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Objectives: Medical students experience worse psychological well-being than the general population. Social determinants of health (SDOH) relate to conditions in which people live, work, and age and significantly influence mental health. This study examines the association between depressive symptoms and SDOH in medical students from four countries: Czechia, Iran, Kenya, and Venezuela. Methods: An online cross-sectional survey was conducted in the spring of 2022. The questionnaire focused on depressive symptoms (using a validated psychiatric scale DASS-21 to assess mental health) and various SDOHs. Results: A total of 2,033 medical students participated in the survey, with a median age of 23.0 years; 64.8% were females; 60.8% of respondents had some degree of depressive symptoms (mild-to-moderate 32.5%, severe-to-extremely severe 28.3%). Several SDOHs, such as low engagement in social life, low personal funds, and low social class, were strongly associated with severe-to-extremely severe depressive symptoms (p < 0.001), and the associations differed among countries. The prevalence of severe-to-extremely severe depressive symptoms varied significantly across the four countries, with Iran having the highest prevalence (OR = 2.1 compared to Czechia), followed by Czechia (OR = 1, reference value), Kenya (OR = 0.9), and Venezuela (OR = 0.6). Conclusion: The study demonstrates the high prevalence of depressive symptoms among medical students from four global regions and the significant association with specific SDOH. Notably, the variation in prevalence across countries and differential relationships with SDOH underscore the importance of considering transcultural factors in research and management to improve mental health among medical students.

Objectives: With increasing life expectancy, the prevalence of atherosclerosis and dementia is expected to rise in the future and as such represents a public health threat. This study focused on analysis of atherosclerosis risk factors and the protective factors of leisure-time activities in the development of dementia. Methods: The sample comprised 1,298 participants that were selected from university hospitals and outpatient clinics between 2019-2023. All participants completed a questionnaire and medical data were obtained. We used logistic regression to identify dementia risk factors and we also compared the leisure-time protective factors between four groups based on the presence of atherosclerosis and/or dementia. Results: Hypercholesterolemia (aOR = 3.25, p > 0.001), stroke (aOR = 1.43, p = 0.015), and carotid stenosis (aOR = 2.23, p > 0.001) were significantly associated with risk of dementia whereas age (aOR = 0.93, p < 0.001) and female gender (aOR = 0.70, p = 0.012) were negatively associated. The model of these factors demonstrated moderate discriminatory ability of AUC 0.737 (95% CI: 0.702-0.769). Higher education levels and regular cognitive and physical activities such as reading and exercise had positive effects against dementia. Conclusion: These findings accentuate the importance of cardiovascular health in reducing risk of dementia. Preventive strategies targeting hypercholesterolemia, carotid stenosis and inactivity, along with promotion of cognitive engagement and education, could substantially reduce the global burden of dementia.

Objectives: Atopic dermatitis (AD) is a common allergic disease with potential links to environmental pollutants, including heavy metals. This study investigates the association between co-exposure to cadmium and mercury and AD among Korean children. Methods: Data from the fourth cycle of the Korean National Environmental Health Survey (KoNEHS) included 736 elementary school students. Urinary cadmium and mercury levels were measured, and their association with lifetime prevalence of AD was analysed using logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (QGC), and Bayesian kernel machine regression (BKMR). Confounders adjusted included age, sex, urinary cotinine, income, and body mass index. Sensitivity analyses used symptomatic AD and AD treatment as outcome variables. Results: Among two metals, only cadmium in the highest tertile showed an odds ratio (OR) of 2.39 (95% CI: 1.12-5.10) compared with lowest tertile, with a significant trend per tertile increase (OR 1.58, 95% CI: 1.08-2.31) in multiple logistic regression. Co-exposure analysis using WQS and QGC revealed significant associations with AD prevalence, with WQS showing an OR of 1.47 (95% CI: 1.18-1.83) and QGC showing an OR of 1.60 (95% CI: 1.20-2.13) per tertile increase of exposure. BKMR indicated a dose-dependent relationship between overall exposure and AD risk. For symptomatic AD, similar trend was found. The treatment status of AD did not show a significant association with either heavy metal. Conclusion: This study suggests a significant association between co-exposure to cadmium and mercury and atopic dermatitis, emphasizing the need to consider combined environmental exposures in epidemiological studies.

