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Background and Aim: Child maltreatment, i.e. abuse and neglect, is a significant problem worldwide and can cause impaired physical and mental health throughout life. The true extent still remains unknown in all countries, including Turkey. The aim of this study was to apply the two versions of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool of ICAST-C and ICAST-P, which are used to assess child and parent feedback and to compare reports given by children and those given by parents. This is the first study of its kind conducted in Turkey. Methods: First, ICAST was translated into Turkish by bilingual experts. Students and their parents were asked to complete ICAST-C and ICAST-P respectively, with the help of trained researchers. In total, data from 2,608 matched reports (2,608 children and 2,608 parents) was obtained. Descriptive statistics were used to evaluate demographical variables, and chi-square tests were employed to investigate the statistical significance of comparisons. Results: The present study demonstrated that Turkish parents consider rebukes, insults and corporal punishment effective ways of disciplining children. According to parents' reports, the use of psychological abuse was most prevalent against boys aged 16, while the use of physical abuse was most prevalent against boys aged 13. A statistically significant relationship was found between parents' economic conditions and child abuse (p<0.01). No significant relationship was detected between maternal educational levels and child abuse (p>0.05). However, the relationship between paternal educational background and psychological abuse was observed to be significant (p<0.05). A comparison of children's and parents' reports shows that parents tended to under-report child maltreatment. Conclusions: The results show that there is a significant healthcare problem in Turkey, since child maltreatment is prevalent, but parents are not generally aware of its extent. Possible approaches to changing this situation include efforts to increase education levels, promoting public awareness, and strengthening political commitments.

Aim: This study seeks to assess smoking habits, attitudes and intention to quit in students of the Third Faculty of Medicine of Charles University in Prague, Czech Republic. Methods: A cross-sectional survey designed to obtain information on smoking history, current smoking status, cessation attempts, and attitudes towards smoking among health professionals was conducted in 452 students of the first and last years of a 6-year Master's Study Programme (General Medicine) and a 3-year Bachelor's Study Programme (Public Health). An anonymous questionnaire was administered during the classes in the course of academic years 2011-12 and 2012-13. Results: 5.7% of the Master's Study Programme students (3.3% women and 9.0% men ) and 4.8% of the Bachelor's Study Programme students reported that they are regular smokers. The share of regular smokers was almost twice as big in students of the English Curriculum of the Master's Programme (10.7%) in comparison with the students of the Czech Curriculum (4.5%), and more than twice as big in students of the last years of both study programmes (3.9% in students of the 1st year and 10.8% in students of the 6th year of the Master's Programme; 3.2% in students of the 1st year and 7.0% in students of the 3rd year of the Bachelor's Study Programme). At the time of the research, 18.9% of students of the Master's Programme and 17.1% of students of the Bachelor's Programme were occasional smokers. 5.9% of students of the Master's Programme and 19.0% of students of the Bachelor's Programme reported that they quit smoking during their studies at the medical faculty; on the contrary, 9.8% of students of the Master's Programme and 14.3% of students of the Bachelor's Programme started smoking during that time. Conclusions: Smoking in health professionals undermines their significant role in health promotion and prevention of chronic diseases in their patients. Therefore, education at the medical faculty should focus on motivation of future health professionals towards non-smoking except providing knowledge on current research and guidance on early identification and further intervention in smokers.

Movement is an inseparable part of one's life, and has been a basic everyday activity through the history of mankind. However, a lack of physical activity and availability of food have resulted in a variety of serious health impairments. The 20th century has witnessed a steep rise of mortality from cardiovascular disease, increase in the prevalence of type-2 diabetes mellitus, malignant diseases, and dramatic increase in body weight initially in industrialized nations followed, in the last two decades of the last century, by the populations of third-world countries with all inherent consequences of this phenomenon. Preventive programmes involving physical activity have also been on the list of top priorities of various materials issued by the World Health Organization. Physical activity is one of the simplest non-pharmacological tools in the prevention of a plethora of diseases. The simplest physical activity, even for therapeutic purposes, is walking. We can walk any time, virtually anywhere, so walking is also the least expensive therapeutic option.

Aim: The assessment of quality of life (QoL) among elderly people is of great importance when preparing health care programmes for this social group. Many researchers indicate that poor health is less frequently observed in senior citizens who display levels of physical activity (PA) prescribed by WHO. The aim of the study was to investigate the relationship between the level of PA among students of the University of the Third Age (U3A) and their self-assessment concerning their QoL. Methods: The research sample consisted of 131 students from three U3A in West Pomeranian Voivodeship in Poland. PA was assessed with the aid of a short Polish version of the International Physical Activity Questionnaire (IPAQ). The assessment of QoL was conducted with the use of a Polish version of the WHO Quality of Life - BREF instrument (WHOQOL-BREF). Results: The present study has shown that highly active U3A students declare high QoL in the psychological and social domains more often than other respondents. Conclusion: The level of PA recommended by WHO has a positive impact on the perceived QoL. Possible differences are visible mostly in the assessment of different domains of life in relation to the presented levels of PA.

