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Aim: To report on Polish hospital health care workers' and lay persons' knowledge about counterfeit medicine products. Materials and methods: Cross-sectional design was used. Two types of questionnaire survey about counterfeit medicine, separate for health care professionals and lay persons were completed by 201 physicians and nurses, and 450 adult Polish residents between October 2008 and January 2009. Results: Physicians and nurses working in hospitals are more aware of counterfeit medicine than lay persons and more often notice the presence of drugs from unknown sources. Nearly 90% of physicians, 80% of nurses, and more than 40% of representatives of the lay persons had heard about the possibility of importing illegal medicine from Ukraine or China. The majority of medical workers does not know the procedure for reporting suspicious medicine and do not warn their patients against purchasing medicine from unknown sources. Conclusions: Increase education of nurses and physicians about counterfeit medicine particularly including the procedure of reporting suspicious medicine from unknown sources. In practice, reinforce a role of nurses and physicians in warning their patients against purchasing medicine from unknown sources and educate them about possible health hazards and life risks.

Background: The metabolic syndrome (MS) is a clustering of cardiovascular risk. The high prevalence of metabolic syndrome among populations of lower socioeconomic status is a cause of concern and calls for an effective public health response. Objectives: The aim of this study was to determine the prevalence of metabolic syndrome in the Roma population compared with the non-Roma population in the eastern part of Slovakia and to determine the parameter which has the strongest association with metabolic syndrome. Results: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. In the subgroup of Roma men, we found that waist circumference conferred the highest chance of MS (more than 12-times), followed by triglycerides (TG) (3.670-times). In the subgroup of non-Roma men, we found that waist circumference conferred the highest chance of MS (more than 16-times), followed by high-density lipoprotein (HDL) (4.348-times increased risk per one unit decrease in HDL). In the subgroup of Roma women as well as non-Roma women, we found that serum TG conferred the highest chance of MS, followed by waist circumference for Roma women. Comparing non-classical risk factors for MS we found that only age (with OR 1.977) and high-sensitivity C-reactive protein (hsCRP) (OR 1.887) were significant and independent predictors of MS in Roma men. Among Roma women apolipoprotein B100 was also found to be an independent predictor of MS, besides age and hsCRP. Conclusion: Our study confirmed that the prevalence of metabolic syndrome is strongly associated with hypertriglyceridemic waist, besides other risk factors, a marker of the atherogenic metabolic triad among younger Roma population, which may be the reason for the increased cardiovascular (CV) morbidity and mortality in elderly Roma compared with non-Roma. In light of these results, better prevention of CV events for Roma minority settlements in Slovakia should be provided.

Introduction: Egypt adopted a comprehensive strategy to eliminate measles and rubella by conducting a catch up campaign (in 2008) targeting children and young adults in the age group 10-19 years. This study aimed to explore the seroprevalence of rubella among females aged 20 to 30 years in order to provide the Ministry of Health with information to develop future strategies for rubella supplemental immunization activities among women of childbearing age before marriage and conception. Methods: A total of 339 females in the age group 20 to 30 were selected. The study group comprised women who attended the central laboratory of the Ministry of Health for checking up before travelling abroad as pre-travel requirements for visa application. The collected serum samples were tested for rubella-specific IgG antibodies. Results: The overall prevalence of rubella antibodies in the study group was 88.2%. Around 5.0% of females, who reported that they had been vaccinated, were susceptible to rubella. Age, history of measles, mumps and rubella (MMR) vaccination and past history of rubella infection were considered factors associated with seropositivity for rubella. Conclusion: The seroprevalence rate of rubella antibodies among our female study group was considered low.