Objectives: The first aim of this cross-sectional study was to reveal the prevalence of overweight and obesity among Czech military personnel (CMP). The second aim was to compare accuracy of the body mass index (BMI) classification with the body fat percentage (BF%), waist circumference (WC), and visceral fat area (VFA). BMI is a commonly used method to assess obesity, but its accuracy in reflecting body composition, especially in physically fit individuals, has been questioned. Methods: Data were collected from six military units in the Czech Republic. Soldiers underwent anthropometric assessments including height, weight, WC, BF%, and VFA using the bioelectrical impedance method (BIA). Results: The study group consisted of 446 soldiers (337 males, 109 females). The prevalence of obesity in Czech soldiers regardless of gender was 18%-20% according to BF% and 13%-16% according to WC. There were almost one fifth of obese males and more than 5% of females with BMI ≥ 30. The risk level of VFA was observed in 24% of male a 34% of female soldiers. In male soldiers there was a high rate (43%) of false positives according to BMI (BMI ≥ 25, BF% < 20), on the other hand, a certain part (18%) of female soldiers was classified as false negative according to BMI (BMI < 25, BF% ≥ 28). When overweight and obesity were assessed by WC and BMI, significant false positives (56%) were found in male soldiers (BMI ≥ 25, WC < 94). When obesity was evaluated using VFA and BMI, a certain rate of false negatives (30%) was found in female soldiers (BMI < 25, VFA ≥ 100). Conclusion: Through an analysis we explored the limitations of BMI, and we propose an alternative method (measurement of BF%, VFA using BIA) for a more accurate assessment of body composition in this specific population.

Objectives: Temperature is the most important environmental variable associated with the varicella frequency across the world. The present study compares the incidence of varicella in the districts of Bulgaria against some climatic factors and tries to find environmental variables which account for the differences in the varicella distribution observed among the Bulgarian districts. Methods: The 28 Bulgarian districts were used as units of observation and their average 10-year varicella incidence (2009-2018) was tested for correlation with the standard bioclimatic variables of WorldClim, version 2. Results: The WorldClim estimates for the annual mean temperature, the maximal temperature of the warmest month, the minimal temperature of the coldest month, the mean temperature of the coldest quarter, and the solar radiation inversely and not significantly correlated with the average 10-year varicella frequency. The precipitation of the warmest quarter and the wind speed correlated positively and also not significantly. Only the mean temperature of the driest quarter correlates significantly with the incidence at district level (Spearman's rank correlation coefficient of -0.45, p = 0.02). The mean of average 10-year varicella incidence rates among districts with driest quarter during the winter (January, February, March) was 387.6 ± 114.1, while among districts with driest quarter during the summer/autumn (July, August, September or August, September, October) 283.3 ± 102.1 (p = 0.02, ANOVA test). Conclusions: Dry winter and/or wet summer appear as significant determinants for the fluctuant spread of varicella infection in Bulgaria.

Objectives: Having adequate level of health literacy is a very powerful tool of improving health. "Emerging adulthood" is described as a period between age of 18-25 years, characterized by changing life circumstances, developing personality and exploring possibilities. The aim of this study was to establish the relationship between health literacy and socioeconomic status of young adults in Serbia and their individual influence on the reproductive health and sexual behaviour. Methods: This research was conducted as observational, cross-sectional study. We used STOFHLA to assess the health literacy level of young people and general information questionnaire for demographic, social and economic characteristics of respondents, health knowledge and behaviour in the area of reproductive health. Chi-square test was performed to assess the existence of association between categorical variables using the Statistical Package for the Social Sciences (SPSS). Results: Results of our research found significant connection between levels of health literacy and age groups, marital status, but also connection with living in rural place. Socio-demographic factors and health literacy levels had significant impact on various aspects of sexual behaviour and reproductive health knowledge. Conclusion: The importance of this research is reflected in its contribution to a clearer understanding of the impact of health literacy and socioeconomic status on the reproductive health of young people in Serbia, with the aim of improving public policies, health interventions and educational programmes, which would contribute to reducing health inequalities, improving health outcomes, and developing targeted educational initiatives.

Objectives: Work of an arborist – tree climbing – is a dangerous activity associated with great physical effort, influenced by incorrect body posture and significantly stressed individual parts of the body. This research was initiated with the objective to draw attention to this hitherto little explored issue connected with ergonomics of the work of tree climbers. The goal of the research was to gather information about the fatigue of individual parts of the human body in professional tree climbers who access trees using so-called rope techniques (ascent to the tree crown, movement in the tree crown, descent from the tree crown) by means of a questionnaire. Methods: The assessment included 12 body parts (8 in the upper body, 4 in the lower body), with each part being divided into right and left parts. The research was conducted in the Czech Republic, 98 respondents were professional tree climbers. The questionnaire contained two sections of questions. Questions from the questionnaire were analysed, evaluated and plotted into clear graphs which were then statistically quantitatively described. Furthermore, the linear relationship between the duration of work performance and the occurrence of fatigue in individual parts of the body was assessed (Pearson's correlation coefficients). Results: Results indicated that the most stressed part of the body of tree climbers who access trees using rope techniques is the area of wrist and hands. On the other hand, the least stressed part of their body is lower leg. Furthermore, the results of Pearson's correlation analysis show that the relationship between the number of hours and the occurrence of musculoskeletal problems is weak, unstable, and nonlinear in most body segments. Conclusions: The research has shown that arborists who care for trees using rope techniques are exposed to varying degrees of fatigue in different parts of the body.