Aim: The rates of HIV acquired through heterosexual contact are increasing in the Czech Republic. This study explored potential HIV risk associations with alcohol, illicit drugs and sexual behaviours among adults from a community-based sample attending gay- and non-gay venues in Prague. Methods: Women attending bars, cafes and beer gardens in central Prague responded to the self-administered, time-site survey. Alcohol use was measured by the AUDIT-C and CAGE questionnaires. Sexual network structuring identified number, gender and coital frequency with current and recent sexual partners. Statistical analysis included central tendency, chi-square and logistic regression. Female participants (n=124) ranged from 18 to 67 years of age (mean 29 years); 25% self-identified as non-heterosexual. Results: We found alcohol to be the preferred drug of choice. Younger heterosexual women with new and casual sexual partners were more likely to use alcohol excessively. Women with children reported the least alcohol use. Sixty percent of the sample had never used condoms; condom-use was associated with longer relationship duration and discussions about HIV status with a sexual partner; non-use tended to occur among unmarried women with multiple male partners in short, serial sexual relationships. Women who sought HIV testing tended to be younger and more self-identified as non-heterosexual. Protective practices were rarely reported even when HIV transmission increases via heterosexual sexual partnering. Conclusion: Further research is recommended regarding cultural and contextual influences on HIV risk behaviours among Czech women.

Aim: Influenza virological surveillance is an essential tool for studying the evolution of influenza viruses as well as for annual updating of the vaccine composition. The aim of the present study is to analyse the circulation of the influenza viruses in Bulgaria during the four recent post-pandemic seasons. Methods: A total of 3,681 respiratory samples from patients with influenza like illness (ILI) or acute respiratory illness (ARI) were tested for influenza viruses using Real Time RT-PCR. Results: Influenza viruses were detected in 1,367 (37%) samples. Of those viruses, 941 (69%) were of type A and 426 (31%) of type B. Among the subtyped A viruses, 543 (60%) were A(H1N1)pdm09 and 369 (40%) A(H3N2). Co-circulation of all seasonal influenza types/subtypes was registered during each season, with the exception of A(H1N1)pdm09 virus in the 2011/12 season. In this study, data gathered from the antigenic and genetic analyses of influenza viruses, their antiviral susceptibility, and the epidemiological and clinical characteristics of the infections are presented. Conclusions: Yearly variations in the distribution and frequency of influenza types/subtypes and an annual shift of the predominant type/subtype were observed. In the seasons with predominant spread of A(H1N1)pdm09 virus - 2010/11 and 2013/14, a greater number of influenza-related pneumonia cases, ICU admissions and fatal cases was registered (p<0.05). The results of the present study confirm the need for continuous and comprehensive influenza surveillance.

Background: Colorectal cancer (CRC) is the third most common cancer worldwide, after lung and breast cancer, and is associated with the population dietary and lifestyle factors. Aim: To determine the relation between dietary and lifestyle factors and development of CRC in patients attending Minia oncology centre and compare them with their control. Methods: Study included 150 CRC patients attending Minia oncology centre and 300 control subjects matched by age and sex. Subjects participating in the study filled in a questionnaire including questions about socio-demographic data, medical data concerning CRC and its treatment as well as dietary and lifestyle factors. Results: The most significant dietary and lifestyle CRC risk factors were higher consumption of red meat (OR=57.1), preserved food (OR=39.4), artificial sweeteners (OR=20.8), fast foods (OR=12.8), soft drinks (OR=4.6), spicy foods (OR=4.2), processed meat (OR=2.4), and smoking (OR=8.8). The most significant protective factors were physical activity (OR=0.001), calcium rich diet (OR=0.08), higher consumption of fruits and vegetable (OR=0.02), cruciferous vegetables (broccoli OR=0.11, cauliflower OR=0.30 and cabbage OR=0.30), high fiber bread (OR=0.15), fruit juice (OR=0.18), and sea foods (tuna OR=0.28 and fish OR=0.38). Conclusion: Sedentary lifestyle and unhealthy dietary choices were prevalent among CRC cases. This study provides strong evidence that lifestyle and dietary modification are important factors in the prevention of colorectal cancer.

