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Results 631 to 660 of 1060:

Key Items of Innovation Management in the Primary Healthcare Centres Case Study: Finland

Alireza Aslani, Mohammad Mahdi Zolfagharzadeh, Marja Naaranoja

Cent Eur J Public Health 2015, 23(3):183-187 | DOI: 10.21101/cejph.a3889

Trends such as aging populations, excess costs, rising public expectations, and progress in medical science and technologies point out the necessity of adaptation and development of innovation in the healthcare systems particularly in developed countries. The main objective of this article is to review diffusion of innovation in the healthcare sector. Different types of innovation, diffusion characteristics, and adoption mechanisms are the subjects that are discussed in the selected case study, Finland. Finally, the key items of innovation management in the Finnish health system are introduced. The results can be implemented in other countries as well.

Testing Two Nutrient Profiling Models of Labelled Foods and Beverages Marketed in Turkey

Derya Dikmen, Mevlüde Kızıl, Muhemmet Fatih Uyar, Gülden Pekcan

Cent Eur J Public Health 2015, 23(2):155-160 | DOI: 10.21101/cejph.a3992

Aim: The objective of this study was to evaluate the nutrient profile of labelled foods and also understand the application of two international nutrient profiling models of labelled foods and beverages. Methods: WXYfm and NRF 9.3 nutrient profiling models were used to evaluate 3,171 labelled foods and beverages of 38 food categories and 500 different brands. Results: According to the WXYfm model, pasta, grains and legumes and frozen foods had the best scores whereas oils had the worst scores. According to the NRF 9.3 model per 100 kcal, the best scores were obtained for frozen foods, grains and legumes and milk products whereas the confectionery foods had the worst scores. According to NRF 9.3 per serving size, grains and legumes had the best scores and flavoured milks had the worst scores. A comparison of WXYfm and NRF 9.3 nutrient profiling models ranked scores showed a high positive correlation (p=0.01). Conclusions: The two nutrient models evaluated yielded similar results. Further studies are needed to test other category specific nutrient profiling models in order to understand how different models behave.

How Parental Attitudes Affect the Risky Computer and Internet Usage Patterns of Adolescents: a Population-based Study in the Bursa District of Turkey

Yeşim Uncu, Pınar Vural, Çağatay Büyükuysal, Züleyha Alper, Emine Zinnur Kılıç

Cent Eur J Public Health 2014, 22(4):266-272

Background: We aimed to evaluate the computer usage patterns of adolescents and to determine the effects of family life and parental attitude on these patterns. Methods: This was a descriptive, cross-sectional, population-based survey that included 935 children between 11 and 16 years of age who were students in the second level of primary school and their parents as well. The following instruments were used in the survey: student and parent questionnaires on computer usage patterns and the Parental Attitude Research Instrument (PARI) to assess parental attitudes towards child-rearing and family life. Results: Of the study population, the majority of the students had a computer in their homes and spent a lot of time on the Internet. Parental control over the amount of time spent on the Internet and the websites that were visited had sometimes limited and contradictory effects on computer usage among the students. A democratic parental attitude was the best approach. Using the computer as a reward or punishment had a negative impact on the children's computer usage patterns. Conclusions: Although parents are confused concerning the benefits and harms of the Internet for their children and not certain how to manage their children's use of the computer and safe navigation of the Internet, a democratic parental attitude appears to be the best approach for reaching the most beneficial computer usage patterns for students.

What Is the Real Public Health Significance of Iron Deficiency and Iron Deficiency Anaemia in Croatia? A Population-Based Observational Study on Pregnant Women at Early Pregnancy from Eastern Croatia

Ines Banjari, Daniela Kenjerić, Milena L. Mandić

Cent Eur J Public Health 2015, 23(2):122-127 | DOI: 10.21101/cejph.a3962

Aim: Studies imply that significance of iron deficiency (ID) and iron deficiency anaemia (IDA) for pregnancy outcomes is especially highlighted in the early pregnancy. Prevalence around the world varies widely, however, no data is available up to date for Croatia or neighbouring countries. Therefore, the objective was to determine the prevalence of ID and IDA among pregnant women from Croatia at the first trimester. Also, the aim was to compare two criterions; the World Health Organization (WHO) one and the clinical one. Methods: Randomised observational population based study was set up and 265 pregnant women at the first trimester were enrolled. Results: Based on the WHO criteria, 17.7% on haemoglobin basis and 18.5% on haematocrit basis had either ID or IDA. Clinical criteria showed that even 32.8% had either ID or IDA (transferrin saturation <20.0%). The WHO criterion shows less sensitivity, especially in detecting less severe stages of IDA. Conclusions: Regardless of the criteria used, ID and IDA present a mild to moderate public health problem in pregnant women population. This high share of pregnant women who are starting their pregnancy as iron deficient, presents a potentially high risk for the pregnancy outcomes, especially in terms of a newborn, and it is fully justified to treat them as diseases of public health significance.