Objectives: Allergic patients may be concerned about more frequent and/or more severe adverse events following vaccination, which may lead to the refusal of vaccines among these patients. The aim of this study is to assess whether allergic patients have more frequent adverse events (AEs) after vaccination than healthy individuals. Methods: Study participants (N = 591) underwent vaccination of their choice at a selected Vaccination and Travel Medicine Centre. At a 10 to 14-day interval, they were contacted for a telephone questionnaire survey on the occurrence of AEs after vaccination. A group of allergic patients (n = 188) and healthy controls (n = 403) were followed in the study. Results: No significant difference was found in the occurrence of AEs between study and control group. Only in redness and swelling, which was more common in allergic patients, but only in a few individuals. All side effects were minor, such as pain at the injection site or fatigue. No participant experienced a serious or life-threatening adverse event. In the studied group, no statistically significant differences were found even in the occurrence of AEs after singular vs. simultaneous administration of vaccines (p = 0.094), nor after vaccination with inactivated vs. attenuated vaccines (p = 0.655), or after vaccination against bacterial vs. viral infections (p = 0.140). Conclusions: Vaccination of allergic patients did not cause more frequent and/or more serious adverse events in our study compared to healthy people. If general contraindications are observed, then vaccination of allergic patients is considered safe.

Objectives: Nanotechnology is a fast-growing field in both science and industry. However, experimental studies brought warning data concerning the negative effect of engineered nanoparticle exposure leading to oxidative stress, inflammation, decreased immune cell viability, and genotoxicity. The consequences of human exposure may appear with decades of latency. Therefore, more data is needed to identify the hazardous effects of nanoparticles. Exposure should be under control and biomarkers of effect are urgently searched. Methods: Exposures of researchers working with nanocomposites were measured in yearly intervals for 5 years and biomarkers of oxidative stress and/or antioxidant capacity were analysed. Exposure to aerosols with nanoparticles was measured repeatedly using online and offline instruments during both the machining of geopolymer samples with epoxide resin and nanoSiO₂ filler and metal surface welding. The levels of biomarkers of oxidation of lipids, nucleic acids and proteins were analysed in exhaled breath condensate (EBC) of researchers and controls in 2016-2018. In 2019 and 2020, glutathione was measured in plasma to assess their antioxidant status. The trends in both exposure and EBC biomarkers' levels were analysed. Results: On average, 21 researchers were examined yearly (aged 40 ± 5 years, exposure 14 ± 3 years). After 5 years, the mean mass concentration dropped from 0.921 to 0.563 mg/m³ and mean total number of particle concentrations from 146,106 to 17,621/cm³. The majority of biomarkers of oxidation of lipids, proteins and nucleic acids decreased (p < 0.05) during repeated measurements from the highest levels being mostly found in 2016. Glutathione in plasma in 2019-2020 was elevated (p < 0.01) as compared to controls. Conclusions: The adaptation of long-term exposed researchers may give a plausible explanation. However, to our meaning, the precautionary principle and higher attention of the employers to the potential risk of nanoparticles by reducing nanoparticles exposure by almost one order of magnitude played the key role.

Objectives: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected hundreds of millions of individuals globally. Vaccination has become a promptly effective preventive procedure. People living with HIV (PLHIV) are in increased risk of many infections including COVID-19. We aimed to analyse the first phase of vaccination (January 2021–June 2022) in the Czech Republic in PLHIV focusing on vaccination coverage, vaccine hesitancy and breakthrough infections. Methods: In this single-centre, open-label, prospective study we have enrolled 1,758 PLHIV with median age of 42.5 years and median CD4+ T cells count (cluster of differentiation) 800/µL. Results: Vaccination coverage was 84.7% and first booster dose was received by 71.7% of those who completed vaccination. Only 78 individuals (4.4%) have actively rejected vaccination. The most frequent vaccination scheme (60.3%) was Comirnaty vaccine plus booster of the same vaccine. There was a significant difference between vaccinated and unvaccinated individuals in age, CD4+ count, CD4/CD8 ratio, virological suppression on antiretroviral therapy (ART) duration of HIV and level of education (p < 0.001). Prevalence of breakthrough infection was seen in 21.4%. There was no significant difference among individual vaccines (p = 0.715). Individuals with breakthrough infections were statistically younger (p = 0.001) with some risk factors in 25.1%. Conclusion: In this prospective study we have seen higher vaccination coverage against COVID-19 in PLHIV in the Czech Republic in comparison with the general Czech population. Hesitancy, resulting in rejection of vaccination, was lower in our cohort as regards affinity to the HIV clinic, and breakthrough infections were noticed and occurred particularly in younger age groups.