Aim: This paper investigates the correlation between liver cancer mortality and consumption of food-groups in Serbia. Methods: We conducted an ecological study. The study comprised the population of the Republic of Serbia (about 7.5 million inhabitants) during the period 1991-2010. This ecological study included the data on food consumption per capita which were obtained by the Household Budget Survey and mortality data for liver cancer made available by the National Statistical Office. Linear trend model was used to assess a trend of age-adjusted liver cancer mortality rates (per 100,000 persons) that were calculated by the method of direct standardization using the World Standard Population. Pearson correlation was performed to examine the association between liver cancer mortality and per capita food consumption quantified with a correlation coefficient (r value). Results: In Serbia, over the past two decades a significantly decreasing trend of liver cancer mortality rates has been observed (p<0.001). Liver cancer mortality was significantly (p<0.01) positively correlated with animal fat, beef, wine and spirits intake (r=0.713, 0.631, 0.632 and 0.745, respectively). A weakly positive correlation between milk consumption and mortality from liver cancer (r=0.559, p<0.05) was found only among women. The strongest correlation was found between spirits consumption and liver cancer mortality rates in women (r=0.851, p<0.01). A negative correlation between coffee consumption and age-adjusted liver cancer mortality rates was found (r=-0.516, p<0.05) only for the eldest men (aged 65 years or older). Conclusions: Correlations between liver cancer and dietary habits were observed and further effort is needed in order to investigate a possible causative association, using epidemiological analytical studies.

Background: Major depressive disorder (MDD) is a main public health concern worldwide. Despite extensive investigations, the exact mechanisms responsible for MDD have not been identified. Epidermal growth factor (EGF) and insulin growth factor binding protein-3 (IGFBP-3) are involved in brain function. Tumour suppressor protein p53 is widely involved in neuronal death in response to different forms of acute insults and neurological disorders. The present study focuses on the possible associations of the single-nucleotide polymorphisms (SNP) of EGF A61G (rs4444903), IGFBP-3 C32G (rs2854746) and TP53 G72C (rs1042522) genes with MDD risk in the Slovak population. Methods: The present case-control association study was carried out in 111 confirmed MDD patients and 207 healthy subjects. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism methods. Results: Logistic regression analysis showed no association between SNPs of selected genes and MDD risk in the Slovak population. However, the stratification of individuals by gender revealed that males carrying IGFBP-3 G alleles (G32G or GG) had marginally increased risk for developing MDD as compared to CC homozygous males (p=0.09). In women, inverse association was observed between SNP rs1042522 and MDD risk (p=0.04 for recessive model). Conclusion: Our results suggest the protective effect of minor allele 72C of TP53 gene towards MDD. The disruption of mechanisms involved in cell survival and death regulation may be involved in pathophysiology of MDD.

Aim: To compare the effects of exergames (EGs) using the Xbox Kinect™ device and home exercise (HE) on balance, functional mobility, and quality of life of individuals aged 65 years or older. Method: One hundred participants who met the inclusion criteria were randomized to the EG or HE group. The EG group took part in a 6-week programme using the Xbox360Kinect™ device, and the HE group took part in a 6-week balance exercise programme at home 5 days a week. The Berg Balance Scale (BBS) was used to assess balance, the Timed Up and Go (TUG) test was used to evaluate functional walking, and the Short Form 36 (SF-36) was used to assess quality of life. Results: Forty-eight participants in the EG group and 42 participants in the HE group completed the study. The groups were similar in terms of age, sex, and pretreatment values of BBS, TUG, and SF-36. Although the BBS scores of both groups improved significantly (all p<0.05), the post-treatment scores of the EG group were better than those of the HE group. The TUG scores improved only in the EG group (p<0.05). The increase in the BBS scores and decrease in the TUG test scores were significant only in the EG group (all p<0.05). A significant improvement was also observed in the quality of life parameters of physical functioning, social role functioning, physical role restriction, general health perceptions, and physical component scores in the post-exercise evaluations of the EG group. The participants commented that they found the EG programme very entertaining. Conclusion: The EG can be considered a safe, entertaining and sustainable alternative to HE programmes, and it may have positive effects on balance, functional walking and quality of life in geriatric subjects.

Aim: The objective of the study was to report gender and age-specific percentile values for fourteen commonly used field-based physical fitness tests among a national representative sample of Polish children aged 7 to 19 years. Methods: A descriptive cross-sectional and population-based study examines the physical fitness among a random and large national representative sample of schoolchildren aged 7 to 19 years in Poland. A sample of 49,281 children and adolescents (25,687 boys and 23,594 girls) was assessed by the EUROFIT fitness test battery, the International Committee on the Standardization of Physical Fitness Tests and Cooper Test of physical fitness. The LMS statistical method was used. Results: Smoothed gender and age-specific percentiles for the physical fitness tests in boys and girls aged 7 to 19 years are reported and expressed as both tabulated and curves values (2.3rd, 9th, 25th, 50th, 75th, 91st, and 97.7th). Figures showed greater physical fitness levels in boys, except for the flamingo balance, sit-and-reach, and stand-and-reach tests, in which girls performed slightly better. There was also a trend towards increased physical fitness levels as the age increased in both boys and girls. Conclusion: The percentile values provided will enable the correct interpretation and monitoring of fitness status of Polish children.

