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Objective: The purpose of the study was to investigate the prevalence of health risk behaviours among a random sample of Korean adolescents and the relationship of psychological variables with health risk behaviours. Methods: 885 students ranged from 7th to 9th grade were randomly selected from 3 junior high schools in Dobong-gu district, Seoul. Four Korean-version measures were used to assess the health risk behaviour and psychological variables of adolescents. Frequency analysis, correlation analysis, and regression analysis were performed to accomplish the purpose of the study. Results: Korean adolescents showed high prevalence of physical inactivity (n=67%), smoking (n=54%), drinking alcohol (n=69%), eating problem (n=49%), mental health problem (n=57%), and viewing pornography (n=47%). In addition, this study revealed that the three psychological variables (multidimensional health locus of control, self-efficacy, and self-esteem) were significantly correlated with health risk behaviours, and had significant effect to account for health risk behaviours (R²=0.42 for physical inactivity, 0.33 for viewing pornography, 0.31 for smoking, 0.28 for mental health problems, 0.26 for illegal drug use, 0.19 for drinking alcohol, and 0.15 for eating problem). Conclusion: The current study provides significant information on psychological variables related to adolescents' health risk behaviour. This study has the potential to influence the development of better health education and promotion programs for adolescents.

The objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in relation to cigarette smoking in 174 Roma children and adolescents (88 males and 86 females) and 131 non-Roma probands (males and females) aged 7-18 in central Slovakia. In this biethnic study, 26.4% of the Roma children and adolescents (more than twice contrary to the control group) were smokers. Among the studied ethnicities, the majority of smokers was Roma (79.3%, 46 subjects). Smoking Roma have higher means of TG, Lp(a) and WHR compared with non-smoking non-Roma. The most frequent CVD risk predictors of smoking Roma probands was low serum levels HDL-C, apo A (the Fisher test confirmed a significant relationship between cigarette smoking and HDL-C, apo A; p<0.01). The results of the research should help to develop an effective preventative health education programs focused on Roma education (who live in a higher-risk environment compared to the majority population) in order to stem the spread of CVD as well as morbidity and mortality in this ethnic group living in Slovakia.

Objectives: Health status is represented by people's subjective assessment of their sense of well-being and ability to perform social roles and has been well accepted as a health indicator of different populations. The aim of this study was to determine health-related quality of life in Slovenian population. Methods: We performed a cross-sectional postal survey in a random stratified sample of 1,000 adult Slovenian inhabitants. The questionnaire consisted of the respondents' demographic data (sex, age, education level, employment status, living environment), self-reported chronic conditions, self-reported use of health services and EQ-5D instrument for measuring quality of life. Results: The response rate was 41% (53.1% men, mean age 51.5 years). Respondents reported most problems in the pain dimension of EQ-5D (59.3%), following by mobility (30.4%), anxiety/depression (30.3%), daily activities (29.8%) and self-care (9.0%). At least one moderate problem was reported by 272 (66.3%) respondents. Independent factors, associated with problems in any EQ-5D dimension were primary and vocational education, older age, high blood pressure, rheumatic diseases, back problems, anxiety/depression, a visit to the emergency department in the past year, and a house visit from a family doctor in the past year. Conclusions: The present study showed that the health-related quality of life of the Slovenian inhabitants is lower than the one found in some other European countries. This finding is surprising and also worrying. Because we cannot find any perceptible reason for this observation, larger and prospective studies are needed to confirm those results and to determine the reasons for that.

Contents of lead and arsenic were determined in 617 tobacco samples and 80 samples of cigarettes. The mean content of lead in tobacco was 0.93 µg/g (range 0.02-8.56 µg/g) and arsenic was 0.15 µg/g (range <0.02-2.04 µg/g). The mean content of lead in cigarettes was 1.26 µg/g (range 0.02-6.72 µg/g) and arsenic was 0.11 µg/g (range <0.02-0.71 µg/g). There was a large variability in lead and arsenic content among samples of tobacco and samples of cigarettes. Positive correlation between lead and arsenic contents in tobacco was found (r=0.22; p<0.0001). Based on our data and data from literature we compare the content of lead and arsenic in tobacco and cigarettes in other studies and discuss the influence of smoking to lead and arsenic exposure and health. In conclusion, at the same time with the implementation of tobacco use prevention programmes it is advisable to implement continuous monitoring of lead and arsenic in tobacco and cigarettes in order to reduce the health risk due to exposure of these metals.

