample was randomized by age, gender and skin type. Stratified and block randomizations were used. The participants were separated into an intervention group (n = 40) and control group (n = 40). Data were collected using a personal information form and two scales for sun protection behaviour and self-efficacy. Results: In the intervention group, the pretest mean score for sun protection behaviour was 19.25 ± 5.44 and increased significantly in the posttest assessment (33.05 ± 4.23, p < 0.001). Self-efficacy scores also increased significantly after the intervention (pretest 20.50 ± 6.68, post-test 35.85 ± 4.70, p < 0.001). However, there were no significant increases in mean sun protection behaviour or self-efficacy scores in the control group (p > 0.05). Conclusion: A nurse-led school-based sun protection programme effectively promoted children's self-efficacy and sun protection behaviour.

Objective: The aim of this study was to determine the most common psychosocial risk factors for absenteeism and the extent to which low back pain occurs among Slovenian professional drivers as result of various psychosocial risk factors. Method: The study involved 275 professional drivers, mostly men (mean age 41.6 years). Statistical data analysis was conducted using SPSS package version 21, MS Excel version 2007 and Pajek, version 3. The main method for data processing was regression analysis. Results: The results of the quantitative survey showed that lower back pain is mostly caused by lifting and carrying heavy loads, inadequate working conditions, poor physical fitness, regular nights out, shift work, and stress. Dissatisfaction with work, shift work and unsuitable working conditions significantly affect the incidence of low back pain. Absenteeism is influenced by factors such as dissatisfaction at work, disrespectful attitude of managers, unsuitable working conditions, personal dissatisfaction, lack of understanding of the partner, and enjoying nightlife on a regular basis. Conclusions: The study clarifies the unexplained holistic psychosocial risk factors and treatment effects on health in the population of professional drivers. Such factors can lead to absenteeism. The study also provides initial demonstration research in the Slovenian practice. Furthermore, it provides solutions in a holistic approach to solve the problem of risk factors management.

OBJECTIVE: The aim of this study was to report on trends in the prevalence in age at first intercourse of Czech schoolchildren and a difference between sexes.
METHODS: Prevalence in age at first intercourse of Czech schoolchildren was observed under the Health Behaviour in School-aged Children study in the years 2002, 2006, 2010 and 2014. In addition, a random representative sample of children attending 9th grade completed the questions related to sexual behaviour. A total of 4,804 boys and girls at the age of 15 years were included in the study. The chi-square test and analysis of variance were used for data assessment.
RESULTS: Experience with first sexual intercourse before 15 years was confirmed by 16% of boys and 19.4% of girls. Average age of coitarche in both sexes most often ranged between 14 and 15 years. Since 2006 boys had significantly lower age at coitarche. Only in 2010 the girls had first intercourse more frequently than boys. Since 2010 the number of Czech adolescents of both sexes having first intercourse before the age of 15 years has significantly increased. However, a rise in average age of coitarche over 15 years in both sexes occurred in 2014.
CONCLUSIONS: The number of Czech children having a sexual intercourse before 15 years has significantly increased since 2010.

Aim: The purpose of this study was to investigate whether physical fitness variables are related to overweight or obesity in Korean women. Methods: From 2007 to 2011, 10,790 women aged 20-82 years visited a public health centre for evaluation of cardiovascular function, health-related physical fitness, and motor-related physical fitness. We used the definitions of overweight and obesity provided in the World Health Organization's Asia-Pacific Standard Report. Cardiovascular function was evaluated using the Resting Heart Rate (RHR) and vital capacity. Health-related physical fitness was evaluated using the VO₂max measure, sit-up number, grip strength, and sit-and-reach distance. Motor-related physical fitness was evaluated using the vertical-jump distance, side-step number, and balance (standing on 1 foot with eyes open) measure. Results: The prevalence rates of overweight and obesity were 26.9% and 28.8%, respectively. Results are presented as odds ratios (with 95% confidence intervals) after adjusting for age and number of alcoholic drinks consumed per week, cigarettes smoked per day, and exercise sessions per week. When RHR increased by 1 beat per minute, overweight prevalence was 1.012 times higher (1.007-1.017, p<0.001) and obesity prevalence was 1.006 times higher (1.000-1.011, p=0.037). When VO₂max increased by 1 mL.kg^-1.min^-1, overweight was 0.949 times less prevalent (0.939-0.959, p<0.001), and obesity was 0.916 times less prevalent (0.906-0.926, p<0.001). As grip strength increased, overweight prevalence and obesity prevalence increased. An increase in vertical-jump distance by 1 cm was accompanied by a decrease in overweight prevalence by a factor of 0.975 (0.967-0.982, p<0.001) and a decrease in obesity prevalence by a factor of 0.940 (0.932-0.948, p<0.001). Conclusion: Overweight and obesity were associated with poor physical fitness as assessed by variables related to cardiovascular function and health-related and motor-related physical fitness.