Aim: The aim of the study was to estimate the awareness of healthy lifestyle behaviours in cardiovascular diseases (CVD) prevention and to find out possible determinants of this knowledge among adult residents of Polish provinces with the highest CVD mortality rates. Material and Methods: A cross-sectional analysis of randomly selected representative sample of 2,211 (51.9% women) aged 20-74 years from Łódź and Lublin voivodeships participating in the National Polish Health Survey WOBASZ. Knowledge on CVD prevention, sociodemographic and lifestyle characteristics were collected by an interviewer-administered questionnaire. Blood pressure, anthropometrics, plasma lipids and glucose were measured according to the WHO MONICA protocol. Results: Approximately 68% of participants, had poor awareness of preventive methods and majority of them were not able to name any specific approach. Most often mentioned method of CVD prevention was relaxing/avoiding stress (51.2%). The least known healthy behaviour was a reduction of salt intake and adequate fruit/vegetables consumption, mentioned by 18.2% and 23%, respectively. About 16.4% of women and 23% of men with risk factors of CVD were not aware of any non-pharmacological preventive method. Poor knowledge of CVD prevention was significantly more prevalent among persons aged ≥65 years, with elementary education level, lower income, living in the rural settings, declaring poor self-rated health. Dietary and physical activity advice given by a primary care physician was significantly related to better knowledge among men with CVD risk factors. Conclusions: There is a need to focus on increasing educational level in this regions, especially in rural settings. Due to important role of primary care physicians in health education, more attention should be paid to individuals with CVD risk factors as their preventive knowledge level is very low and comparable to the level of low-risk individuals.

Background: Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. Methods: The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. Results: A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p=0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). Conclusion: Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is necessary.

Background: In addition to genetic predispositions and environmental factors, healthy lifestyle education is very important for children and adolescents. The purpose of this research was to estimate the number of overweight and obese children and adolescents from small towns and villages and to find out an association between health awareness in children and the risk of becoming overweight or obese. Methods: The research was conducted in 1,515 healthy children aged 6-18 years from small towns and villages in Poland. Overweight was diagnosed when BMI for age and sex was over the 90th percentile; obesity - when it was over the 95th percentile. The study consisted of a lifestyle interview and anthropometrical measurements. The lifestyle interview was conducted with the use of an anonymous questionnaire form and included questions about food frequency, diet habits and physical activity. The research was analysed using the SAS System for Windows, release 8.02. Results: Overweight status was diagnosed in 9.0% and obesity in 5.1% of respondents. Excess body mass was statistically more frequently diagnosed in girls than in boys aged 14-18 years. Girls of this age group significantly more frequently chose wholemeal bread, smoked sausages, meat and poultry as products that are believed to keep them fit. Older children substantially more often indicated that stress, smoking cigarettes, consuming fatty meat, sweets, being obese, and a lack of physical activity are factors that damage health. Boys spent more time in front of a computer or TV than girls; in the older group of children, the phenomenon even intensified. Conclusion: Awareness of healthy lifestyle behaviour is not sufficient to maintain optimal body mass. Knowledge about proper eating habits is better among girls than among boys, especially in the older age groups. However, in older groups, there was less physical activity due to spending more time in front of TV or the computer. High percentage of obese/overweight children and insufficient knowledge of nutrition may consequently result in increased risk of cardio-vascular diseases in adult population.

Cardiovascular diseases (CVD) and especially coronary heart disease (CHD) are the main causes of death in the Slovak Republic (SR). The aim of this study is to explore trends in age-adjusted coronary heart disease mortality rates in the whole Slovak population and in the population of working age between the years 1993 and 2009. A related indicator - potential years of life lost (PYLL) due to CHD - was calculated in the same period for males and females. Crude CHD mortality rates were age-adjusted using European standard population. The joinpoint Poisson regression was performed in order to find out the annual percentage change in trends. The age-adjusted CHD mortality rates decreased in the Slovak population and also in the population of working age. The change was significant only within the working-age sub-group. We found that partial diagnoses (myocardial infarction and chronic ischaemic heart disease) developed in the mirror-like manner. PYLL per 100,000 decreased during the observed period and the decline was more prominent in males. For further research we recommend to focus on several other issues, namely, to examine the validity of cause of death codes, to examine the development of mortality rates in selected age groups, to find out the cause of differential development of mortality rates in the Slovak Republic in comparison with the Czech Republic and Poland, and to explain the causes of decrease of the age-adjusted CHD mortality rates in younger age groups in Slovakia.

Many school-based physical activity (PA) interventions have been developed, but only a few have assessed their long-term effects. A PA intervention taking place in the first four years of some Slovenian primary schools entails an enhanced physical education (PE) curriculum, including two extra lessons of PE per week, a wider selection of PE content, and additional outdoor education delivered by both a specialist PE teacher and a general teacher. The effects of the intervention on children's physical fitness (motor tasks and anthropometry) were evaluated within a quasi-experimental study. In total, 324 children from nine Slovenian primary schools either received the enhanced curriculum (intervention (n=160)) or standard PE (control (n=164)), and were followed for a four-year intervention period and seven years post intervention. Data from the SLOFIT database were used to compare differences in the physical fitness of children each year. Linear Mixed Models were used to test the influence of the PA intervention. Over an 11-year period, the PA intervention group significantly differed in all motor tasks, but not in anthropometric measures or body mass index, after controlling for year of measurement and sex. Differences between the control and intervention groups decreased with time. This study highlights the importance of tracking the long term effects of PA interventions. PA intervention in the first four years of Slovenian primary school offers the possibility of improving physical performance in children; initiatives aiming to increase their performance (physical fitness, physical activity) and health outcomes are warranted.