Objectives: This study aimed to determine trend in polyphenol consumption in the Czech Republic during the last three decades. Additionally, it provides a brief overview of the beneficial effects of polyphenols in several body systems. Methods: Data from the Phenol-Explorer 3.6, a specialized database of polyphenolic substances, were assigned to the resources of the Czech Statistical Office on the consumption of food and beverages in the Czech Republic for the years 1989-2022. The average daily intake of polyphenols was determined by multiplying the average annual consumption of each type of food by the polyphenol content obtained from the database; results were given in milligrams of polyphenols per inhabitant and day. Since the food items in the data sources are not identical, it was necessary to create an extensive model of food categories. Results: The current value of polyphenol intake is 1,673 mg per day per inhabitant; however, this level most likely reflects methodological underestimation. The favourable increase in dietary polyphenol intake in the Czech population - doubling, to be precise - which we observed from 1989 to 2007, has been replaced by the opposite trend in the last 15 years. The current intake of polyphenols corresponds to the level that was already achieved in 2004. Hydroxycinnamic acids (from the group of phenolic acids) are the most prevalent dietary polyphenols, followed by flavanols (from the group of flavonoids). The most frequent source of polyphenols in the Czech population are non-alcoholic beverages such as coffee, tea and juices, followed by fruits, cereals, and vegetables, respectively. Conclusion: Current trend of dietary polyphenol intake in the Czech population is slightly decreasing. This tendency, lasting since 2008, is indisputably negative. Plant polyphenols offer opportunities for inexpensive interventions in health promotion.

Objectives: Given the widespread use of macrolide antibiotics and growing concerns over antimicrobial resistance, this study aimed to investigate recent trends in macrolide consumption in Slovakia and to determine the corresponding changes in Streptococcus pneumoniae resistance in a paediatric cohort.
Methods: We conducted a retrospective analysis of 1,083 nasal swab cultures from children with recurrent respiratory infections and atopy, comparing two distinct 5-year periods: 2008-2012 and 2019-2023. Consumption data was based on the European Centre for Disease Prevention and Control reports.
Results: National data confirmed that Slovakia has one of the highest consumption rates of macrolides, lincosamides, and streptogramins (ATC group J01F) in Europe. The comparative analysis of patient samples revealed a statistically significant 11% increase in erythromycin-resistant S. pneumoniae (p < 0.001) and a 5% increase in clindamycin-resistant strains (p < 0.001) between the two study periods.
Conclusions: The concurrent rise in macrolide consumption and S. pneumoniae resistance in Slovakia highlights a significant public health threat. These findings underscore the urgent need for robust antibiotic stewardship programmes and the promotion of rational prescribing practices to preserve the efficacy of macrolides.

Objectives: The aim of the study was to identify potential areas for improvement in the prevention of oral diseases in pregnant women by assessing their oral care habits and awareness regarding oral health. Methods: An original, anonymous, web-based survey was conducted among women at any stage of pregnancy. The survey consisted of 23 questions regarding oral care habits, knowledge about oral health of mother and child, general and oral health changes, and attendance of oral healthcare services during pregnancy. The data analysis was performed using IBM SPSS 27.0 version software. Descriptive statistics, Chi-square and Wilcoxon signed-rank tests were used to analyse the data. The level of statistical significance was set at p < 0.05. Results: A total of 714 pregnant women participated in the study, with a mean (SD) age of 30.2 (4.4) years. Majority of the respondents demonstrated acceptable oral health-related knowledge and habits. A lack of interdental care among pregnant women was discovered. Nearly a third (27.6%) of the respondents reported a decline in their oral health during pregnancy. The most commonly reported general and oral health issues during pregnancy were increased stomach acid levels (71.3%) and gum bleeding (43.3%). Pregnant women were most frequently informed about the importance of oral care by an obstetrician-gynaecologist (25.4%). Conclusions: The study revealed the need for targeted interventions to enhance oral health awareness and practices among pregnant women in Lithuania. While overall oral hygiene habits were acceptable, deficiencies in interdental care and knowledge regarding oral health during pregnancy were evident. Higher level of education and urban residency were associated with superior oral care practices of pregnant women. In order to improve oral health of mother and child, interdisciplinary collaboration and dissemination of accessible, evidence-based information are essential.

Objectives: Influenza A and B viruses cause epidemics every year, with approximately 3-5 million serious cases and about 290,000 to 650,000 deaths worldwide. Most patients die from bacterial complications of influenza. The aim of our study was to describe the clinical pictures of influenza and the development of the complications in seniors over 65 years of age, who were treated in University Hospital Pilsen. The course of the disease and changes in laboratory parameters were evaluated with regard to the method of treatment performed. Methods: A descriptive retrospective study was performed. Clinical and laboratory data of seniors with the diagnosis of influenza were extracted from electronic medical records and later analysed. The data were processed with Excel 2016 and Statistica. Results: A collection of 261 seniors, of whom 218 were hospitalized and 43 treated in an outpatient setting, has been studied. Patients who later developed complications had elevated values of CRP, procalcitonin, urea, and creatinine. The antiviral drug oseltamivir was administered to 226 of 261 seniors. Forty-seven seniors (18.0%) died from influenza and its complications (severe pneumonia with acute respiratory insufficiency or heart failure). Conclusions: The course of influenza in seniors was usually more severe and required hospitalization along with antiviral treatment. The mortality rate in the monitored group exceeded 18%. Annual timely vaccination, but also other preventive measures, and maybe considering other risk groups are methods to prevent severe or even fatal cases of influenza.