Relationship between Czech Parent and Child Pedometer-assessed Weekday and Weekend Physical Activity and Screen Time

Erik Sigmund, Dagmar Sigmundová, Petr Baďura, Jaroslava Voráčová

Cent Eur J Public Health 2015, 23(Supplement):S83-S90 | DOI: 10.21101/cejph.a4181

Aim: Uncovering the influences of parents' behaviour on their children's physical activity provides an insight into the lifestyle of families and development of effective family-based interventions. The aim of this study was to determine the relationship between parents' behaviour (step count (SC) and screen time (ST)) and children's SC on weekdays and at weekends. Methods: The participants (388 parents aged 35-45 and their 485 children aged 9-12) were randomly recruited from 21 Czech governmentfunded primary schools. The participants recorded SC and ST duration for seven consecutive days (≥10 h/day) during April-May and September-October 2013. The associations between parents' behaviour (SC and ST) and children's SC were estimated using general linear regression separately for weekdays and weekends. Each 1,000 SC increase in mothers' (fathers') SC/weekday was associated with an extra 261 SC/day in their daughters and 413 (244) SC/day in their sons. Results: Each 1,000 SC increase in mothers' (fathers') SC/weekend day was associated with an extra 523 (386) SC/day in their daughters and 508 (435) SC/day in their sons. A reduction in mothers' ST by 30 minutes per weekend day was associated with an extra 494 SC/day in their daughters and 467 SC/day in their sons. Conclusions: This study reveals a quantifiable relationship between parent-child SC/day and mothers' ST and children's SC at weekends. Weekend days are more suitable for the implementation of family-based interventions.

Mathematical Modelling of Varicella Spread in Slovakia

Jana Zibolenová, Veronika Szabóová, Tibor Baška, Daniel Ševčovič, Henrieta Hudečková

Cent Eur J Public Health 2015, 23(3):227-232 | DOI: 10.21101/cejph.a4076

Aim: Varicella is a highly contagious disease. In Slovakia, 15,000-30,000 cases are reported annually. However, vaccination against varicella is not widely used in Slovakia. The aim of this paper is to predict the influence of vaccination administrated in different ages on the disease occurrence in different age groups. Methods: Deterministic, age-stratified SIR (susceptible-infected-recovered) model with stable population was used for prediction of varicella spread in Slovakia. Results: Vaccination of a group designated as 0 influences the proportion of susceptible and infected persons in all age groups, vaccination of 10 years old ones affects only the proportion of susceptible and infected individuals older than 10 years. Conclusion: The increase of vaccination coverage should have a positive impact on the incidence of varicella in Slovakia. In case of vaccination coverage of 0 group in the range of 30-75%, it is necessary to pay attention to the protection of older children and adults.

Maternal Smoking during Pregnancy and Birth Outcomes in a Sample of Romanian Women

Cristian I. Meghea, Ioana A. Rus, Răzvan M. Cherecheş, Nicolae Costin, Gabriela Caracostea, Alexandra Brînzaniuc

Cent Eur J Public Health 2014, 22(3):153-158

Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. Smoking cessation in early pregnancy seems to reduce these risks, although the research evidence is limited. In a sample of Romanian women, differences in birth outcomes were assessed between non-smokers and women who continued to smoke during pregnancy and non-smokers and women who stopped smoking when they found out about the pregnancy. Pregnant women were recruited in two urban clinics (N=474). A baseline questionnaire collected information on their smoking status, depressive symptoms, stress, demographics, and other characteristics at recruitment. The women reported the newborn weight and birth term by phone in the first weeks following birth. Descriptive statistics and multivariate regressions were used to analyze the relationship between smoking status during pregnancy and birth outcomes. Over 61% (N=290) women were non-smokers, 15% (N=72) smoked during pregnancy, and 24% (N=112) quit smoking when they found out about the pregnancy. Compared to non-smokers, continuous smokers delivered babies 165 grams lighter (95% CI -313, -17). Women who stopped smoking when they ascertained the pregnancy had higher odds of delivering a newborn who was small for gestational age compared to non-smokers (OR=2.16, 95% CI 1.05, 4.43). Elevated maternal stress was associated with reduced birth weight (-113 grams, 95% CI -213, -11), and higher odds of a preterm birth (OR=2.8, 95% CI 1.17, 6.76). In a predominantly urban sample of Romanian women, continuous maternal smoking during pregnancy was a risk factor for restricted foetal growth. Smoking cessation when the pregnancy was ascertained did not seem to reduce this risk. Smoking prevention efforts should therefore begin before pregnancy and should integrate psychological components, addressing maternal stress in particular.