Background: Obesity and overweight are major contributors to the global burden of chronic diseases and disability in both majority and minority populations. Methods: Data from the cross-sectional population-based HepaMeta study conducted in Slovakia in 2011 were used. The sample comprised a total of 452 Roma. Measurements of special bioactive mediators were taken in final groups consisting of 63 male Roma respondents (mean age = 32.59; SD=8.63) and 117 female Roma respondents (mean age = 34.55; SD=8.35). Respondents were divided into three groups: those with normal weight, those with overweight and obese. Values for anthropometric parameters, lipids parameters, C-reactive protein, TNF-α, IL-6, leptin, and adiponectin were determined. Results: 27.6% of examined Roma females and 26.9% of males were overweight. Obesity (BMI>30.0 kg/m²) appeared in a higher proportion of males (28.8%) compared with female (26.5%). Mean levels of total cholesterol, triacylglycerol and LDL-cholesterol were significantly elevated in the overweight and obese subjects compared to normal-weight Roma respondents. The relation was reversed for HDL-C level, with significantly decreased levels in both male and female obese Roma (p<0.001). The concentration of adiponectin was significantly lower in obese subjects of both genders versus non-obese (Roma male p<0.001, Roma female p<0.05). Plasma levels of leptin, IL-6, hs-CRP as well as TNF-α increased in Roma significantly with increasing BMI. Conclusion: The study is the first one to provide data about selected biomarkers. Results may be useful in predicting obesity and its related diseases in the Roma population from the eastern part of Slovakia.

Aims: This study examined the influence of leadership in multi-stakeholder partnerships. Four W.K. Kellogg-funded community partnerships in South Africa were evaluated. Participants included community, academic and health service partners. The partnerships aimed to achieve interprofessional community-sensitive health professions education. Methods: We undertook: 1) quantitative assessment (survey, N = 529) of whether leadership skills were systematically associated with three partnership factors (satisfaction, sense of ownership and commitment); and the individual contributions of these factors to the partnerships' outcomes; and 2) qualitative assessment (semi-structured interviews, N = 46) of the extent of coalition members' ratings of their leadership, the likelihood of concerns about their leaders; and the nature of these concerns. Results: Quantitatively, partner's positive ratings of their leadership were consistently and significantly attended by better sense of ownership, commitment to and satisfaction with the partnerships. Variance in partnership outcomes was accounted for by leadership skills (26%), ownership (21%), commitment (20%) and satisfaction (11%). Partnership members who rated their leadership highly expressed fewer concerns (qualitatively) about their leaders. These concerns were: leadership visibility, openness and legitimacy; leadership features, styles and characteristics; the consequences of lack of appropriate leadership; and management procedures that were lacking. Conclusions: Coalition efforts would benefit from focusing on factors that are conducive to effective leadership.