Aims: To use the data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) for the evaluation of birth outcomes beyond congenital abnormalities and to show as example the study of 49 antimicrobial drugs used in Hungary for the reduction of preterm births.
Methods: The population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996, included 38,151 newborn infants without birth defects and this sample represented 1.8% of Hungarian births. Medically recorded gestational age at delivery and birthweight, in addition the rate of preterm births and low birthweight newborns born to mothers with or without different antimicrobial drugs used at least by ten pregnant women were analysed.
Results: Of 49 antimicrobial drugs, two: ampicillin (adjusted POR with 95% CI: 0.8, 0.7-0.9) and clotrimazole (0.8, 0.7-0.9) showed a preterm birth preventive effect. This preterm preventive effect was found mainly after the use of ampicillin and clotrimazole during the first trimester of pregnancy.
Conclusions: Ampicillin and clotrimazole may be effective for the reduction of preterm births due to infectious diseases of pregnant women in general but particularly caused by genital infections. However, the limitation of the data set did not allow the appropriate evaluation of some antimicrobial drugs (e.g. clindamycin).

Background: Maternal cervical incompetence in pregnancy (CIP) showed an association with a higher rate of preterm births. The objective of this study was to determine the prevalence of CIP in Hungarian pregnant women, to determine the rate of preterm birth, and to check the preventive efficacy of preterm births due to CIP by therapeutic cerclage or bed rest alone. Methods: Analysis of the population-based large data set of 38,151 newborns (without any defects) of the Hungarian Case-Control Surveillance System of Congenital Abnormalities (HCCSCA), born during 1980-1996, i.e. 1.8% of Hungarian newborns. Prospective cohort analysis based on medically recorded variables of CIP, birth weight and gestational age. Results: A total of 2,795 (7.33%) newborns born to mothers with CIP. The newborns of mothers with CIP had a shorter gestational age at delivery (39.0 wk) and higher rate of preterm birth (11.1%) than the Hungarian reference sample without CIP (39.4 wk and 9.0%). Of 2,795 pregnant women with CIP 1,112 were treated by cerclage, while 1,683 with bed rest alone. The mean gestational age was shorter both after therapeutic cerclage (39.2 wk) and particularly bed rest alone (38.9 wk). The rate of preterm births was 9.1% and 12.7% after therapeutic cerclage and bed rest alone. Conclusions: CIP is very frequent in Hungary probably due the extremely high number of previous induced abortion performed by dilatation and curettage method. CIP associates with an increased risk for preterm births; however, this increased risk was reduced by bed rest alone and mainly by therapeutic cerclage.

The aim of the study was to evaluate clinical, epidemiological and demographic data of patients with syphilis hospitalized at the Department of Dermatovenereology of the General Teaching Hospital in 2009 and to identify the groups at high risk of sexually transmitted diseases. The results were compared with the previous surveys carried out between 1999 and 2005 and also with the data of the National Registry of Venereal Diseases for 2008. A total of 232 patients were hospitalized in 2009 (including 26 women admitted for compulsory retreatment in pregnancy). We noticed a 25% increase in the number of patients in comparison with the year 2008. Of the total number of patients, 206 were patients with newly diagnosed syphilis, of which 153 (74.3%) were men and 53 (25.7%) women. There was 22.3% of patients with primary and 31.6% with secondary syphilis. As in the previous years, heterosexual contact remained the most frequent route of syphilis transmission. However, the number of homosexual and bisexual men increased, amounting to 64.7% of all hospitalized men. Four men were HIV positive. The age distribution did not change; majority of the patients were aged between 30 and 40. The proportion of foreigners also remained unchanged (19.9%); they came mainly from the Slovak Republic (31.1%) and Ukraine (26.7%). The absolute number of reported syphilis cases has been increasing in the Czech Republic since 2006. From the epidemiologic point of view, the increasing incidence of early stages of the disease is alarming. Men prevail over women among the infected persons; the men having sex with men (MSM) has been increasing in the last three years.

It is considered, according to statements from different sources, that data on the number of deaths in the population of a certain country or region are accurate and correct, but determining causes of death is, for different reasons, often incorrect. There is, therefore, a justified doubt that there are more inaccurately registered drug abuse-related deaths in state registries. Hence, this paper tends to show the most frequent difficulties encountered when recording mortality resulting from drug abuse.