Influence of the Environment and Occupational Exposure on the Occurrence of Q Fever

Erik Dorko, Kvetoslava Rimárová, Emil Pilipčinec

Cent Eur J Public Health 2012, 20(3):208-214 | DOI: 10.21101/cejph.a3754

Q fever, which is caused by Coxiella burnetii, is a worldwide zoonotic infectious disease and ruminants are the main reservoir for human infec-tions. Humans become infected primarily by inhaling aerosols that are contaminated with C. burnetii. Ingestion (particularly drinking raw milk) and person-to-person transmission are minor routes. Animals shed the bacterium in urine and faeces, and in very high concentrations in birth by-products. The bacterium persists in the environment in a resistant spore-like form which may become airborne and transported long distances by the wind. Q fever is considered primarily an occupational disease of workers in close contact with farm animals or processing their products, however, it may occur also in persons without direct contact. To prevent the introduction and spread of Q fever infection, preventive measures should be implemented including immunisation with currently available vaccines of domestic animals and humans at risk.

WHO Calls for Urgent Action to Curb Hepatitis.

Cent Eur J Public Health 2015, 23(3):187, 194

Depression and Self-Esteem in Early Adolescence

Ingrid Tripković, Romilda Roje, Silvana Krnić, Mirjana Nazor, Željka Karin, Vesna Čapkun

Cent Eur J Public Health 2015, 23(2):166-169 | DOI: 10.21101/cejph.a4017

Aim: Depression prevalence has increased in the last few decades, affecting younger age groups. The aim of this research was to determine the range of depression and low self-esteem in elementary school children in the city of Split. Testing was carried out at school and the sample comprised 1,549 children (714 boys and 832 girls, aged 13). Methods: Two psychological instruments were used: the Coopersmith Self-Esteem Inventory (SEI) and the Children and Adolescent Depression Scale (SDD). Results: The average value of scores obtained by SEI test was 17.8 for all tested children. No statistically significant difference was found between boys and girls. It was found that 11.9% of children showed signs of clinically significant depression, and 16.2% showed signs of depression. Statistically significant association between low self-esteem and clinically significant depression was found. No statistically significant difference among boys and girls according to dimension of cognitive depression was found, whereas statistically significant level of emotional depression was higher in girls than boys. It was found that both dimensions of depression decreased proportionally with the increase of SEI test score values: cognitive and emotional dimension of depression. Conclusion: The results of this study show that it is necessary to provide early detection of emotional difficulties in order to prevent serious mental disorders.

The Impact of the July 2007 Heat Wave on Daily Mortality in Belgrade, Serbia

Dragan C. Bogdanović, Zoran G. Milošević, Konstansa K. Lazarević, Zana Ć. Dolićanin, Dragan M. Ranđelović, Stefan D. Bogdanović

Cent Eur J Public Health 2013, 21(3):140-145 | DOI: 10.21101/cejph.a3840

Objective: Mortality has been shown to increase with heat waves. Serbia experienced the hottest heat wave in July 2007. In this study, we examined patterns of non-traumatic excess mortality in Belgrade during this event. Methods: The numbers of deaths observed during the 9-day heat wave were compared to those expected on the basis of mortality rates reported for the previous eight years and two following years. Excess mortality was analyzed by age, gender and cause of death. Results: There was a total of 167 excess deaths (38%) between 16 and 24 July. People aged 75 years and older accounted for 151 (90%) of all excess deaths. An increase of mortality among elderly was 76% in comparison to the baseline mortality. Excess female mortality was over two times higher than excess male mortality (54% : 23%). The biggest increase in mortality was from diabetes mellitus (286%), chronic kidney disease (200%), respiratory system diseases (73%), and nervous system diseases (67%). Cardiovascular and malignant neoplasms mortality accounted for the highest absolute numbers of excess deaths (77 and 49, respectively). There was no decrease in mortality in the 60-day period after the heat wave. Conclusions: There are several causes of an increase in heat-related mortality. The most vulnerable population group is the elderly females.

Monitoring of Microscopic Filamentous Fungi in Indoor Air of Transplant Unit

Ondřej Holý, Ivanka Matoušková, Alena Kubátová, Petr Hamal, Lucie Svobodová, Eva Jurásková, Luděk Raida

Cent Eur J Public Health 2015, 23(4):331-334 | DOI: 10.21101/cejph.a4062

Aim: The aim of the study was to control the microbial contamination of indoor air monitored monthly at the Transplant Unit of the University Hospital Olomouc from August 2010 to July 2011. Methods: The unit is equipped with a three-stage air filtration system with HEPA filters. The MAS-100 air sampler (Merck, GER) was used. Twenty locations were singled out for the purposes of collecting a total of 720 samplings of the indoor air. Swabs of the HVAC diffusers at the sampling locations were always carried out after the sampling of the indoor air. Results: In total, 480 samples of the indoor air were taken for Sabouraud chloramphenicol agar. In 11 cases (2.29%) the cultivation verified the presence of microscopic filamentous fungi. Only two cases involved the sanitary facilities of a patient isolation box; the other positive findings were from the facilities. The most frequent established genus was Aspergillus spp. (4x), followed by Trichoderma spp. (2x) and Penicillium spp. (2x), Paecilomyces spp., Eurotium spp., and Chrysonilia spp. (1x each). In 2 cases the cultivation established sterile aerial mycelium, unfortunately no further identification was possible. A total of 726 swabs of HVAC diffusers were collected (2 positive - 0.28%). The study results demonstrated the efficacy of the HVAC equipment. Conclusions: With the continuing increase in the number of severely immunocompromised patients, hospitals are faced with the growing problem of invasive aspergillosis and other opportunistic infections. Preventive monitoring of microbial air contaminants is of major importance for the control of invasive aspergillosis.