Roma people constitute one of the oldest and largest minorities in Europe. In Slovakia, there are approximately 400,000 Roma, and represent 7.5% of total population. However, according to recent official census in 2010, only 105,738 (2% of total population) citizens declared themselves as Roma ethnic. Approximately one sixth of Roma people live in segregated settlements. This supplement contains results of the HepaMeta study, which has aimed to map the socioeconomic, lifestyle, selected anthropometric, and health-related aspects of young Roma people living in the settlements and their majority counterparts. This study was conducted in 2011 and its main goal was to explore the prevalence of hepatitis B and C and metabolic syndrome. A group of 452 Roma aged 18-55 years, living in settlements (mean age = 34.7; 35.2% men) was compared to a control group of 403 non-Roma randomly chosen (mean age = 33.5; 45.9% men) from the patient database of collaborating general practitioners. Data were obtained by questionnaire, anthropometric measures and analysed blood and urine samples.

Background: For the development of cervical cancer, apart from the simple presence of HPV, the viral oncoproteins E6/E7 have to be over-produced.
Objectives: The aim of this study was to evaluate two different techniques for E6/E7 HPV mRNA detection.
Materials and Methods: 44 cervical samples in PreserveCyt vials were typed for HPV DNA with ClinicalArrays HPV (Genomica, Spain). Flow cytometric evaluation of E6/E7 mRNA of high risk HPV types was performed with HPV OncoTect (Invirion Diagnostics, USA). Endocervical cells were gated according to their FSC-SSC parameters and the cut-off was set at 1,5%. NucliSENS EasyQ® HPV (BioMerieux, France) was used to amplify E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45.
Results: 7 samples were negative with both FC and NASBA. 2 samples were negative with FC, but positive with NASBA. 11 samples (5 HgSIL, 3 SCC, 3 AdenoCa) were positive for both methods only if the gating for FC was set according to CAM5.2 and CD16 expression. Another 17 samples (1 WNL, 4 LgSIL, 11 HgSIL, 1 SCC) were positive with both methods. 7 more samples (6 LgSIL, 1 SCC) were only positive in FC, out of which 5 harbored coinfection of HPV-16 with at least another high risk type. The remaining 2 were single HPV-16 positive samples.
Conclusions: Total agreement of the two methods was at 93,18%. Flow cytometry proved to be more efficient a screening method, since all high risk types can be detected. On the other hand, due to the morphological changes in size and granullarity of cells in HgSILs and carcinomas, a three color staining procedure is needed. To conclude with, the two methods seem to be complementary since FC can be easily used as a screening method, while NASBA as a typing one.

Aim: The aim of the study was to develop a computational module for the prediction of compressive force on the L4/L5 disc suitable for use in field settings. Method: The value of compressive force is intended to be used as a proxy measure of the mechanical burden of low-back when performing work activities. The compressive force predicted by the module in a particular worker should be compared with the NIOSH limit value of 3,400 N for the assessment of lumbar spine load during manual lifting tasks. Exceeding the limit will be considered as the fulfilment of "hygienic criterion" that should be met to acknowledge low-back disorder as an occupational disease. To develop the computational module we used the ergonomic software TECNOMATIX Classic Jack taking into account the anthropometric parameters of a worker and ergonomic parameters of his/her work activity. Results: We calculated compressive forces on the L4/L5 disc in about 1,300 simulated combinations of various factors influencing compressive force. Parameters which turned out to be crucial for the compression of L4/L5 disc were included in the computational algorithm. Conclusion: Our study was primarily aimed at the assessment of lumbar disorders as occupational diseases. Moreover, the study can contribute to the recommendation of preventive measures to decrease health risks in occupations associated with the overload of low-back region. The graphic maps generated by the computational module enable a fast and exact analysis of particular job.

Child survival is the focus of the fourth Millenium Developmental Goal (MDG4). This paper describes levels, trends, and differentials in Under-Five Mortality Rate (U5MR) and also summarizes state programmes in Turkey between 1988 and 2010. Turkey is among only a few countries that have already surpassed MDG4 and have reduced their under-five mortality rate by more than two-thirds. In 2010, 13 out of every 1,000 children died before their fifth birthday. Low birth weight, high-birth order, short birth intervals, rural residence, low level of maternal education and lowest wealth quintile have affected negatively children's chances of survival. Expanding the scope of free vaccination programmes for children, improving screening and disease prevention schemes aimed at children, encouraging breastfeeding, implementing an emergency obstetric care programme, improving the services provided to newborns (a newborn intensive care programme) have brought about a significant decrease in the rate of infant and under-five mortality. The implementation of state and region specific action plans should be necessary to increase the chance of an access to the Continuum of Care for each mother and infant and to surpass MDG4.