Objectives: COVID-19 disease, which has caused a global pandemic, poses significant threat to the healthcare system as healthcare workers (HCW) are at an elevated risk of contracting the disease and being temporarily removed from their regular duties. This study analyses and evaluates a cohort of employees at the University Hospital Ostrava (UHO) who applied for the recognition of COVID-19 as an occupational disease. Methods: The disease characteristics and risk factors for severe cases of COVID-19 were analysed for all 474 claimants who applied for recognition of an occupational disease during the reporting period (March 2020 to November 2022) and were obtained from medical records. Statistical evaluation was performed using Fisher's exact test, Pearson's chi-square test and logistic regression analysis. Results: The largest number of diseases was objectified in the period from September to November 2020. The most frequently reported symptoms were subfebrilia or febrilia (81.4%), olfactory dysfunction (75.1%), and dry cough (74.3%). A severe course of COVID-19 was experienced by 15.4% of the cohort. Additionally, 76.8% reported having at least one chronic disease. The risk of severe course was found to increase with the number of chronic diseases (p = 0.017). Individuals with chronic respiratory disease (CRD) had a 2.75-fold increased risk, and women had an approximately threefold increased risk. Higher risk was also associated with increasing age. Conclusions: Healthcare workers face a heightened risk of severe COVID-19, particularly among those with CRD, women and older age. Identifying these risk factors underscores the need for targeted preventive measures and early interventions to protect this vulnerable group and reduce the incidence of severe outcomes.

Objectives: This study aimed to identify factors contributing to the early diagnosis of HIV in Turkey, with a particular focus on high-risk populations, comorbid conditions, and temporal trends. It also evaluated whether initial clinical findings could inform the expansion of screening strategies. Methods: A retrospective analysis was conducted on 1,703 individuals living with human immunodeficiency virus (HIV) who attended our clinic between 2004 and 2023. Patients were grouped into five-year intervals and assessed based on demographic characteristics, reasons for testing, and reported comorbidities. Results: Among the participants, 90.3% were males, with a mean age of 36.6 years. Of those who disclosed their sexual orientation, 46.8% identified as heterosexual. Common comorbidities included anal region disorders, cardiovascular and pulmonary diseases, diabetes, and syphilis. HBsAg positivity was 5%, and anti-HCV positivity was 0.86%. Nearly half of the patients (48.6%) were asymptomatic at the time of diagnosis. Physician-initiated testing and routine screenings played a significant role in early detection. Conclusion: Early diagnosis of HIV is essential for reducing transmission and improving patient outcomes. Screening programmes should be expanded to include not only high-risk groups but also sexually active individuals presenting with relevant clinical symptoms. Public health efforts must address stigma and improve access to HIV testing to optimize early detection and treatment.

Objectives: Isocyanates are known to induce occupational diseases. The aim of this work was to assess the health effects of exposure to isocyanates and to test the sensitivity of selected parameters for early detection of isocyanate-related allergic diseases. Methods: In total, 35 employees from one factory were tested: 26 workers exposed to isocyanates (exposed group) and nine office workers (control group). All subjects filled in a questionnaire regarding possible health problems. Fractional exhaled nitric oxide (FeNO) and spirometry were measured for each subject at the same time during two consecutive working days. A urine sample was taken for a biological exposure test (BET). Results: No significant difference was found between the exposed and control groups for spirometry parameters and FeNO. However, in the exposed group, FeNO was highly elevated (> 50 ppb) in five subjects (all reporting health problems at the workplace, all with normal spirometry and non-smokers). The BET revealed a significant difference (p < 0.001) between the exposed and control groups for 4,4´-methylenediphenyl diamine (MDA) in the urine. Conclusions: Our examination showed the usefulness of the BET in monitoring of workplace exposure to isocyanates and the importance of FeNO in monitoring of allergic inflammation of airways in non-smoking employees with normal spirometry.

Objective: The article deals with occupational health protection and identification of health risks in the work environment of the Ministry of Defence (MoD) of the Czech Republic (CR). It focuses on the assessment of the incidence of occupational diseases (OD) in high-risk and risk-free occupational categories in the years 2010-2019 and compares them with data from the civilian sector. It identifies the differences between military staff and civilian employees of the MoD. Methods: From the records of OD at the Department of Occupational Diseases of the Central Military Hospital in Prague, the data on acknowledged OD from the years 2010 to 2019 were obtained and then a retrospective analysis focusing on the classification of work at risk was performed. The obtained data were compared with the data from the Czech National Registry of Occupational Diseases (NROD), which are published annually by the National Institute of Public Health. Results: In the years under review, 191 OD were confirmed at the area of MoD, 26% of all OD occurred in employees classified in the occupational risk category. Compared with the data in the NROD, where 50% of OD were found to have been caused by high-risk work, the incidence of OD caused by high-risk work in professional soldiers is lower. Only 1.6% of all OD occurred in professional soldiers whose work was classified as high-risk one. In civilian employees of MoD 24.6% of all OD were connected with high-risk work. On the contrary, the proportion of OD occurring in professional soldiers working in risk-free categories was 57.6%, in civilian employees of MoD was the ratio much lower - 16.2%. Conclusion: Work at the Ministry of Defence was not adequately categorized, therefore, in 2020 a new categorization of work was introduced, which together with preventive measures could contribute to reducing the incidence of OD at the Ministry of Defence.