Background: Herpes simplex virus (HSV) infects antigen-presenting cells very efficiently indicating its potential as an efficient antigen delivery platform for vaccine purposes. HSV encodes various proteins to block a potent immune response. These proteins include ICP47 (blocks MHC loading); vhs (blocks DC activation); ICP34.5 (blocks interferon-mediated responses); US5 (inhibits apoptosis in infected cells); and UL43 (reduces immunogenicity by an unknown means).
Materials and Methods: We have produced an HSV-2 vaccine (ImmunoVEXHSV-2) in which these genes are deleted, the first immune evasion function-deleted HSV vaccine candidate to be produced. Unlike wild-type HSV, this non-pathogenic, replication impaired virus significantly activates DC enhancing its immunogenicity. Results: We have previously reported that ImmunoVEXHSV-2 gave 100% efficacy as a prophylactic vaccine in the female guinea pig model of genital herpes. The vaccine was shown to generate specific and neutralising anti-HSV antibodies in this model and to reduce the level of latent infection in DRG following challenge. We have also shown that ImmunoVEXHSV-2 induces HSV-specific antibody and T-cell responses in mice and rats. Pre-clinical studies have shown that ImmunoVEXHSV-2 does not induce any macroscopic or microscopic toxicological findings following repeat subcutaneous dosing with clinically relevant doses in guinea pigs or rats. In contrast to wild type HSV-2, ImmunoVEXHSV-2 does not induce inflammation or PNS/CNS disease following intranasal or intracranial administration in mice. In addition, ImmunoVEXHSV-2 does not establish latent infections following intranasal or subcutaneous administration in mice as measured by qPCR. A clinical trial with this stand-alone HSV vaccine candidate is planned to begin during 2008.
Conclusions: It is our belief that a combined vaccine for HSV2/HPV is scientifically and commercially attractive. To this end, we have used the ImmunoVEXHSV-2 platform to develop two combined vaccines where codon-optimised versions of HPV-16 E2/L1/L2, or E2/E6/E7 have been expressed from the ImmunoVEXHSV-2 backbone in place of ICP34.5 and vhs. These combination vaccines for HSV-2 and HPV are currently in pre-clinical testing.

Background: Early childhood is a critical period for shaping and influencing feeding behaviours which have implications for future health. Understanding the food consumption patterns and their shifts over time can provide guidance to health care providers and nutrition specialists who provide nutrition counselling and develop nutrition messages. Objectives: To examine feeding patterns of 1-5 year old children and their changes with age. Methods: A cross-sectional questionnaire study designed to obtain information on basic demographic indicators and feeding habits was conducted in Prague and all 13 regions of the Czech Republic. The carers of 1,130 children aged 1 to 5 years were approached in public places. Obtained data were computerized, descriptive statistics and t-tests for food intake frequency by age, breast-feeding status, sex, maternal education, and domicile were calculated. The difference was considered significant when P value was <0.05. Results: The median duration of breast-feeding of children not breast-fed at the time of the interview was 9 months; 29.5% one-year olds were still breast-fed at the time of the interview. Median number of meals per day was 4 in 1 and 5 year olds and 5 in children 2 to 4 years old. The diet of one-year-olds, albeit with lower fruit and vegetable consumption and low fish consumption, was close to recommendations. The milk and milk products, fruit, vegetable, and poultry intake frequency significantly decreased with age. The meat and grains groups, smoked meat and meat products, sweets, and fried food intake frequency significantly increased with age. Fish consumption remained low. Higher vegetable intake frequency was associated with breast-feeding, maternal education, and female sex. Higher fruit consumption was associated with breast-feeding and living in Prague. Higher meat group intake frequency was associated with male sex. Conclusions: Our data confirm that the dietary habits are formed early in the life. Enhancement of multi-channel delivery of nutrition messages for feeding of toddlers and pre-schoolers and for the improvement of family eating habits are needed.