Occupational hazardous exposure in healthcare workers is any contact with a material that carries the risk of acquiring an infection during their working activities. Among the most frequent viral occupational infections are those transmitted by blood such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Therefore, they represent a significant public health problem related to the majority of documented cases of professionally acquired infections. Reporting of occupational exposures in University Hospital Dubrava has been implemented in connection with the activity of the Committee for Hospital Infections since January 2002. During the period of occupational exposures' monitoring (from January 2002 to December 2011) 451 cases were reported. The majority of occupational exposures were reported by nurses and medical technicians (55.4%). The most common type of exposure was the needlestick injury (77.6%). 27.9% of the accidents occurred during the blood sampling and 23.5% during the surgical procedure. In 59.4% of the exposed workers aHBs-titer status was assessed as satisfactory. Positive serology with respect to HBV was confirmed in 1.6% of patients, HCV in 2.2% of patients and none for HIV. Cases of professionally acquired infections were not recorded in the registry. Consequences of the occupational exposure could include the development of professional infection, ban or inability to work further in health care services and last but not least a threat to healthcare workers life. It is therefore deemed necessary to prevent occupational exposure to blood-borne infections. The most important preventive action in respect to HBV, HCV and HIV infections is nonspecific pre-exposure prophylaxis.

The purpose of this study was to determine prevalence of natural rubber latex (NRL) allergy among healthcare employees and identify sensitive individuals. A total of 1,115 healthcare workers (HCWs) employed in Izmir Tepecik Education and Research Hospital participated in the study. Information on age, gender, occupation, history of allergy, and complaints were collected through a questionnaire. Serum latex-specific IgE level was determined. Among HCWs enrolled in the study, prevalence of latex sensitization was determined as 4.2%. More frequent occurrence of latex allergy was detected among nurses. Family history of allergy and history of personal food allergy were significantly more often noted among individuals with latex allergy. Latex is considered to be the leading source of occupational health problems.

Objectives: The aim of the study is to describe attitudes which underlie Pole's declarations of support for a smoking ban in public places. Methods: The qualitative study using semi-structured individual in-depth interviews was conducted. The 30 IDI-s (in depth interviews) being a part of a larger research project entitled 'Lay meanings of health and life orientation of Polish society versus prevention and health promotion attitudes' were realized between 2007-2009. People belonging to all key socio-demographic categories identified by variables such as sex, age, education, and place of domicile were interviewed. The resulting material was subjected to content analysis. In the study the structural concept of 'attitude' was adopted. In order to identify the attitudes towards smoking bans in public places statements related to all three components of attitudes were analysed, but the typology of attitudes was constructed mainly on the basis of the emotional-evaluative component. Results: The study identified as many as four attitudes behind the declared support for a smoking ban in public places. Those attitudes were labelled 'supportive', 'accepting', 'conditionally accepting', and 'ambivalent'. They differ as regards degree of acceptance for the ban, conviction about harmfulness of passive smoking, setting great store by other regulators of smoking like cultural norms or healthy consciousness, and propensity to observe and execute the smoking ban. The 'supportive' attitude can be characterized not only by total support for the smoking ban in public places but also by insistence on the need for its extension. The 'accepting' attitude means approval for the smoking ban, and the 'conditionally accepting' attitude is distinguished from the others by the stress put on the right of smokers to have an access to places where smoking is permitted. The 'ambivalent' attitude can be typified by underlining other than legal ways of influencing smoking in public places. Conclusions: The study suggests that the attitudes underlying the Pole's declarations of support for a smoking ban in public places can be differentiated. However, because of the low number of participants in the study the results should be verified thus the further research is needed. Therefore, there is a need not only to study people's declaration of support or objection for the smoking ban in public places but also to examine their attitudes including cognitive and behavioural components using both qualitative and quantitative methods of social research.