Background: Dental caries as an infectious disease is still a major oral public health issue. As documented in some recent studies, it has been recognized as the most common chronic childhood disease. Aim: The aim of this study was to evaluate caries prevalence, DMFT and dmft scores, as opposed to caries free children at the age of 6 years from a well developed western region of Primorsko-Goranska county. The purpose was also to evaluate a Significant Caries Index (SiC) and a Restoration Index (RI) in the same study sample of 6 year olds. Methods: Data for a sample of 1,825 (868 girls and 957 boys) children was collected and analyzed by using Chi-square and Mann-Whitney U Tests. Results: Results showed that the mean dmft was 4.68±4.19, and the mean DMFT was 0.22±0.69. D/d component constituted a major part of caries score (DMFT/dmft) in both primary and permanent dentitions in the population of 6 years old children. Caries prevalence was 74.5 in primary dentition and 11.9 in permanent dentition. Significant Caries Index value (SiC) was 0.66 for permanent and 9.6 for primary teeth, respectively. The Restoration Index (RI) was 20.1 for primary and 39.5 for permanent dentition. Conclusion: The results obtained in this study revealed that dental caries still appears to be quite a significant problem among 6 year olds. However, collected data, particularly considering the SiC Index, can be used for further planning of preventive and restorative dental treatments as well as setting up future goals for the prevention of dental caries in Croatian school children of Primorsko-Goranska county.

Roma constitute the largest ethnic minority in Europe and the second largest minority in Slovakia. Their health problems originate mainly from their low socioeconomic status, certain cultural aspects and their health-threatening lifestyle as well as the psycho-social burden arising from poverty and frequent migration. Evaluation of glucose, albumin, triacylglycerol (TAG) and low density lipoprotein cholesterol (LDL-C) concentrations did not reveal any clue about the presumed deteriorated health of the Roma population. Higher proportions of subjects with elevated serum total cholesterol were found in Roma women as compared to both control groups of women (p=0.027, p=0.006) and in Roma men as compared to the male control group living in standard conditions. Only the low level of HDL-cholesterol gives a glimpse of their deteriorated health. Significantly lower levels of serum HDL-C were reported in Roma men and women compared to the respondents in both control groups with a p value of p<0.001. Comparing the ratio of LDL-C/HDL-C yielded significant differences between the number of physiological values in Roma men and men from the control group 1 (p=0.022) in favour of the control group. When comparing the number of people with physiological values of cholesterols and with worsening TAG parameters at the same time, the increased risk of Roma men compared with men from the control group 1 became evident, with a level of significance of p=0.023. Evaluation of urine samples pointed to significantly higher concentrations of urinary protein in Roma women compared with women in the control group 1 (p=0.012).

Aims: To assess university students' extent of smoking, knowledge of smoking health risks, and awareness of existing national anti-smoking laws. Methods: Self-administered questionnaire was employed across 7 universities (1,104 students, equal proportions of males and females) located in Gaza Strip, Palestine. Results: About 55% of participants reported ever smoking, 31% were current cigarette smokers, and 36% were 'strictly' (only) narghile (water pipe) smokers. Mean age of smoking initiation was 17±3.15 years. Smokers had less knowledge of smoking associated health risks than nonsmokers. Students' knowledge of existing anti-smoking laws was generally low (11.3-25.5%), and significantly more smokers had knowledge about existing laws (ban of advertisement of smoking, ban of smoking in public places, and ban of selling cigarettes to minors) than non-smokers. About 81% of current smokers tried to quit smoking at least once during their life, 53% felt ready to quit smoking if cessation assistance was provided, 17% were not ready to quit, and 30% were reluctant/felt unsure if they were ready to quit. Most students (94.3%) reported that there were no smoking cessation centres in Palestine, or did not know if such centres existed. Males were associated with almost all categories of smoking (e.g. smoking both cigarettes and narghile, or smoking narghile only). Conclusions: There is a lack of knowledge about the existing national anti-smoking legislation among university students in Gaza, Palestine. Smoking cessation centres also seem non-existent in Gaza. Multi-level interventions and actions are required by policy makers, educators and non-governmental agencies to prevent smoking among university students in Gaza, and to educate them on tobacco cessation counselling, on the dangers of tobacco use, and about effective stress management strategies to help them to cope with stressors. Smoking cessation interventions are required to address both cigarette and narghile use. Efforts need to be invested in ensuring compliance with legislation and for follow-up activities to enforce the anti-smoking laws through coordinated actions across ministries and departments.