Background and Aim: Transfusion transmitted diseases (TTD) are a major challenge to transfusion services all over the world. Cytomegalovirus (CMV) is considered one of the main viruses associated with blood transfusion. As CMV screening is not included in routine screening tests done for donated blood in blood banks in Egypt, the detection of CMV Immunoglobulin G (IgG) avidity needs to be tested for being a useful tool to diagnose recent infection among blood donors. The aim of this work was to study CMV IgG avidity index (AI) among blood donors. Methods: A total of 88 blood samples were collected from the non-remunerated volunteer blood donors who attended the Alexandria Regional Blood Transfusion Centre. A quantitative enzyme linked immunosorbent assay for the avidity detection of the specific IgG antibodies to CMV in human serum samples was used. Results: Eighty five studied blood donors (96.6%) were positive for CMV IgG. Eighty one donors (95.3%) showed high avidity (>45.0%). Regarding the remaining four CMV IgG positive donors; three had medium avidity (<45.0%) and only one had a low avidity of <25.0%. A moderate agreement of 42.4% was found between IgG concentration and avidity. Conclusions: CMV seroprevalence was found to be high among volunteer blood donors, where age and gender were statistically significant factors associated with CMV IgG concentration. The use of the avidity assay as a screening tool for CMV among blood donors is highly suggested. The exclusion of the low and medium AI units will ensure the availability of a safe stock of blood units, hence eliminating the risk of CMV transmission to vulnerable groups.

Aim: The aim of this study was to investigate the seasonal fluctuation of PCDD/Fs and dl-PCBs levels in the ambient air of Upper Silesia in the aspect of human inhalation exposure as well as the estimation of health risk attributed to this exposure pathway to dioxins and dl-PCBs. Methods: In the study air samples were taken in five urban districts of Upper Silesia, Poland, where the houses are heated with coal. The same sampling points in summer and winter were analyzed for dioxins/furans and dl-PCBs. In addition, information was collected on awareness of the residents about the co-incineration of plastic waste and effects of this activity on human health. Results: The results show that the average daily exposure of residents of Upper Silesia to TCDD and DLCs in the heating season was about 6.5.-fold higher than in summer. The risk assessment showed that expected excess of cancer cases per 1,000,000 people ranged from 4.5 to 13.2 in winter and from 0.9 to 2.1 in summer. The practice of mixing waste with coal for houses heating has been confirmed by investigated families, who do not associate it with the possibility of negative health effects. Conclusions: Air pollution can be a significant source of dioxin and dl-PCB for people during the winter season, as a result of co-burning coal and waste containing plastics. The dose of dioxins inhaled through the respiratory pathway in winter can be associated with the higher cancer risk in the population of Upper Silesia.

Objectives: Seasonal fluctuations in mortality are associated with age, outdoor temperature, influenza, health care provision, lifestyle risk factors and economic factors. In the Republic of Serbia almost one half of the Roma population lives in poverty and their housing conditions are very poor. The aim of this paper is to describe and compare excess winter mortality (EWM) in Roma and non-Roma population in Serbia from 1992 to 2007. Methods: Using the national mortality database, this study compares EWM index and rates in Roma and general populations in Serbia. Mean winter temperature and ethnicity are analysed against the results for relative EWM by multiple linear regression adjusted for age. Results: Frequency analysis showed that Roma population had significantly higher EWM rate per 10,000 (129.2 vs. 76.6) for all causes, all respiratory diseases (26.5 vs. 8.0), and chronic lower respiratory diseases (23.0 vs. 5.2) in comparison to non-Roma population. Influenza and pneumonia related deaths represented a small proportion of EWM in both populations. Cardiovascular EWM rate was slightly higher among non-Roma population. Regression analysis demonstrates that Roma ethnicity was associated with significant increase of respiratory EWM rate (regression coefficient (B)=1.49; 95% CI: 0.45-2.54). There was no relationship between ethnicity and cardiovascular and all causes EWM rates. Conclusions: Although both Roma and non-Roma populations in Serbia suffer from very high rates of excess winter mortality, Roma are significantly more vulnerable. EWM rate from chronic lower respiratory diseases is more than four times higher among Roma people and suggests that they represent one of the most important health problems in Roma population in Serbia.