Prevention of Taxi Accidents in Xi'an, China: What Matters Most?

Yonggang Wang, Ming Li, Jianhua Du, Chengyuan Mao

Cent Eur J Public Health 2015, 23(1):77-83

Objectives: Since the city of Xi'an has been extremely concerned with the serious problem of taxi involved crashes, injuries and fatalities, the primary purpose of this study is to identify the risk factors associated with the magnitude and nature of the problem and provide possible measures for enhancing the overall safety performance of taxi industry. Methods: Using 726 crash samples from the original of 7,183 observations in Xi'an over the period from 2006 to 2012, comparative statistics and systematic analysis were employed to describe the distribution of taxi crashes by driver characteristics, roadway contributors and environmental factors and then determine the significant factors contributing to crash injuries and fatalities. Results: The trend and pattern of taxi involved crashes vary significantly. Middle aged (77.27%) male (91.60%) drivers with limited education (68.59%) and less driving (31.27%) and job (82.50%) experience were much more likely to be involved in such a crash. Additionally, it is found that a large majority of taxi crashes occurred with the most frequent type of rear end collisions (30.72%), on six-lane segments without median (16.94%) or four legged intersections (15.29%), under adverse weather conditions (31.82%), at weekends (34.99%), and during winter days (34.72%), but fatal and serious crashes were more likely to happen at night (30.72%) or under wet road surface conditions (16.94%), due to driver's overspeeding, unbelted, disregarding signs or signals, or other types of risk driving behaviour. Conclusions: The risk of taxi related crashes varies by drivers, roadways and environment. To reduce the risk of potential crashes for taxi drivers, we recommend the targeted legislation and enforcement, stronger night and trip restrictions, awareness of risk behaviour, and periodical training requirement. Such proposals and measures are expected to help mitigate taxi crashes and promote road safety in China.

Comparison of Knowledge, Attitudes and Behaviour of Health Professionals and Parents Regarding Child Injuries

Nikolina Brčina, Aida Mujkić, Milan Milošević, Maja Miškulin, Anne Baber Wallis

Cent Eur J Public Health 2014, 22(4):245-250

Objective: We wanted to primarily examine the knowledge, attitudes and behaviour of parents and health workers (community nurses and paediatricians) regarding child injuries in order to understand the essence of the problem and to find out the most common misconceptions. Methods: Respondents were tested through an anonymous, self-administered questionnaire and all p values below 0.05 were considered significant. Results: Of all respondents, paediatricians answered accurately most of the questions considering knowledge than the other groups. More than 90% of respondents, in all groups, identified correct answers to 10 questions about attitudes towards child injury prevention and safety promotion. Conclusion: This study, which shows the current level of knowledge, attitudes and behaviour patterns of parents and health professionals in Croatia, could help in the preparation of appropriate prevention programmes.

Use of Selected Prediction Equations (CG, MDRD4, CKD-EPI) in Improving Glomerular Filtration Rate Assessment in Clinical Practice in Slovakia

Tomáš Žatko, Branislav Kolena, Ida Petrovičová, Tomáš Pilka, Anton Kolačan

Cent Eur J Public Health 2014, 22(1):34-41 | DOI: 10.21101/cejph.a3858

Our study aimed to establish the best prediction equation for different age ranges in estimating Glomerular Filtration Rate (GFR) in clinical practice in Slovakia. The GFR by 24-hour creatinine clearance (Ccr) and the estimated GFR (eGFR) using the Cockcroft-Gault (CG), the four-variable Modification of Diet in Renal Disease (MDRD4) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were obtained in adults aged 30-80 (n=433, 10-years intervals). The correlation between these prediction equations and Ccr was evaluated. Errors in prediction equations were detected by moving average and by comparisons of the formulas for GFR <1.5 ml/s and >1.5 ml/s. The best correlations were established between Ccr and MDRD4 for women (r=0.7790) and men (r=0.8009), and between Ccr and CKD-EPI for women (r=0.7780) and men (r=0.8002) in the 60-69 age range. High correlation was also established between Ccr and CG (r=0.8655) and MDRD4 (r=0.8713) for men in the 40-49 age range. With the exception of the 30-40 age range, a low prediction error was observed for each age range in both genders when GFR was <1.5 ml/s. We recommend utilization of the MDRD4 and CG equations for men (40-49 years) and MDRD4 and CKD-EPI for women and men (60-69 years), as preferred substitutes for Ccr.