Introduction: Civil society organisations (CSO) are not-for-profit, non-governmental organisations operating in the public interest. They are the "third sector" that is strongly developed in Western European countries, ensuring the link between citizens and government and working as a counterbalance to the business sector. Their role in support of public health research deserves attention. Methods: Within a broader European study (STEPS - Strengthening Engagement in Public Health Research), public health organisations in eight European Union new member states (Cyprus, Estonia, Latvia, Lithuania, Malta, Romania, Slovakia, Slovenia) identified national CSOs with interests in health. A questionnaire was developed jointly, translated into national languages and sent by e-mail to 474 organisations, with 128 completed responses (27%). Results: Most CSOs would like to be more involved in setting or advising on public-health research policy, and greater collaboration between CSOs, professional organisations and governmental institutions. Respondents did not see CSOs directly doing research, but recommended mobilizing researchers and organsations, supporting research themes, and lobbying to use public health evidence in policy and decision-making. They could receive more education for, and discussion of, public health research, and offer support in applying for research funding. Conclusion: Civil society organisations can contribute importantly in setting public health research agendas. Research commissioning should give greater recognition of this role, improve links between CSOs, researchers and governmental institutions, and develop a stronger shared basis for public health policy and practice.

Living in Roma settlements is associated with worse health in comparison with the majority population; this might be partially explained by socioeconomic disadvantages as well as cultural differences, including lifestyle. Eating habits represent an important part of lifestyle closely related to primary causes of morbidity and mortality, such as cardiovascular diseases, metabolic diseases or cancers. The eating habits of the population living in Roma settlements in comparison with those of the majority population were explored using the cross-sectional epidemiological HepaMeta study conducted in 2011. A representative sample of Roma (n=452, mean age = 34.7; 35.2% men) and non-Roma (n=403, mean age = 33.5; 45.9% men) aged 18-55 years living in the Košice region were asked about breakfasting and recent consumption of fruits, vegetables, dairy products, meat products, meat, farinaceous dishes, and soft drinks. A logistic regression model was used separately for male and female participants. The population living in Roma settlements reported the recent consumption of fruit, vegetables and dairy products significantly less frequently in comparison with the majority population. Moreover, Roma females, in comparison with non-Roma females, reported significantly more frequently the consumption of meat and soft drinks. No differences were found between Roma and non-Roma in the consumption of meat products and farinaceous dishes. The population living in Roma settlements reported more frequently unhealthy eating habits in comparison with the majority population; this might contribute to worse health status of this population. The differences might be attributed to cultural differences between ethnic as well as socioeconomic groups, reduced availability of certain food items due to segregation or poverty and lower health literacy.

Background: There has been limited investigation of the sexuality and sexual dysfunction in homosexuals by the sexual medicine community. The purpose of this article is to describe the methodology of the online GAy MEn Sex StudieS (GAMESSS) on the sexual behaviour and sexual dysfunctions of Belgian men who have sex with men (MSM). Aim: To describe the methodology of an online study that investigate sexual behaviour and sexual function and dysfunction in a sample of Belgian MSM. Methods: An internet-based survey on sexual behaviour and sexual dysfunctions was administered to MSM between April and December 2008. The questionnaire was a compilation of the Kinsey Scale for Sexual Orientation, the Index of Premature Ejaculation (IPE), the Erection Quality Scale (EQS), the Female Sexual Function Index (FSFI), the Brief (Male) Sexual Function Inventory (BSFI) and the Gay Men Sexual Addiction Screening Test (G-SAST). The analytic sample comprised 1,830 Belgian men aged 18 years or older, who reported having sex with men. Conclusion: The use of an online questionnaire is a convenient way to gather information from a hidden population such as MSM. The anonymity of the participants is guaranteed. The collected data can be easily analyzed. With this online study, we aim to detect variables in sexual behaviour (SB) and sexual dysfunction (SD) that can help to improve care for MSM. Belgian MSM have a very active and varied sex life. They are rather promiscuous and do not always practice safe sex. This behaviour poses a high risk of spreading sexually transmitted diseases. Additional research in this MSM population is needed.