Smoking increases the risk of forming, growing, and rupture of intracranial aneurysms. We retrospectively reviewed patients with intracranial aneurysms treated by neurosurgical or endovascular treatment - 154 patients (45 men, 109 women, 15 to 62 years, average 46.3 years, CI±1.72). We found 74% (114/154) of smokers - 80% (36/45) men and 71.6% (78/109) women, with the mean value of the Fagerström Test of Nicotine Dependence 4.4 (CI±0.40). The average age of smoking initiation was 18.2 years (CI±0.66), the average period of smoking 26.8 years (CI±2.13). The average number of cigarettes consumed daily was 18.2 (CI±1.58). With statistical significance p<0.05, the athero-index was lower in non-smokers than smokers: 3.4 (CI±0.56) vs. 4.5 (CI±0.51). HDL cholesterol was higher in non-smokers than smokers: 1.6 mmol/l (CI±0.25) vs. 1.4 (CI±0.10), and triglycerides were higher in smokers than non-smokers: 1.3 mmol/l (CI±0.16) vs. 1.9 (CI±0.35). Forty-two per cent of smokers (48/114) were controlled one year after the treatment; 18.8% of them stopped smoking, 41.7% reduced smoking, and 39.6% continued to smoke as extensively as before. The prevalence of smoking in our sample was higher than in the Czech population (28.2%). Only 18.8% of controlled smokers were able to quit one year after the intervention.

Objective: To study the association between common cold during pregnancy and pregnancy complications and delivery outcomes: gestational age/birth weight, in addition preterm birth and low birthweight.
Method: In the population-based large data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities (HCCSCA), 19801996, controls without congenital abnormalities were analysed.
Results: Of 38,151 newborn infants, 5,475 (14.4%) had mothers with common cold. The prevalence of threatened preterm delivery, placental disorders and severe nausea and vomiting was lower while the occurrence of anemia was higher in pregnant mothers with common cold than in mothers without common cold. Mothers with common cold in pregnancy had 0.1 week shorter gestational age, thus the proportion of preterm births (9.8% vs 9.1%) was somewhat larger. However, mean birth weight was somewhat larger (3,305 vs 3,271 g) and the proportion of low birthweight newborns (4.2% vs 5.9%) was smaller.
Conclusion: Common cold during pregnancy does not increase the occurrence of pregnancy complications except anemia, while delivery outcomes showed minor but opposite (higher rate of preterm birth and lower rate of low birthweight) changes.

Objective: The aim of the research was to assess the oral hygiene habits in the elderly group of study population of Southern Poland. Methods: The study was conducted in dental services in two selected cities in Southern Poland. The group of subjects consisted of 664 respond-ents (272 men, 392 women) aged 65 to 81 years. Oral hygiene was measured with the author's anonymous questionnaire consisting of twenty questions. Questions related to information on personal history and general health, comorbidities, dietary habits, alcohol consumption, smoking, taking drugs and the state of oral hygiene practices as frequency of visits to the dentist and the number of own teeth. Results: The majority of the subjects had higher n = 240 (36.1%) and secondary n = 219 (33%) education and were predominantly n = 590 (89%) professionally inactive (retirees or pensioners). No significant differences were found between the groups: women and men. But there were differences in technologies used, the examined men significantly often used computer in comparison with the women's group. In total, 19.6% had own natural teeth only, 45.0% own teeth and dentures, 30.0% dentures only, and 5.4% neither teeth nor dentures. Majority of subjects brush their teeth or dentures only 1-2 times a day (80%) and visit the dentist less than once in 2 years or once a year (75%). Women significantly more often stated use of a toothbrush and taking care of oral hygiene and compared to men, they declared higher number of own teeth. Conclusion: People aged over 65 neglect hygiene and oral care. Women pay more attention to oral hygiene and they have more own teeth than men. The most frequent cause of oral hygiene neglect in the elderly could be gender, the socio-economic conditions, behaviour habits and lack of sufficient health education. The dentist may need to consult with the patient's GP the development of the appropriate personalised treatment plan for the elderly. Young dentists need to be educated in order to provide appropriate dental care to the elderly.