The Attitudes of Older Adults Living in Institutions and Their Caregivers to Ageing

Hana Janečková, Eva Dragomirecká, Iva Holmerová, Hana Vaňková

Cent Eur J Public Health 2013, 21(2):63-71 | DOI: 10.21101/cejph.a3774

Objectives: The aim of this study was to explore the attitudes of older people living in institutions and their caregivers to ageing. Recent outcomes showed prevailing negative social stereotype to ageing in CR. Methods: The Attitudes to Ageing Questionnaire (AAQ-24) was used in two waves of data collection to measure attitudes of 400 randomly selected residents of 19 Senior Residential Homes. The reduced sample of 220 seniors and 276 professional carers employed at twelve Senior Residential Homes completed 12 items of general form (AAQ-12). All respondents expressed their agreement or disagreement with the statements presented in the questionnaire regarding positive or negative attitudes to ageing. Results: The AAQ total score proved significant influence of gender, having children, self-perceived health, depression, and quality of life. Subscale scores (psychosocial losses, physical changes, psychological growth) were significantly influenced by gender, age, activities limitations, having own children, depression, self-perceived health status, and quality of life. Globally, the attitudes of professional caregivers to ageing were more positive compared to the attitudes of older people living in institutions. Older adults showed higher agreement with negative statements about ageing. There was no difference between professional caregivers and older people in the positive attitudes to ageing expressed as the growth potential. Physical activity, wisdom, better ability to cope with life and contacting young generation were effective in the positive attitudes of both groups.

Impact of Comorbidity and Socioeconomic Status on Quality of Life in Patients with Chronic Diseases who Attend Primary Health Care Centres

Hakan Tüzün, Sefer Aycan, Mustafa Necmi İlhan

Cent Eur J Public Health 2015, 23(3):188-194 | DOI: 10.21101/cejph.a3990

Aim: The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres. Methods: The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). Results: Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL. Conclusions: The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.

Healthcare System Financing and Profits: All That Glitters is Not Gold

Tomáš Zelený, Vladimír Bencko

Cent Eur J Public Health 2015, 23(1):3-7

The objective of this paper is an analysis of two main attributes of healthcare systems. First of the main attributes is the trend of ever growing expenditures of healthcare systems all across the world. Second attribute is the efficiency of chosen mixed healthcare systems, where mixed system is one which features involvement of both private and public sector. Countries chosen for analysis are USA as the country with high private sector influence on healthcare, France with its mediocre influence and Japan, where the private companies participate in health care but are very strictly regulated by a zero profit rule, and the Czech Republic, where public sector dominates the health care. The result is that the systems with higher influence of the private sector tend to have lesser occupancy, not significantly better performance and higher expenditures. This raise doubts whether the private sector brings anything of value for the patients within the healthcare system. However, more detailed analysis should be carried out to confirm or refuse this hypothesis.

The Level of Neighborhood Walkability in a Place of Residence and its Effect on Body Composition in Obese and Overweight Women

Tereza Sofková, Miroslava Přidalová, Josef Mitáš, Jana Pelclová

Cent Eur J Public Health 2013, 21(4):184-189 | DOI: 10.21101/cejph.a3849

A neighborhood environment allows defining typical features for physically active or inactive lifestyle. An accelerated pace of life and higher availability of an unhealthy lifestyle increase obesity rates. An analysis of body composition can be used as a predictor for assessment of current somatic conditions. The aim of the study was to determine the dependence of selected body composition parameters on neighborhood walkability in 167 women aged 20-60 years attending weight-loss programme called STOB-courses. A multifrequency bioimpedance analysis InBody 720 was used to determine the body composition of respondents. Further, ANEWS questionnaire was used to determine the level of neighborhood walkability. We divided the sample into two age groups (<40 years; ≥40 years) and into partial subgroups according to the neighborhood "level of walkability" (lower and higher level). Based on the assessment of body composition, it can be assumed more walkable neighborhood opportunities positively affect body composition. Body composition in older women is positively influenced if they lived in high walkable areas. In younger women we found only one indicator of body composition (body fat mass) influenced by neighborhood walkability. The relationship between health indicators of body composition and residential infrastructure might be useful in strategies aimed at maintaining and developing a healthy lifestyle within the community.