Objectives: The objective of this paper is to provide information on indoor air quality and on the quality of the broader indoor environment of the houses in Roma villages in Slovakia and Romania and to discuss possible implications for health. Methods: Indoor air was sampled in 11 houses in a Romanian Roma village and in 19 houses in a Slovakian Roma village. Levels of Carbon Monoxide (CO), Carbon Dioxide (CO²), total particulate matter (PM), temperature and humidity were measured. A questionnaire and a checklist were used to obtain additional information on the indoor environment and behavioural factors. We have sampled the same houses in winter and in summer. Results: Levels of CO and CO² were higher in winter in both countries as compared to summer. The limit value of 10 mg/m³ CO was exceeded in a few cases in both countries. In general, levels of CO, CO² and PM were higher in Romania. Further environmental and behavioural hazards such as indoor smoking, pets inside or lack of ventilation were found. The reported self-perceived quality of the indoor environment was poor in many aspects. Conclusions: Our findings of CO, CO² and PM levels suggest that indoor air pollution in Roma settlements has the potential to be a health threat. The fact that the inhabitants spend a relatively long time inside the houses and that a number of additional environmental and behavioural hazards were identified by our study emphasizes the importance of the indoor air quality for health and thus priority attention should be paid to these issues by health authorities and researchers. Further research is essential and study designs must consider cultural background and specific characteristics of the community, especially in order to obtain valid data on health outcomes.

Aims: The current study assessed, by university and sex, the association between nutritional behaviour (twelve independent variables), and stress and depressive symptoms (dependent variables) in a sample from three UK countries. Methods: A cross-sectional survey was undertaken among undergraduates enrolled across seven universities in England, Wales and Northern Ireland (N=3,706). Self-administered questionnaires included a 12-item food frequency questionnaire, Cohen's Perceived Stress Scale and modified Beck Depression Inventory. Sex and university comparisons were undertaken. Univariable and multivariable regression analyses were computed for each of the two outcomes - perceived stress and depressive symptoms. Results: The frequencies of consuming of the various food groups differed by university and sex, as did depressive symptoms and perceived stress. Multivariable regression analyses indicated that consuming 'unhealthy' foods (e.g. sweets, cookies, snacks, fast food) was significantly positively associated with perceived stress (females only) and depressive symptoms (both males and females). Conversely, consuming 'healthy' foods (e.g. fresh fruits, salads, cooked vegetables) was significantly negatively associated with perceived stress and depressive symptoms scores for both sexes. There was significant negative association between consuming fish/sea food and depressive symptoms among males only. For males and for females, consuming lemonade/soft drinks, meat/sausage products, dairy/dairy products, and cereal/cereal products were not associated with either perceived stress or depressive symptoms. Conclusions: The associations between consuming 'unhealthy' foods and higher depressive symptoms and perceived stress among male and female students as well as the associations between consuming 'healthy' foods and lower depressive symptoms and perceived stress among male and female students in three UK countries suggest that interventions to reduce depressive symptoms and stress among students could also result in the consumption of healthier foods and/or vice versa.

We compared neighbouring regions of the Czech Republic (CZ) and Poland (PL) situated within 100 km of the country border, in order to compare surveillance systems performance in measuring the burden of tick-borne diseases in both countries. We used routine surveillance notifications from 1999-2008 on tick-borne encephalitis (TBE) and Lyme borreliosis (LB). We assessed the crude risk ratio (RR) across the country border, and its estimates adjusted for both population density and the expected epidemiological gradient across the region, using negative binomial regression. The crude RR between CZ and PL was 7.43 (95% CI 6.20-8.90) for TBE, and 1.80 (1.76-1.83) for LB. The adjusted RR for TBE increased from 4.47 in 1999-2001 to 10.01 in 2005-2008, but for LB decreased from 9.30 to 2.51 during the respective periods. Those results reflect possible differences in surveillance systems performance between the two countries, as the administrative boundaries cannot constitute a barrier for zoonotic diseases and no biological processes alone can explain such large differences in disease occurrence.