Aim: The aim of this study was to evaluate the prevalence of HPV types in the female population with either normal or abnormal Pap smears in Southern Croatia (Dalmatia County) and to evaluate the distribution of HPV types and their association with different cytological findings. Methods: During one year period, we routinely screened 1,160 women for HR HPV at the Educational Public Health Institute of Split and Dalmatia County, by using Hybrid Capture 2 HPV DNA test. Only HR HPV positive specimens determined by HC2 were further genotyped by polymerase chain reaction (PCR) based assay at the Department of Pathology and Forensic Medicine, Split. Results: Out of the total number of tested women, 406 (35%) of them were positive to HR HPV. The following frequency was observed: HPV 16 in 10.8%, HPV 18 in 7.8%, HPV 31 in 2.3%, HPV 33 in 1.1%, HPV 52 in 0.9%, HPV 45 in 0.6%, and HPV 59 in 0.4% specimens. Conclusion: The data obtained from our study indicate that HPV 16 is the most common HPV type found in the cervical specimens among women of Southern Croatia, as in most studies worldwide, followed by HPV 18 and HPV 31. The positivity rates in our study slightly differed for HPV types 18 and 31 from those found in the other studies conducted in Northern Croatia. These suggesting geographic and environmental factors are related to the prevalence of HPV types. We consider it very important to gather information on regional variations in the HPV type spectrum.

Background: The purpose of the current study was to describe tuberculosis (TB) knowledge, beliefs, and experience with TB services among injecting drug users. Methods: Participants for this anonymous, cross-sectional study were recruited from a community based syringe exchange programme in Tallinn, Estonia. A structured questionnaire was completed and included information on socio-demographics, health history, drug use, and knowledge about TB and HIV. Results: The study included 407 people (79% male, mean age 27.9 years, mean injection drug use 9.4 years). 32.9% of participants reported HIV infection and 1.7% lifetime history of TB. 26.4% participants (n=106) reported symptoms suggestive of TB. 93% of participants recognized correctly that TB is air-borne infection and 91% that HIV is a risk factor for TB. Only 40% of the participants knew that TB diagnostics and treatment in Estonia are free of charge for everybody and 58% reported they knew where to get health care services in case they suspected that they had TB. TB transmission and treatment adherence knowledge was better among those in contact with either health care or harm reduction services, e.g the community based syringe exchange programme. Conclusion: Similar to HIV services, TB prevention and education should be integrated into harm reduction and drug treatment programmes to facilitate early diagnosis and treatment of TB among injecting drug users.

Tobacco is the largest cause of morbidity and mortality. The aim of this study is to analyse several health and economically related indicators of tobacco consumption: smoking prevalence, standardized death rates (SDRs) from lung cancer and the proportion of GDP spent on tobacco in Croatia and other transitional countries - the Czech Republic, Slovakia, Poland, Hungary, Slovenia, Romania, and Bulgaria. The overall smoking prevalence in Croatia decreased by 5.2% during 1994-2005, more among females (-9.9%) than males (-0.3%). There is no significant difference in the smoking prevalence between Croatia (27.4%) and other countries. However, 33.8% of Croatian males smoked during 2002-2005, more than in Romania and the Czech Republic, and less than in Hungary and Poland. The prevalence of female smoking (21.7%) in Croatia is similar to the female smoking prevalence in Poland, the Czech Republic, and Hungary, but male smoking is predominant in all countries. The proportion of smokers among youth is above 20% and it is the highest in the Czech Republic (29.7%), followed by Hungary (26.7%), Slovenia (24.9%), Croatia (24.1%), and Poland (21.5%). The proportion of smokers among girls is higher than among boys in Slovenia, Hungary, the Czech Republic, and Croatia, contrary to Slovakia, Bulgaria, and Poland where boys smoke slightly more. There is no significant difference between the prevalence of smoking among girls in Croatia and Bulgaria, Poland, the Czech Republic, Hungary, Slovenia, and Slovakia. According to the SDR from lung cancer in males (70.3/100,000), Croatia is ranked high assuming the 3rd place, after Hungary (99.7) and Poland (72.0). With a SDR of 15.9/100,000 for females, Croatia is ranked slightly better - 5th place. Tobacco consumption continues to be a major public health problem in transitional countries. Croatia conducted several campaigns and programmes in the past. However, results reveal that current anti-tobacco strategies are ineffective in reducing the smoking prevalence among men and youth. Men do not smoke less than a decade ago and, despite the observed decline among women, increasing trends are observed among teenage girls. Croatia should apply a comprehensive approach that would include raising aware-ness of health risks, restriction of smoking in public places, higher taxing, implementing stricter bans on advertising and promotion of tobacco as well as supporting smoking cessation. This last measure is believed to bring about some results in the medium term in targeted population groups, provided that it is supported by all health professionals. Otherwise, we may expect progress at the population level in the field of social stigmatization of smoking and wider intolerance to second-hand smoke. The full impact of smoking on the population health is yet to be seen and in the future it will undoubtedly remain one of the major contributors to the poor public health situation in Croatia.