This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Bulgaria. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) requirements for tobacco control legislation that reduces smoking consumption. The issue of tobacco control is not a simple one and requires a multi-pronged approach. While Bulgaria has made some progress in adopting legislation, it needs to strengthen its efforts in terms of enforcement, stronger legislation and increased taxation of cigarettes.

Background: Type 2 diabetes is a growing health problem globally; however, awareness about diabetes remains low. Aim: To assess the public perception of diabetes - how much does the public know about it? What are the beliefs about this challenging issue? Methods: A public opinion survey was performed in April 2012. Interviews with a random sample of 1,002 residents of Lithuania aged 16-74 were conducted in the households of the respondents. This sample took into account age, sex, education, employment, family status, and the size of the residential location. The topics covered by the 15-item questionnaire used for these interviews concerned the perceived severity of different health conditions and the respondents' knowledge of diabetes risk factors and normal glycemic indicators as well as their perceptions related to diabetes and insulin. Results: More than half (56.3%) of respondents had previously undergone the glycemic control test, 33.8% of study participants were familiar with the normal parameters of glycemia. Diabetes was ranked fourth among 13 health problems (the top three were attributed to malignancies, AIDS and mental illnesses). The highest score of all risk factors for developing diabetes was attributed to obesity; however, obesity was never mentioned in associating with diabetes by participants. The perceptions people had about diabetes revealed marginally medicalized images of this health condition. Conclusions: Study findings suggest the potential social stigmatization of diabetes and encourage looking for new ways in approaching the community as well as individual diabetic patients in regard to the issue of diabetes.

Aim: This study aims to determine the frequency of behaviour change and related factors generated in the population through the "Fighting Obesity Campaign" of the Turkish Ministry of Health. Methods: Twelve statistical regions from NUTS-1 and 18 provinces were selected for the study sample. At least one province from each region was randomly selected, and strata were defined as urban or rural. Of the sample selected, 2,038 respondents completed a face-to-face survey. Logistic regression analysis was used to analyse the data. Changing behaviour as result of the campaign was defined as the dependent variable. Behaviour change was defined as an individual taking at least one action to increase physical activity, calculate her/his Body Mass Index (BMI) or minimise meal portions. Results: Of the sample selected, 84% of participants lived in urban areas. Of total sample selected, 49.8% were men and 50.2% were women. According to BMI categorisation, 41.4% of participants were underweight or normal weight, 34.3% were overweight and 24.3% were obese. Of the total participants, 85.2% learned about the "Fighting-Obesity Campaign" through television, 28.1% through radio, 11.0% from newspapers, 6.0% from billboards, and 19.2% from other sources. This study revealed that 28.5% of the participants adopted desired behavioural changes after exposure to the campaign. Logistic regression results demonstrated that behaviour change is greater among women, individuals living in urban settings, group of persons approving public spots, obese individuals, and among the 20-39 age group. Conclusion: Media campaigns may cause behavioural changes by increasing motivation to prevent obesity within the target population. Continuing these campaigns can lead to success at the national level.

The first objective is to project obesity trends to 2030 based on the current data from Poland. The second objective is to test the effect of a 1% or 5% decrease in population BMI upon future incidence and prevalence of related non-communicable diseases. A two-stage modelling design projecting overweight and obesity trends and related diseases in a microsimulation model was developed. Epidemiological data for entry into a microsimulation model were gathered from Poland. This study used population level data from Poland creating a virtual population within a microsimulation model. Obesity and overweight in Poland was found to increase to very high levels in men while trends remained unchanged in women. In a country that currently has about 38 million inhabitants, it is anticipated that by 2030, there might be more than 9 million new cancer cases; 10 million CHD and stroke cases, and 7 million new cases of type 2 diabetes. These findings have policy implications highlighting the need for action to curb trends and to reduce increases in the rates of diet-related non-communicable disease.

In many countries the incidence of melanoma has been doubling in every 10 years. Since 1930, the rate of melanoma has increased over 1,800% and researchers are expecting this trend to continue and increase for the next 10 to 20 years. Primary prevention and early detection of skin cancer in childhood is important to reduce the risk of developing skin cancer later in life. Primary prevention programmes are more beneficial and effective in children, not only due to the particular importance of sunlight exposure during this period, but because this is when individuals are more open to changes and adopt new attitudes and behaviour. The purpose of this manuscript is to review the results of intervention studies designed to modify sun exposure behaviour among children in the United States of America, Australia and Europe. An additional purpose is to summarize the recommendations obtained from the reviewed studies. The strongest recommendation to emerge from this review is that the skin cancer primary prevention programme should be carried out over several school years, not just one time, to produce changes in the sun safety behaviour. Moreover, it recommends that parents should be targeted to educate their children about sun protective skills and promote skin cancer prevention behaviour.