Objectives: Smoking is one of the biggest public health problems in the world. The World Health Organization (WHO) has declared the MPOWER package which provides a guide for tobacco control. The package includes six evidence based anti-smoking interventions. This meta-analysis study aims to assess the effectiveness of MPOWER - (M)onitor, (P)rotect, (O)ffer, (W)arn, (E)nforce, and (R)aise. In the study, "smoking prevalence rate, smoking cessation rate and number of cigarettes smoked daily" outputs were used in adult and adolescent age groups. Methods: Literature search has been made with "smok*, tobacco, cigarette*" keywords from the databases of Medline, Web of Science, Scopus, and Cochrane-Library. Abstracts were assessed in detail according to the inclusion criteria by the research team. Quality of articles was evaluated with modified Jadad criteria. The follow-up periods of articles were determined in two groups named as short and long term periods. We used random effects model (p ≤ 0.05) and fixed effects model (p > 0.05) according to the heterogeneity test results. Results: P and O interventions, which are evaluated with smoking cessation rate, increased the smoking cessation rate in adults by 39% in the longest follow-up period - RR: 1.39 (1.23-1.57). However, it was determined that the interventions were not effective on smoking cessation rate in adolescents - RR: 1.13 (0.90-1.42). Nicotine replacement therapy (NRT) was the most effective intervention for smoking cessation rate in adults. W interventions, which are evaluated with smoking prevalence rate, decreased the smoking prevalence rate in adults by 13% in the longest follow-up period - OR: 0.87 (0.82-0.92). P, W and E interventions, which are evaluated with smoking prevalence rate, decreased the smoking prevalence rate in adolescents by 26% in the longest follow-up period - OR: 0.74 (0.68-0.80). Conclusions: MPOWER interventions affect smoking prevalence rate, smoking cessation rate and number of cigarettes smoked daily in different age groups. Well-controlled, well-planned and cost-effective anti-smoking interventions have great importance for public health protection.

Objectives: The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic. Methods: In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective. Results: In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine. Conclusions: This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.

Objective: This study aimed to analyze the complications of planned home births treated at healthcare facilities in the Czech Republic. Methods: This prospective cohort observational study is based on analysis of women hospitalized with complications related to planned home deliveries in the Czech Republic between 2016 and 2017. The data were collected using an online form made accessible to the directors of all maternity hospitals in the Czech Republic. The results were statistically evaluated. Results: We identified 45 complications during planned home deliveries. Complications occurred most often among women living in largely populated cities with higher levels of education. Overall, 40% of patients did not receive routine antenatal care, and 38% of women gave birth after the 41st week of pregnancy. In 60% of cases, no professionals attended the birth. Hospital transfer frequencies were 42% after delivery, 36% at third-stage labour, 11% first-stage labour, 9% second-stage labour, and 2% before delivery. We recorded four neonatal deaths and one severe newborn morbidity. There was one maternal death unrelated to the home-birthing process and six cases of severe maternal haemorrhagic shock requiring intensive care. Conclusion: Complications of planned home births occurred more frequently in women living in largely populated cities and with higher education levels. Planned home births were also observed among women who were at a higher risk of complications. Risk factors included nulliparity, postdate pregnancy, and lack of prenatal care. Hospital transfers occurred most often in the third stage of labour and postpartum.

Objectives: The aim of the study was to synthesize the body of knowledge on the factors that are important to the process of returning to work after ischaemic stroke in young adults under 55 years of age. Methods: Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA checklist for scoping reviews were used. A total of 2,249 studies were identified through a bibliographic search in six databases. Results: A total of ten studies were finally selected to respond to the research questions. Eight studies were quantitative observational studies, and two studies had a case study design. The rate of returning to work varied between the studies. The frequency of returning to work in young stroke patients, independent of the time of assessment, ranged from 42.4% to 86%. Returning to work after ischaemic stroke in young adults is a complex process and multidimensional problem which is affected by clinical variables (level of neurological deficits, cognitive ability, independency in activities of daily living, fatigue and depression, cardiovascular factors), as well as the socioeconomic and occupational status. Conclusion: There is insufficient evidence concerning interventions promoting return to work. Future studies should focus on examining effective interventions to help young stroke survivors return to work.