The HIV infection remains a major public health issue in the world and especially in those countries where there exists unprotected sexual intercourse between people of the same sex. It is namely the category of men having sex with men (MSM) that still represents a group at high risk of being infected with HIV or transmitting the virus. The aim of our study was to present HIV 2nd generation surveillance data on MSM in Slovakia in the period between the years 2008 and 2009. Time-location sampling (TLS) was used to recruit participants and oral fluid samples together with completed anonymous questionnaires were collected simultaneously. The oral fluids were tested with use of the Genscreen HIV 1/2 version 2, (Bio-Rad) and Western Blot (Genlabs) diagnostic kits. The data analysis was performed using Stata version 8. Saliva testing revealed HIV prevalence of 6.1% (21/349) among MSM in Slovakia. 75% of HIV-positive cases were undiagnosed. The high-risk behaviour of MSM in respect to the number of their sexual partners as well as drug and condom usage did not correspond with their relatively high knowledge about HIV/AIDS. People's attitude towards MSM was found to be the worst in the religious context. Though our results reflect a relative good knowledge of MSM about HIV/AIDS infection, new HIV-positive cases and high-risk behaviour still appear, suggesting the need for more effective HIV prevention among members of this high-risk group in Slovakia.

Objective: This study analyses the role of ethnicity-based birth weight differences at term (37-42 weeks) between neonates of Roma and non-Roma populations in Hungary, controlling for socio-demographic and biological characteristics of the mothers. Methods: A cross-sectional survey among 9,040 mothers coupled with biometric data of the neonates was conducted in 2010. Inclusion criteria were: at term (37-42 weeks gestation) non-pathological pregnancies, and self-reported ethnicity. Birth weight was based on mothers' ethnicity, age, body mass index, education, marital and employment status, poverty level, household amenities, dietary and smoking habits using multiple linear regression. Results: The mean difference between Roma and non-Roma neonates measured without controlling for possible confounding factors was -288.7 grams (p<0.001, 95% CI = -313.4-263.9). In the linear regression model Roma neonates weighed on average 69.67 grams less than non-Roma neonates (p<0.001, 95% CI = 30.51-108.83). The mother's underweight BMI, low education and smoking during pregnancy (p<0.001), age under 18 years, no amenities of housing and insufficient consumption of fruits and dairy products also significantly influenced (p<0.05) the neonates' birth weight. Conclusion: Roma ethnicity was independently correlated with lower birth-weight among at term neonates, controlling for known risk factors. Roma ethnicity may serve as a proxy for other unmeasured social or biological factors and should be considered an important covariate for measurement among neonates.

Background: Several studies have revealed a high prevalence of risk factors associated with unhealthy lifestyle among individuals with lower socioeconomic status. In Slovakia, one of the most socially and health-disadvantaged groups is the Roma minority. The aim of this study is to explore differences in physical activity, smoking and alcohol consumption between the population living in Roma settlements and the majority population in Slovakia. Methods: Data from the cross-sectional epidemiological HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. The differences in health-related behaviour between the population living in Roma settlements and the majority population were analysed using logistic models separately for males and females. Results: These data show a clear difference between the population living in Roma settlements and the majority population with regard to leisure-time physical activity (only in women) and smoking, although not alcohol consumption. The prevalence of leisure-time physical activities such as walking or some other type of sport was significantly lower among Roma women than among non-Roma women. Men and women living in Roma settlements are more likely to smoke on a daily basis and they are heavier smokers in comparison with the majority population. HepaMeta study did not find differences in alcohol consumption between the Roma and non-Roma men. However, Roma women reported less frequent recent drinking and binge-drinking of 6 or more doses of alcohol on a single occasion. Conclusion: The higher prevalence of unhealthy lifestyle activities among Roma seem to contribute to these inequalities in cardiovascular diseases morbidity and mortality in comparison with the majority population.

Tick-borne encephalitis (TBE) is caused by tick-borne encephalitis virus (TBEV), a virus species of the genus Flavivirus within the Flaviviridae family. In Western Europe, TBEV is transmitted primarily by the Ixodes ricinus (I. ricinus) tick. During the last 30 years, there has been a continued increase in human cases of TBE in Europe. A total number of 102 cases in Slovakia was reported in 2012 (1.89/100,000), with two local outbreaks after the ingestion of raw milk and dairy products. Active vaccination is the most effective method of preventing TBE. According to the available data in Slovakia from 2012, 8,491 children under 15 years of age were vaccinated that year, which, when compared to 2009 with approximately 17,000 vaccinated children, represents a decrease of more than 50%. The data on vaccination of adults are not available, but the estimated vaccination coverage in Slovakia is around 1% (1.3/100,000). The education of the population is also an important precautionary measure in the prevention of tick-borne illnesses.