The incidence of surgical site infection and urinary tract infection following orthopaedic procedures has diminished in recent years due to modern antimicrobial prophylaxis. We conducted a case-control study (100 cases, 100 controls) in order to evaluate the risk factors associated with infection after orthopaedic procedures. The following risk factors were defined: gender, age, comorbidities [rheumatoid arthritis, diabetes mellitus, obesity (>30 kg/m²), peripheral vessel disease], pre- and post-operative glucose levels, pre-operative and post-operative length of stay (days), duration (days) of urinary catheterization, type of parenteral antibiotic prophylaxis (cefotaxime or vancomycin), time of surgery (elective or scheduled), American Society of Anesthesiologists (ASA) Score (0-3), type of surgery (fracture osteosynthesis, joint replacement, spinal surgery, other), and the type of anesthesia administered (general, epidural, spinal). Urinary tract infection was the most frequent post-surgical infection (71 out of 100 cases) followed by surgical site infection (15 out of 100 cases). Using the multivariable logistic regression model, we found out that only the type of chemoprophylaxis was statistically significant risk factor (p<0.001) associated with post-surgical infection. More specifically, the use of vancomycin instead of cephalosporin is associated with a lower risk of infection.

Little information is available on the predicting factors for hospitalisation and mortality in heart failure. The aim of this study was to determine the symptoms and clinical signs at the time of the diagnosis of heart failure that predict hospitalisation within the first month after diagnosis and mortality within the first six months after diagnosis. Data were prospectively collected during a two-year period by a nationwide network of sentinel family practices. All adult patients for whom the first time the diagnosis of heart failure was clinically suspected were registered. One, six and twelve months after the initial diagnosis, the family physicians completed a follow-up form with questions about the final diagnosis, evolution and outcome. In total 557 patients with confirmed heart failure were recorded (median age = 78 years). Hospitalisation within the first month after the diagnosis was best predicted by peripheral oedema (p=0.001), nocturnal dyspnoea (p=0.022) and pleural effusion (p=0.032) at the time of the diagnosis. Six months after the initial diagnosis the mortality was 19% and after 12 months it was 26%. Mortality within the first six months after the diagnosis was best predicted by age (p<0.001) and pulmonary rales (p=0.001). Peripheral oedema appeared more among the survivors (p=0.035). Peripheral oedema, nocturnal dyspnoea and pleural effusion are highly associated with hospitalisation within the first month after diagnosis.

The study was conducted among 76 injecting drug users (IDU) from seven Croatian cities during a three-year period (2005-2007). Each par-ticipant completed a questionnaire on sociodemographic characteristics and potential risk factors for hepatitis C virurs (HCV) infection followed by anti-HCV and anti-HIV antibody testing. The mean patient age was 30. The majority of patients (69.8%) reported more than one potential exposure to HCV: 97.1% had shared injecting equipment, 75% reported risk sexual behaviour, and 56.3% reported a history of travelling abroad. The overall HCV seroprevalence was 51.3% (95% CI=40-63%). HCV seroprevalence increased with increasing number of risk behaviours (p=0.026). Needle sharing frequency was the most important risk factor for hepatitis C. The HCV seroprevalence rate ranged from 27.3% in IDUs who answered that they shared needles occasionally to 100% in IDUs who always shared needles (p<0.001). No other risk factors (age, gender, educational level, marital and employment status, history of travelling abroad and sexual risk behaviour) were associated with HCV seropositivity.