Objectives: The dietary composition is able to rapidly and significantly influence the diversity of the gut microbiome. This article focuses on how various types of diet affect the composition of the gut microbiome and how dietary changes are able to prevent or slow down the development of non-communicable diseases including obesity, type 2 diabetes mellitus, cardiovascular diseases, and low-grade inflammation. Methods: A review in PubMed and a hand search using references in identified articles were performed. Studies published in English from 2000 to 2024 were included. Results: The studies showed the significant effect of diet on the development of non-communicable diseases dependent on the state of the gut microbiota and molecules it produces. The Western diet that continues to gain in popularity for Czech people, leads to dysbiosis and production of bacterial lipopolysaccharide or trimethylamine N-oxide causing systemic chronic inflammation in the body and thus promoting the development of non-communicable diseases. Conclusions: Findings from this review emphasize the importance of healthy eating habits in the prevention of intestinal dysbiosis and still increasing prevalence and incidence of obesity and other non-communicable diseases.

Objectives: The scale of the economic problem of the occurrence of nosocomial infections and the resulting high additional costs of treatment can only be assessed using economic analyses. The aim of the study was to analyse the impact of a nosocomial infection in a patient in the treatment process and the direct costs of patient hospitalisation. The article contributes to a cost analysis, which is a relevant basis for adopting effective solutions and decisions on the introduction of new programmes and measures to reduce nosocomial infections and associated costs. Methods: In the first phase of the micro-economic analysis, we analysed the course of hospitalisation of a non-colonised patient treated in an ordinary hospital room. In the second phase, we analysed the process of hospitalisation of a patient who developed a nosocomial infection and was transferred to an isolation room. The difference in cost of both types of treatment allowed us to carry out an economic analysis to estimate the direct costs of nosocomial infection, which are not related to the initial diagnosis of the patient but only to the patient hospitalisation. To calculate the individual types of direct costs of both alternative treatments, we first used the process flow diagram method, which then enabled us to analyse the impact of the occurrence of nosocomial infection on the efficiency and costs of the hospital. Results: The results showed that the total direct cost of hospitalisation of a non-colonised patient was 1,317.58 euro per day, and the direct cost of hospitalisation of a patient with a nosocomial infection was 2,268.14 euro per day of hospitalisation. Conclusions: We found that reducing nosocomial infections would have a significant impact on the savings or reduction in healthcare costs associated with a different work process for patients in isolation. It would save 950.56 euro per patient for each day of hospitalisation for individual treatment of a patient hospitalised in an isolation room as consequence of a nosocomial infection.

Objectives: The growing popularity of diets that restrict the consumption of animal-based foods is an important new challenge for the public healthcare system in Czechia. While the environmental and health-related benefits of plant-based diets are widely discussed in the media, people who follow these diets may lack professional support in terms of nutritional advice and even access to healthcare. The present study aims to map the nutritional practices and experiences with the healthcare system of people in Czechia who follow vegan diets. Methods: In a qualitative study we conducted semi-structured interviews with twenty-one self-reported adult vegans (14 women and 7 men; 18 with university education) who were on a vegan diet for at least a year. We were specifically interested in their motivation for why and how they became vegans; their everyday diet and eating routines; their use of health care and experiences with medical professionals; their nutritional knowledge and use of supplementation; and their perception of their health and embodiment. Results: The primary motivations for going vegan are ethical, environmental and health-related. Vegans see themselves and their diet as generally healthier, but for this to be true they must spend a considerable amount of time researching nutritional requirements and what dietary supplements they need. To this end, they tend to rely mainly on non-medical sources of information. Because of the lack of acceptance of veganism among primary-care physicians, vegans tend not to seek out medical advice or tell their doctor about their eating habits in order to avoid conflicts and negative experiences. Conclusions: We identified a perceived lack of accessible educational materials and potentially limited access to primary healthcare recommendations for people who eliminate the consumption of animal-based foods. These findings deserve further research and public health risk-mitigation strategies.

Objectives: Higher-than-recommended sugar consumption (< 10% of total energy intake; WHO) leads to negative health impacts and the development of serious diseases. Sugar-sweetened beverages (SSBs) proved to be among the leading sources of free sugar intake, as they contain large amounts of added sugar. Our article aims to propose tax measures that will help change consumer behaviour and reduce SSBs consumption. Methods: For a comparison of the forms of taxation, the experience of seven countries (Denmark, France, Hungary, Italy, Poland, Catalonia - Spain, and the UK) were analysed. The evolution of sugar consumption, consumption of sweetened drinks and obesity before and after the introduction and/or abolition of the sugar tax were reviewed. Results: States that implemented a tax on SSBs were able to reduce SSBs consumption in the first year after the tax was introduced when states with a sugar-content-based tax have implemented it more effectively than states with a volume-based tax. Based on this finding, we propose basic design assumptions for the tax that can be used in European countries that have not yet introduced the tax. Progressive taxation divides beverages into 3 bands. The basic assumption is to encourage the desired consumer behaviour, i.e., consumption of SSBs with lower sugar content. The proposed tax design is applied to the conditions of the Czech Republic as a model case study. Conclusions: The results of our study suggest that SSBs taxation could be an effective policy intervention to improve population health by reducing the health impacts of SSBs among children and adolescents, although further studies are needed to prove the causality of the described associations.