Aims: This cross-sectional study aimed to determine the socio-demographic, lifestyle and well-being variables that are associated with body image concerns (BIC) and whether these associations differed between female and male students. Methods: A cross-sectional survey; 3,706 undergraduate students (2,699 females, 765 males) from seven universities in the UK completed a self-administered questionnaire that assessed socio-demographic, lifestyle, well-being and BIC based on the Body Shape Questionnaire developed by Cooper et al. Multifactorial logistic regression analysis examined the odds ratios for the association between four increasing levels of BIC as the dependent variables (no BIC, mild BIC, moderate BIC and marked BIC) on the one hand, and the socio-demographic (gender, age, year at university), lifestyle (physical activity, nutrition) and mental well-being variables (quality of life, perceived stress, perceived health, depressive symptoms) on the other. Results: More females (35%) than males (8%) reported being moderately or markedly concerned with their body image. For both genders, BIC was associated with a higher level of depressive symptoms and to variable extents, with nutrition and year at university. Females' BICs were exclusively associated with low perceived health, higher perceived stress, studies in general as a stressor, and low physical activity. In contrast, males' BIC were found to be exclusively associated with low quality of life and with older age. Conclusions: Health promoting strategies and activities should address the co-occurrence of depressive symptoms and BIC and should moreover pay attention to the gender-specific correlates of BIC for tailoring evidence based interventions for females and for males.

Background: The United Nations' Global Population Pyramid is undertaking a shift from pyramid to cube. The concomitant decline in fertility and mortality rates produces a higher portion of older people, and, thus, an increased number of deaths due to cancer and cardiovascular disease (CVD). Limited studies have investigated the effect of health care services on longevity. In this work, findings from studies throughout the world are presented and re-analysed in order to evaluate the effect of health care services on population's health status. Methods: Studies that have assessed the associations of nutritional and other health care services (i.e., physicians supply, technical support, inter-collaboration) on longevity and health status were retrieved (searches in PubMed, EMBASE, Scopus, up to January 2010), and summarized here. Results: Few studies, mostly located in the US and the UK, have evaluated the role of health care services on population's health status. The majority of the studies reported a beneficial association between the frequency of physicians and mortality, while some other studies reported weak or no associations between physician's supply and longevity. Also nutritional services (screening) seem to promote better clinical outcome. Conclusion: Although very few data are available, it seems that there is a positive correlation between the quality and quantity of health care services and longevity. Strong primary health care seems to be effective on the population's health outcome. Active health policy and enhance-ment of health and nutritional services within the health care system may contribute to improved population's health and their overall quality of life.

Cessation lag and lingering effect are two important aspects of risk assessment, and have potential applications to dose-response analysis in risk assessment. In addition to providing insight into biological mode of action, the concept of cessation lag is useful for economic benefit analysis. Concept of effect lingering can be used to analyze epidemiological data by uncovering the hidden biological implications related to disease endpoints, thereby advancing current efforts to characterize and reduce risk assessment uncertainties. Multicentre study design is proposed as a way to increase study size and to mitigate criticism of meta-analysis of independent studies. Individual studies from a multicentre study can be either pooled using original data, or combined by meta-analysis of summarized results. A multicentre study of large cohort or case-control study also offers an exciting opportunity to study the contribution of epigenetic events that may be associated with life-style and environmental risk factors for human health. Methods for optimizing exposure assessment and reducing exposure misclassification represent important but difficult components in epidemiological studies. Biomarkers present a potentially useful approach for improving exposure estimates.

Background: Throughout Europe, differences in satisfaction with HIV-care of people living with HIV (PLHIV) persist, despite a tendency towards harmonisation of policy and management. Methods: A European sample of 1,549 PLHIV responded to an anonymous questionnaire assessing demographic background, general health, mental health, sexual health, and HIV-service provision. We compared the results across 3 regions: Western, Southern and Central/Eastern Europe. Results: PLHIV differed in several socio-demographic variables (gender, migrant status, sexual orientation, and financial situation) as well as specific psychosocial aspects (HIV-related discrimination, satisfaction with sexual and reproductive health (SRH) services in HIV-care settings, and complaints about service provision). Using multivariate analysis, a predictive model for satisfaction with SRH services in HIV clinics was developed, resulting into region of residence, and participants' satisfaction with their own health status as significant predictors. Conclusions: Better integration of SRH services in HIV-care should be encouraged. Service providers should be trained and encouraged to discuss SRH issues with their patients to create a supportive environment, free of discrimination. More time should be allocated to discuss SRH issues with individual patients.