Background: Periodontitis was found to be significantly related to obesity as well as the number of missing teeth and oral hygiene. However, the studies addressing these relationships often included smokers and diabetics, and none was performed in Eastern European patients. The aim of this cross-sectional study was to investigate associations between obesity and periodontitis, oral hygiene, and tooth loss in a sample of non-smoking Croatian subjects aged 31-75 years. Methods: A total of 320 patients were recruited by convenient sampling at the Dental Clinic, Clinical Hospital Centre in Rijeka, Croatia. Periodontal examination and data on tooth loss were completed in 292 subjects and each participant completed a structured written questionnaire with questions regarding oral hygiene, education, height, and weight. Periodontitis was categorized as early, moderate and advanced. In multiple regression analysis, periodontitis was used as predictor variable, and BMI, oral hygiene, tooth loss, and education level were used as dependent variables. Results: Use of interdental brushes/flossing and number of missing teeth correlated significantly with BMI, but the same could not be proven for periodontitis and frequency of tooth brushing. However, logistic regression proved that the subset of obese, poorly educated women aged 36-55 years were 5-6 times more likely to develop severe forms of periodontal disease. Conclusions: Obesity was associated with tooth loss, oral hygiene, and education level in the investigated group. BMI could not be correlated with severity of periodontal disease, except in poorly educated women aged 36-55 years.

Introduction: The relationship between body weight and smoking has been well-documented among adult populations, but the data among youth are inconsistent. This study explores the relationship among social, behavioural, body weight-related factors and adolescent smoking while identifying factors associated with the belief that smoking controls weight. Materials and methods: Baseline data from a three-year, prospective cohort study started in 2009 in Hungary's six metropolitan cities. Randomly selected 6th and 9th grade students completed a self-administered questionnaire during the 2009-2010 school year (n=1445; 45% boys, mean age of 6th graders: 12.06 years, SD=0.63; mean age of 9th graders: 15.06 years, SD=0.63). Calculations of Body Mass Index (BMI) were based on objectively measured weight and height data of participants. Appetite-Weight Control Scale of the Short Form of Smoking Consequences Questionnaire was used to measure the belief that smoking supports weight control. Bivariate and multivariate logistic regression analyses were performed to examine the association between the perception of weight control and smoking, while controlling for potential confounding variables (e.g., gender). Results: 24.8% of participants smoked cigarettes within the past 30 days. The odds of smoking were increased among students who were older, had smoking friends, were exposed to parental smoking, and had poorer academic performance. BMI showed positive association with smoking (increases in BMI were associated with higher odds of smoking), and the belief that smoking controls weight mediated this association. There was no difference in smoking prevalence among those motivated either to lose or gain weight (∼30%), but was considerably lower among adolescents satisfied with their body weight (19%). The belief that smoking supports weight control was more common for girls, older students, and those who perceived themselves as overweight. Conclusions: Dissatisfaction with body weight and the belief that smoking has weight controlling effects are associated with an increased likelihood of adolescent smoking, therefore they must be considered in smoking prevention programmes among youth.

Objective: We examined the effect of a 6-month combined aerobic and resistance training programme on cardiometabolic risk factors in non-diabetic subjects and compared its effectiveness when executed under strict professional supervision or without direct supervision. Methods: Eighty-five sedentary, non-diabetic subjects (27 men and 58 women), mean age 47.5±0.6 years, mean body mass index (BMI, 33.8±0.6 kg/m²) participated in a combined exercise programme assigned to supervised (S, n=31), non-supervised (NS, n=24) or control group (C, n=30). Cardiometabolic risk parameters were assessed at baseline and after the 6-month training. Results: In both the S and NS group there was a significant decrease in BMI (-1.6±0.3, p<0.001 and -1.0±0.3 kg/m², p=0.004), waist circumference (-10.1±1.1 cm, p<0.001 and -7.8±0.8 cm, p<0.001), fat mass (-1.8±0.4%, p<0.001 and -2.1±0.6%, p=0.003), and a significant increase in fat-free mass (+1.7±0.4%, p<0.001 and +2.0±0.7%, p=0.008), and aerobic capacity (+6.9±1.1, p<0.001 and +6.9±0.8 ml/kg per min, p=0.008). Fasting glucose did not change in S and NS, but increased in C (p=0.048). In the S group a significant decrease in fasting insulin (p<0.001), homeostasis model assessment of insulin resistance (p<0.001), highly sensitive C-reactive protein (p=0.004), leucocytes count (p=0.04), systolic high (p<0.001) and diastolic (p=0.009) blood pressure was found. Comparable significant decreases in total and low-density lipoprotein cholesterol were observed in all study groups. Conclusions: A 6-month combined exercise programme led to substantial improvement of various cardiometabolic risk factors. This programme was effective even when executed without direct supervision, although the effects were more pronounced in the supervised group. Our findings suggest that non-supervised exercise programmes may be a valuable, cost-effective tool to translate the current physical activity guidelines in a real-life setting.