Physical Activity and Gender Differences: Correlates of Compliance with Recommended Levels of Five Forms of Physical Activity among Students at Nine Universities in Libya

Walid El Ansari, Khalid Khalil, Diane Crone, Christiane Stock

Cent Eur J Public Health 2014, 22(2):98-105

Aims: This cross-sectional survey assessed and compared by gender the levels and correlates of achieving the international guidelines recommendations on five forms of physical activity (PA) (walking, moderate PA, vigorous PA, moderate or vigorous PA - MVPA, and muscle-strengthening PA). We examined the associations between achieving the international guidelines recommendations on five forms of PA and a variety of sociodemographic, health and academic performance variables. Methods: Data was collected across nine Libyan universities (2008-2009, representative sample of 1,300 undergraduates). A self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. Cut-offs for recommended guidelines were set according to the American Heart Association. Results: About 43.7% of students achieved the guidelines for muscle strengthening PA, 20.7% for walking, 11.2% for vigorous PA, 28.5% for MVPA, and 4.8% for moderate PA (excluding walking). Binary logistic regression showed that except for walking, males were consistently associated with achieving the guidelines recommendations for all other forms of PA. Students with higher health awareness were more likely to achieve the guidelines for vigorous PA and muscle strengthening PA. Better academic performance was associated with higher levels of muscle strengthening PA. Students at institutions in the East of Libya were less likely to achieve the guidelines for walking, vigorous PA or muscle strengthening PA as compared to students from the North. Students from the West of Libya were also less likely to walk or to engage in moderate PA than their peers from the North. Conclusions: Overall, relatively low proportions of students achieved the recommended guidelines of PA. Female students were particularly at risk for low level of PA. Attention is required to national policies that promote active living, along with addressing the cultural, geographic and other barriers to engagement of young adult males and females in PA.

The Impact of the Economic Crisis on Neonatal Hearing Screening in Greece

Petros V. Vlastarakos, Efthymios Kalampalikis

Cent Eur J Public Health 2015, 23(1):85-86

Effect of Physical Activity in Treatment of Paediatric Obesity

Dalibor Pastucha, Jana Malinčíková, Stanislav Horák, Jana Povová, Petr Konečný

Cent Eur J Public Health 2015, 23(Supplement):S57-S61 | DOI: 10.21101/cejph.a4189

The aim of the study was to compare the differences in anthropometric parameters, maximal oxygen uptake (VO2max) and physical activity (PA) between groups of 146 obese boys and 128 obese girls. We tried to describe the relationships between changes in PA and changes in VO2max, body fat, weight, waist circumference and hip circumference. We found statistically significant changes in VO2max and waist circumference only in the group of boys and significant changes in VO2max in the group of girls.

Educational Inequalities in Self-Rated Health: Whether Post-Socialist Estonia and Russia Are Performing Better than 'Scandinavian' Finland

Rein Vöörmann, Jelena Helemäe

Cent Eur J Public Health 2015, 23(1):8-13

Aim: The aim of the study is to analyse relationship between self-rated health (SRH) and education in post-socialist countries (Estonia and Russia) and in Finland, a Scandinavian country. Methods: Data from the 5th wave of the European Social Survey (ESS) carried out in 2010 were used. In particular, we used a sub-sample of the 25-69 years old. Two-step analysis was carried out: descriptive overview of relationship between SRH and education to assess the knowledge-related impact of education on SRH in pooled model for all three countries; and logistic regression analysis to evaluate separate models in each country. Results: The prevalence of at-least-good health was the highest in Finland, Estonia occupied the second position and Russia the third. Knowledge-related educational inequalities were lower in Russia compared to Finland, while they were of similar magnitude in Estonia and Finland. Conclusions: Our expectations that knowledge-based inequalities are lower in post-socialist countries compared to a Scandinavian country turn to be true in case of Russia, not Estonia. Possible reasons for the expectations might be a lack of attention paid to educational inequalities in terms of access to social resources, competitiveness in the labour market and to what extent education provide a tool against uncertainty (preventing work- and unemployment-related stress). Series of comparative studies revealing links between certain institutional packages and (socio-economic and knowledge-related) educational inequalities seem to be of special relevance.

High Hepatitis B and Low Hepatitis C Prevalence in Roma Population in Eastern Slovakia

Eduard Veselíny, Martin Janičko, Sylvia Dražilová, Leonard Siegfried, Lýdia Pastvová, Ivan Schréter, Pavol Kristian, Ladislav Virág, Pavol Jarčuška, Ivana Valková, Katarína Cáriková, Gabriela Senajová, Ján Fedačko, Daniel Pella, Mária Mareková, Andrea Madarasová Gecková, Peter Jarčuška

Cent Eur J Public Health 2014, 22(Supplement):S51-S56

Background: Viral hepatitis B and C prevalence in the Roma population of eastern Slovakia is largely unknown. This study aimed to explore the prevalence and associated risk factors of chronic viral hepatitis B and C among Roma living in segregated communities in eastern Slovakia. Methods: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 among Roma living in rural communities were used. Participants were tested for the presence of HBsAg, anti-HBc IgG and anti-HCV. The risk factors were assessed mainly via a structured questionnaire/interview. Results: Altogether 452 Roma were screened, and 11 were excluded due to missing data. A total of 441 patients were included (mean age 34.7±9.14 years; 35.2% men). 12.5% of participants were HBsAg positive, 40.4% anti-HBc IgG positive while negative for HBsAg and 47.2% of participants were negative for all serological markers of hepatitis B. Hepatitis C prevalence was very low (0.7%), while 2 out of 3 anti-HCV positive participants were coinfected with hepatitis B. Risk factors for hepatitis B infection were male sex, higher age, tattoo, and previous imprisonment. No difference was found in intravenous drug use, blood transfusions and sexual behaviour. Conclusion: More than half of the Roma residing in eastern Slovakia have been infected at one point in life with the hepatitis B virus, and 12.5% are HBsAg positive. Hepatitis C prevalence is very low, which is probably due to very low intravenous drug use.