Objectives: This study aimed to determine the metabolic syndrome (MS) prevalence in a sample of adolescents, to calculate their continuous metabolic syndrome scores, and to determine the associations of continuous metabolic syndrome score with overweight/obesity and selected cardiometabolic and lifestyle factors. Methods: We enrolled a sample of 2,590 adolescents (1,180 males, mean age 17.1 ± 1.04 years) from 14 grammar schools and 48 secondary schools in the Bratislava Self-Governing Region, Slovakia. Data were collected from a standard anthropometric examination, biochemical analysis of fasting venous blood, blood pressure measurement, physical fitness assessment, and a comprehensive questionnaire focused on selected lifestyle characteristics. Continuous metabolic syndrome score and paediatric simple metabolic syndrome scores were calculated. Results: The criteria for the MS diagnosis according to the International Diabetes Federation (IDF) guidelines for children and adolescents were fulfilled in the whole sample by 38 (1.4%) adolescents; all were classified as overweight/obese. In the obese subgroup (n = 270), the MS prevalence rose to 13.3%. The largest number of adolescents was in the group without any of the MS components (67.5%). In the groups with 1, 2 or 3 MS components, males predominated; 0.6% of males and no females had 4 components of MS. The increasing number of individual components of MS is accompanied by a continuous increase (in the case of HDL-cholesterol - a decrease) of mean values mostly of blood lipid levels. Mean values of blood pressure (BP) and anthropometric parameters were highest in the group with three MS components. Significant correlations with body fat content or with selected lifestyle factors were not found. Using the continuous MS score calculation we found 31 adolescents, of whom 14 (45.2%) had only 1 or at most 2 MS components, i.e., they did not meet the criteria for the MS diagnosis. Conclusion: From the point of view of atherosclerosis prevention and early intervention, it is extremely important to monitor the MS prevalence in children and adolescents, especially in the current obesity pandemic. The paediatric MS score calculation is simple and accurate, allowing assessment of the severity of cardiometabolic risk in individuals even before the diagnosis of MS. The continuous MS score is useful in identifying individuals at increased risk and in the management of preventive health care for children and youth.

Objectives: Hepatitis C virus (HCV) infection remains a significant public health concern despite the introduction of direct acting antiviral agents. To reach the World Health Organization (WHO) goal of eliminating viral hepatitis as a public health threat by 2030, adequate screening strategies and early diagnosis are crucial. This study aimed to determine the prevalence of HCV infection in an Austrian cohort and assess the feasibility of incorporating HCV screening into colorectal screening programmes. Methods: The study enrolled 1,894 asymptomatic individuals during a colorectal screening programme with a mean age of 57 (± 7 years) years. Sera of the participants were screened for HCV-specific antibodies, and blood samples of individuals with detectable HCV-specific antibodies were tested by the polymerase chain reaction (PCR) to confirm a chronic HCV infection. Furthermore, we evaluated the characteristics of these individuals including their anthropometrics, biomarkers, and liver-specific information such as those obtained with a fibroscan. Results: We found that 14 (0.74%) of the participants had detectable levels of HCV-specific antibodies, with 6 (0.32%) individuals being newly diagnosed with a chronic HCV infection. One of the 6 patients showed signs of liver cirrhosis. The newly diagnosed individuals included 4 cases of HCV genotype 1a and 2 cases of 1b. Conclusion: Our study highlights the importance of screening for HCV infection in asymptomatic individuals, not only for those at risk of HCV exposure or with elevated liver enzymes. Incorporating HCV screening into colorectal screening programmes could be an effective strategy for increasing the rate of HCV diagnosis, thereby improving public health outcomes. Further investigation is needed regarding cost-effectiveness and strategies to reach individuals who have no access to screening programmes or do not adhere to regular preventive screenings.

Objective: This article briefly summarizes the results of existing research on metabolically healthy obesity in the context of health risks. Methods: The PubMed database was searched for relevant meta-analyses addressing metabolically healthy obesity in the context of health risks. Results: We included a total of 17 relevant meta-analyses in this review. The results of the studied meta-analyses showed that metabolically healthy obesity may be only a transient condition associated with an increased risk of developing metabolic abnormalities in the future. People with obesity without metabolic abnormalities have an increased risk of type 2 diabetes, cardiovascular disease, cancer, chronic kidney disease, and depressive syndrome. In addition, all people with obesity are at risk of pathogenesis resulting from the mechanical stress caused by presence of abnormal adipose tissue, such as sleep apnoea syndrome or skin problems. Conclusion: Based on the results of meta-analyses, we recommend motivating all obese patients to change their lifestyle regardless of the presence of metabolic defects.

Objectives: Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics. Methods: This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis. Results: The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices. Conclusions: Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.