Aim: The aim of the study was to map the incidence of mumps in the Czech Republic in terms of clinical symptoms, epidemiological links, and characteristics of circulating genotypes. Methods: Patients with suspected mumps examined in the Infectious Diseases Clinic of the Na Bulovce Hospital in 2013 were enrolled in the study. Buccal swab specimens were tested by means of nucleic acid detection (RT-qPCR) and when positive, they were cultured in tissue culture. Sequencing was carried out using the BigDye Terminator v3.1 Cycle Sequencing Kit and Genetic Analyzer 3500. The SeqScape software was used for the analysis of sequencing data and filtering out low quality reads. The phylogenetic analysis and genotyping were performed using the Mega 6 software. To generate the phylogenetic tree, all sequences were aligned by the MAFFT tool and the alignment obtained was edited using the BioEdit software. In all patients, selected biochemical markers (C-reactive protein, white blood cell count and serum amylase) were measured. The EPIDAT system used for reporting infectious diseases, record keeping, and data analysis in the Czech Republic was the source of statistical data. Results: Eighty-nine patients with suspected mumps were examined in the Na Bulovce Hospital and 65 of them were laboratory confirmed with mumps: 40 males (61.5%) and 25 females (38.5%). The mean age of the study cohort was 25.9 years (median age of 23 years, age range from 10 to 73 years) and 14 patients were under 18 years of age. Thirty-four (52.3%) patients were vaccinated in childhood, 28 (43.1%) were unvaccinated, and for three persons, vaccination data were not available. A severe course of the disease was reported in 15 (23.1%) patients. Fourteen of them needed hospitalization because of orchitis (9 males) and meningitis (5 patients). One patient with orchitis was treated on an outpatient basis. The need for hospitalization tended to be lower in the unvaccinated patients (14.7% vs. 35.7%, p=0.076). In 2013, 1,553 cases of mumps were reported to the EPIDAT system. Of these, 640 were laboratory confirmed. The most often reported complications were orchitis (90 cases, i.e. 10.3%) and meningitis (21 cases, i.e. 1.4%). Orchitis was diagnosed in 30.3% of the unvaccinated and in 6.4% of the vaccinated males. Meningitis occurred in 3.1% of the unvaccinated and in 1.0% of the vaccinated patients. Conclusion: Despite the emergence of mumps among the vaccinated population, the present study has confirmed a positive effect of the vaccine, particularly on the incidence of complications and inflammatory markers. All 30 sequenced mumps virus strains were assigned to group G. A secondary vaccine failure due to waning immunity seems to be a plausible explanation for the rise in mumps cases.

The implantable cardioverter-defibrillator (ICD) is highly effective in reducing sudden death from ventricular tachyarrhythmia among high-risk cardiac patients. Conventional advice given to patients with ICD is to avoid physical activity more strenuous than playing golf or bowling. This recommendation is given due to a theoretical risk of arrhythmia precipitation, and thus increased risk of death due to failure to defibrillate, injury resulting from loss of control caused by arrhythmia-related syncope or shock, and also due to sport related direct damage to the ICD system. Recent prospective data from an international registry involving 372 athletes with ICDs in situ and actively participating in sports has been published. This indicates that, although physical activity resulted in an increased number of shocks compared to rest, there was no significant difference between intensive physical activity and any other activity (10% vs. 8%, p=0.34) in frequency of shocks. Furthermore, over a median follow-up period of 31 months (21-46 months), in the period of sports activity and 2 hour rest directly after there were no occurrences of death, resuscitated arrest or arrhythmia, or shock-related injury. This data is likely to start a shift in every-day clinical decision-making leading to revision of the high level of precautions imposed on the rapidly enlarging ICD recipient population.

Aim: Pneumoconiosis is caused by inhaling dust. The aim of the study was to analyze 208 cases of workers' pneumoconiosis. Method: Patients' files were used for the descriptive study. Results: All patients were male aged 38.82±13 years. The most important symptom was breathlessness. Patients were denim sandblasters (50.5%), dental technicians (12%), coal miners (6.7%), and others. The mean exposure time before pneumoconiosis occurred was shorter in denim sandblasters and teflon kitchenware producers compared to other occupations (5.4±4.2 and 4.5±3.3 years, respectively). Profusion (76.5%) was more than 1/2 by the International Labour Organization (ILO) classification. Pulmonary function tests were negatively correlated with profusion. Conclusion: Denim sandblasters and teflon kitchenware producers have less exposure time before pneumoconiosis occurs and they become symptomatic earlier. As Turkish workers suffering from pneumoconiosis are younger, measures to prevent pneumoconiosis must be the priority of the healthcare authorities.