Ethical Concerns and Contributions in Response to Climate Change and the Links to Well-being: a Study of University Students in the Netherlands

Mona Betour El Zoghbi, Walid El Ansari

Cent Eur J Public Health 2014, 22(2):118-124

Aims: This study explored the concerns and contributions of university students in response to the ethical dimensions of climate change, and the implications for their well-being. The study focused on university students as leaders of future society while facing complex environmental and socio-economic challenges. Methods: A total of 8 focus groups (FG) were conducted (66 participants from over 10 different universities across the Netherlands). In addition, 9 in-depth interviews with Dutch university students from different academic backgrounds, and 16 interviews with Dutch key informants in the environment, youth and public health fields were undertaken. The first author also attended (as participant-observer) three major events themed around youth and environmental issues across different regions in the Netherlands. Results: University students in the Netherlands are mostly concerned about the increasing social and economic inequalities between the global North and South, and the implications for impoverished and uneducated communities. Participants raised concerns over the transfer of materialistic value systems and unsustainable practices from developed to developing countries. The participants' main contributions in response to climate change were largely driven by feelings of guilt and responsibility, an ecological worldview, and desire to play a positive role in society. Conclusion: Establishing formal youth platforms across academic, civic and political institutions could provide legitimate and empowering opportunities for university students to participate in consultations and debates of future environmental policies and development strategies. Such platforms could enhance the agency and well-being of university students for addressing their concerns over existing climate inequalities and other ethical dilemmas.

Influence of Gestational Exposure on the Effects of Prenatal Exposure to Methyl Mercury on Postnatal Development in Rat: a Preliminary Evaluation

Dinesh N. Gandhi, Govind M. Panchal, Dinesh K. Dhull

Cent Eur J Public Health 2013, 21(1):30-35 | DOI: 10.21101/cejph.a3773

Fish and other aquatic organisms are important source of dietary proteins for the human population. Fish meat, however, is contaminated with methyl mercury (MeHg), a potent neurotoxin. The well known Minamata and Niigata epidemic outcomes in Japan have raised the awareness of the health risk resulting from consumption of fish (and shellfish) from water basins polluted with industrial wastes containing mercury. In the present study, pregnant rat dams were exposed to environmental toxic elements - methyl mercury, 1000-1200 h, daily from the fifth gestation day (GD5) till parturition. Three groups of animals were given, by gavages, MeHg (0.5, 1.0 and 2.0 mg/kg/day) and control group received 0.9% saline at the same time. All animals were allowed to deliver and wean their offspring. Pups were evaluated for early development effects. There was a significant effect of treatment on somatic growth such as reduction in percentage of maternal weight gain (20.62%) at higher dose level whereas there was no change in percentage of live birth (100.00%) with 0.5 and 1.0 mg/kg dose treatment groups. There was a significant increase in the percentage of resorption (100.00%) per litter with 2.0 mg/kg/day MeHg dose. Average gestation length (days) and percentage resorption per litter or percentage foetuses/malformations per litter were not affected at 0.5 and 1.0 mg/kg/day dose level. The results of the study confirmed the high-teratogenic potential of MeHg and the need of payng increased attention to MeHg concerning its exogenous use during pregnancy.

Severity, Causes and Outcomes of Traumatic Brain Injuries Occurring at Different Locations: Implications for Prevention and Public Health

Marek Majdan, Martin Rusnák, Alexandra Bražinová, Walter Mauritz

Cent Eur J Public Health 2015, 23(2):142-148 | DOI: 10.21101/cejph.a4025

Aim: Traumatic brain injuries (TBI) are a major public health problem. Although they are well studied, information on some aspects, such as the place of occurrence, is limited. The aim of this study was to describe the patterns of severity, causes and outcomes of TBI occurring at different locations and to identify the primary populations at risk of suffering TBI at each of the analysed locations. Methods: 1,818 patients with TBI admitted to hospitals in Austria, Slovakia, Croatia, Bosnia, and Macedonia were analysed. Primary populations at risk, injury severity and extent along with short/long-term outcomes were analysed for TBI at each location. Results: The highest mean age (57.9 years, p<0.001) was observed in injuries at home. The distribution of injury causes across the group was significantly different (p<0.001), with falls (39%) and traffic accidents (30%) being predominant. TBI occurring on roads or highways were the most severe (mean ISS=32.5, p<0.001; mean GCS=7.8, p<0.001). Injuries at home had the worst outcome (50% mortality, p<0.001 and 70% unfavourable outcome, p<0.001) whereas TBI at sport facilities or outdoors had the best outcome (24% mortality, 44% unfavourable outcome). When adjusted for age and severity, TBI occurring at home had the highest odds of mortality (OR=3.12, 95% CI=1.86-5.25) and unfavourable outcome (OR=2.51, 95% CI=1.54-4.08), compared to sports facility and outdoors as a reference. Conclusions: TBI at different locations display distinctive patterns as to causes, severity, outcome and populations at risk. Location is therefore a relevant epidemiological aspect of TBI and we advocate its inclusion in future studies. Definitions of primary populations at risk at different locations could help in targeted public health actions.