Introduction: The purpose of this study is to determine the prevalence of obesity and to compare the associated risk factors between the adolescent children living in rural and urban areas. Materials: This cross-sectional study conducted among 3,918 high school students getting education in the city centre and rural areas of Eskisehir. A specially designed questionnaire form included questions about socio-demographic characteristics as well as cardiovascular risk factors including smoking status, diet habits (breakfasting, consumption of sugar-sweetened beverages and fruit and vegetable consumption), physical activity and time spent on computer and/or television. Results: The prevalence of being overweight was 10.4% and 12.2% and the prevalence of obesity was 7.9% and 11.3% in rural and urban areas, respectively. In urban areas, being overweight was accompanied by prehypertension (OR=2.3, 95% CI 1.6-3.3), hypertension (OR=2.3, 95% CI 1.6-3.2), and family history of cardiovascular disease (OR=1.3, 95% CI 1.1-1.7), and obesity was accompanied by prehypertension (OR=2.3, 95% CI 1.6-3.3), hypertension (OR=3.9, 95% CI 2.9-5.3), excessive use of computer/TV (OR=1.3, 95% CI 1.1-1.7), having no breakfast (OR=1.3, 95% CI 1.1-1.7), physician-diagnosed diabetes mellitus (OR=4.2, 95% CI 1.3-14.1) and consumption of sugar-sweetened beverages (OR=0.6, 95% CI 0.5-0.8). In rural areas, although the variables accompanying being overweight were parallel with those in urban areas, obesity was only associated with prehypertension (OR=6.1, 95% CI 2.6-14.1), hypertension (OR=22.1, 95% CI 9.9-49.3) and family history of cardiovascular disease (OR=1.6, 95% CI 1.1-2.6). Conclusion: Risk factors may differ in the adolescents from rural and urban areas. It is important in overweight and obese children to assess the family history of cardiovascular disease, blood pressure and blood glucose, to ask about the habit of regularly breakfasting, and to evaluate time spent on computer/TV. As in urban areas, environmental regulations also become important in rural areas. Appropriate social activities for children to spent more time outdoor, e.g. in parks or playgrounds, are important in urban as well as in rural areas.

Aims: This study aimed to enhance the in-depth understanding of the contextual dimensions that shape the relationships between climate change communication approach and youth well-being. The study focused on university students who constitute the key stakeholders and future decision-makers and leaders for managing the long-term climate risks. Methods: A total of 10 focus group interviews were conducted with 117 undergraduate and graduate South African university students from over 12 universities located in different provinces of South Africa. In addition, another 16 interviews were also undertaken with university students, 10 interviews with key experts, and 3 youth national events were attended as participant-observation. Results: As recipients of information on climate change, students' well-being was negatively affected by the media's pessimism of communicating risks and the inadequate or restricted networking of communicating solutions and strategies. As contributors to information on climate change, students faced key barriers to their efficacy and agency that entailed socio-cultural inequalities (e.g. race and language) and a lack of formal forums for community recognition, policy consultation and collaboration. In addition, for some students (e.g. journalism students), the lack of sufficient knowledge and skills on climate change and sustainability issues limited their ability to effectively communicate these issues to their audience. Conclusions: Platforms for interactive and reflective discussions, access to innovative technologies and social media, and opportunities for multi-stakeholder partnerships are keys to the success of youth-targeted and youth-initiated communication on climate change.

According to the World Health Organization, there are more than one billion smokers in the world, and tobacco is said to kill half of its users. The European Region of WHO, with only 15% of the world's population, faces nearly one third of the worldwide burden of tobacco related diseases. Millions of lives could be saved with effective and comprehensive tobacco control strategy. In response to this, the World Health Organization has offered a wide range of information and recommendations to governments, organizations, health-care professionals, and tobacco users and non-users worldwide. This paper is focusing on various activities that governments, organizations or even individuals can undertake to help smokers to quit and decrease percentages of tobacco users and save millions of lives.

Background: Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements. Methods: A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated. Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females. Conclusion: Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.

This paper describes a paradoxical situation in Austria. The vaccination rate against tick-borne encephalitis (TBE) in the general population is 82%, which is the highest worldwide, whereas the vaccination rate against influenza is about 8% and is among the lowest worldwide. A high awareness of TBE among the Austrian population achieved by an annual social marketing programme and the wide use of effective and well-tolerated vaccines have led to a successful containment of that disease. The vaccination coverage increased from 6% in 1980 to 82% in 2013 and exceeds 90% in some high-risk areas. This has led to a steady decline in the number of TBE cases from several hundred cases to 50 to 100 cases per year. The situation in regard to influenza vaccination is the opposite. Although Austria has issued one of the most extensive recommendations for influenza vaccination worldwide, the vaccination rate of the general population is extremely low. The possible reasons for the failure in the implementation of recommendations are ignorance, lack of social marketing and the predominance of a distinct discordance within the health system in general, and the Austrian medical fraternity in particular.