Socioeconomic Disparities in Age of Initiation and Ever Tobacco Smoking: Findings from Romania

Dorota Kaleta, Bukola Usidame, Elżbieta Dziankowska-Zaborszczyk, Teresa Makowiec-Dąbrowska

Cent Eur J Public Health 2015, 23(4):299-305 | DOI: 10.21101/cejph.a4067

Aim: Smoking initiation is considered the fundamental behaviour that determines the future health burden of tobacco smoking in a society. The aim of the study was to evaluate the socio-demographic factors associated with initiation of regular smoking among adults. Methods: The data source was the 2011 Global Adult Tobacco Survey Romania (GATS), which is a cross-sectional, nationally representative study. Multivariate logistic regression model was applied for relevant analysis. Results: Among males, the regular smoking initiation rate was significantly higher compared to females (52.4% vs. 18.5%; p<0.001). Mean age of smoking initiation was lower in men compared to women (18.4 ± 4.8 vs. 21.5 ± 6.8; p<0.001). Age in men, awareness of environmental tobacco smoke consequences and place of living for women as well as educational attainment and employment status in both genders were associated with ever regular smoking. Moreover, cohabitation with a smoker was associated with greater odds for initiating smoking among both genders. Conclusions: GATS revealed a significant but diverse role of socioeconomic factors in initiation of regular smoking among adult Romanians.

Pilot Cross-Sectional Study of Three Zoonoses (Lyme Disease, Tularaemia, Leptospirosis) among Healthy Blood Donors in Eastern Slovakia

Ľubica Zákutná, Erik Dorko, Kvetoslava Rimárová, Marianna Kizeková

Cent Eur J Public Health 2015, 23(2):100-106 | DOI: 10.21101/cejph.a4052

Objective: The aim of the study was to determine the seroprevalence of three zoonotic infections among healthy blood donors/volunteers in Eastern Slovakia. Methods: Sera from 124 blood donors were investigated for the presence of antibodies against Borrelia burgdorferi, Francisella tularensis and Leptospira pomona. The participants also completed the questionnaire about demographic, exposure and epidemiological characteristics. Two serological methods were used for the diagnosis: the enzyme linked protein A/G assay (ELPAGA) and the Western blot (WB). First, sera were screened by ELPAGA (except for leptospirosis). Results: The observed seroprevalence was 15% for Lyme borreliosis (LB) and 4% for tularaemia (TUL). The results were confirmed by WB. Positive IgG antibodies (WB method) were detected only in 1.6% of examined for LB and 0.8% for TUL. Our results did not identify any antibodies against Leptospira pomona agent in the examined healthy blood donors group. Conclusions: ELPAGA seroprevalence for TUL was significantly higher in blood donors working in the agricultural area in the direct contact with hay, straw, manure, and agricultural land. Our outputs determine tick bite as a significant risk factor for LB. The study confirms the explosion of tick-borne diseases in the healthy population of people. The exposure risk for leptospirosis seems to be minimal.

Adolescents' Drinking and Drunkenness More Likely in One-Parent Families and Due to Poor Communication with Mother

Zuzana Tomčíková, Zuzana Dankulincová Veselská, Andrea Madarasová Gecková, Jitse P. van Dijk, Sijmen A. Reijneveld

Cent Eur J Public Health 2015, 23(1):54-58

Objectives: Alcohol use is a relatively common behaviour, particularly among adolescents, and has become a major public health concern. This study explores the associations between family composition, the quality of adolescents' communication with parents and adolescents' recent frequent alcohol drinking and lifetime drunkenness. Methods: Data were obtained from the Slovak part of the 2005-2006 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3,882 students (46.3% males; mean age 13.3±1.6). Data on drinking alcohol in the past week, lifetime drunkenness, communication and family composition were collected via anonymous questionnaires stratified for ages 11, 13 and 15 years and following the methodology of the HBSC study. Results: The results showed that living in an incomplete family increased the risk of frequent drinking and drunkenness among adolescents as well as a low quality of communication between mothers and their children. Risks were higher for drunkenness than for frequent alcohol use and strongly increased by age, with the communication with parents worsening at increasing age. Conclusions: Our findings show the importance of the quality of communication between parents and adolescents in preventing the hazardous alcohol use among adolescents. Preventive interventions to reduce adolescents' use of alcohol should therefore also target the quality of communication in the family.

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