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Flies of the genus Sarcophaga are known to cause myiasis in necrotic wounds and in anatomical cavities where fluids have collected. We present here the first case of external cutaneous myiasis by Sarcophaga larvae in the absence of skin ulcerations or necrosis. The host in this case was a geriatric patient with limited motor and neurological capacity who lives in a nursing home. Of particular importance is that Sarcophaga is capable of causing myiasis even in the absence of cutaneous infections or significant stasis of fluids or secretions and that the larvae can cause damage in otherwise healthy tissue.

Purpose: A short HIV/AIDS risk behaviour knowledge index based on questions about HIV transmission and prevention of HIV infection during sexual intercourse and intravenous drug use is proposed and implemented for an HIV average risk population in Munich. Methods: Knowledge levels about HIV/AIDS risk behaviour was assessed in a group of people (n=210) in sexually active age range of 18-49 years which was at an average risk of contracting HIV. Four questions about HIV transmission by unprotected vaginal, anal, or oral sexual intercourse, and by needle sharing, and two questions about HIV prevention by condom use, and the single use of needles and syringes were chosen from ten others for making a four level risk behaviour knowledge index (HIV/AIDS Transmission through Sex and Intravenous Drug Use, HATSIDU) internally consistent according to Cronbach's alpha. Results: HATSIDU index (mean 3.0, SD±1.18) was not associated (p>0.05) with sex and marital status, but depended (p<0.05) on age, education and social status. General population of Munich in a sexually active age group of 40-49 years, or those without further education or the unemployed, had a significantly lower knowledge of HIV risk behaviour. Conclusion: The HATSIDU is a simple and usable index for the assessment of HIV/AIDS risk behaviour knowledge in a population with an average risk of HIV infection.

The objective of the study was to estimate the possible association of maternal diseases with the risk of isolated ear congenital abnormalities (IECA) including mainly microtia and anotia in their children. Incidence of acute and prevalence of chronic maternal diseases in the mothers with IECA and in the mothers of their matched controls and all controls without any defects, in addition in the mothers of malformed controls with other isolated defects was compared in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. Of 354 cases with IECA, 32 had mothers with high fever related influenza-common cold during the critical period of IECA and it resulted in a higher risk of IECA in their live-born infants (adjusted OR with 95% CI: 4.3, 1.9-7.4) compared with their matched controls. However, the early and effective antifever treatment in these pregnant women prevented them from the IECA. In addition there was an association of maternal otitis media with higher risk of complex defects of middle and external ears (OR with 95% CI: 5.2, 1.6-28.3), however, this association was based on 4 cases only. In conclusion high fever related influenza-common cold with secondary complications may play a role in the origin of IECA, but is preventable with the early and effective antifever treatment of these pregnant women.

Objective: Sleep quality is strongly associated with parameters of mental and physical health and therefore a major public health issue. We wanted to evaluate this association in young and healthy students by a survey. Further, we aimed to detect the relevance of sleep onset latency and sleep duration for sleep quality. Methods: A group of young nursing and technical students was surveyed (N=196) with the objective to measure subjective sleep quality, sleep onset latency, sleep duration, depression score, physical symptoms, trait-anxiety, and pathological eating behaviours. Results: Subjective sleep quality was strongly negative correlated with depression score (Pearson's r=-0.57), physical symptoms (r=-0.51) and trait-anxiety (r=-0.54) (p<0.001 for all three). Subjective sleep quality's association with sleep onset latency was stronger than with sleep duration. Further, high depression score (odds ratio OR=3.90; 95% confidence interval CI=1.88-8.06) and long sleep onset latency (OR=3.56; 95%CI=1.65-7.69) were the best predictors of poor subjective sleep quality. Conclusions: This study supports evidence that links physical and mental symptoms with poor sleep quality. Especially important is the fact that we found this connection in young and basically healthy adults. Taking into account that poor sleep quality has major negative long term impact on health, prevention programmes should focus especially on the association between depressive symptoms and subjective sleep quality that is significantly influenced by sleep onset latency.

Influenza illnesses and positive laboratory tests for the presence of influenza virus in recent years in the districts of Košice I-IV and surroundings have only occurred during the winter season. In May to July 2010 only one positive laboratory test for the presence of influenza virus A/H1N1-2009 was reported. In 2011, during the same period, a total of 29 positive laboratory tests were recorded for the presence of influenza virus A/H1N1-2009 in individuals with typical clinical symptoms of influenza. Of 29 clinical cases, 27 were diagnosed as influenza and 2 as SARI; 4 cases involved children.

Introduction: The EU member states are obliged to elaborate Strategic noise maps (SNM) till June 2007. This duty was given them by the Directive 2002/49/EC of the European Parliament and of the Council of 25 June 2002 relating to the assessment and management of environmental noise. Member States should apply the noise indicators Lden (overall annoyance) and Lnight (10 p.m.-6 a.m.) for the preparation and revision of strategic noise mapping. Until the use of common assessment methods for the determination of Lden (Lden - day-evening-night noise indicator - shall mean the noise indicator for overall annoyance), and Lnight is made obligatory, existing national noise indicators and related data should be converted into the indicators mentioned above.
Material and methods: The National Reference Laboratory for using GIS in public health was delegated by the Czech Ministry of Health with the task to elaborate strategic mapping of rail transport noise. Whereas the Czech Republic did not use the national methodology for calculation of noise annoyance, the Dutch methodology was used. Geographical data (geographic, topographic and geodetic data) was obtained from the Czech Office for Surveying, Mapping and Catastre. It creates a digital topographic model of the Czech Republic territory in measuring scale 1:10,000. Data on categories of railway vehicles, track intensity and track construction was obtained from the Railway Research Institute in RML2 (Dutch computing method) standards. Input data are prepared using GIS (desktop ArcView GIS ESRI) according the recommendation of the EC Good Practice Guide for Strategic Noise Mapping and the Production of Associated Data on Noise Exposure (WG-AEN). The calculation of the noise annoyance follows the European Noise Directive using software LimA, advanced. The current limit values were stated for Lden 70 dB and Lnight 65 dB.
Results: The results of annoyance analysis are performed as a sum of population (houses, school and hospitals) living/being situated in the noise level below 55 dB Lden and 45 dB for Lnight (lower cut-off), over 70 dB Lden and 65 dB for Lnight (limit value) and the categories between by 5 dB. In the area of interest live about 542,000 inhabitants. For indicator Lden 524,000 people live below lower cut-off and 300 over limit value. For indicator Lnight live 485,000 people below lower cut-off and 200 over limit value. Out of 38,700 houses 37,000 is placed in lower cut-off and 50 over limit value for for Lden and 35,000 houses in lower cut-off and 27 houses over limit value for Lnight. Most of the 495 schools is situated below lower cut-off for Lden (484 schools). Out of 26 hospitals the majority (24) is situated in lower cut-off for Lden and 15 hospitals for Lnight. Neither school or hospital is being situated in area with over limit value both for Lden and Lnight. Conclusion: The results of annoyance analysis indicated population living and houses being situated in areas exceeding the limit noise level. In future the strategic noise maps (and its noise levels by 5 dB) may be used in public health whenever the limit noise value will be decreased.

Objectives: Exposure to various sources of radio frequency electromagnetic fields (RF EMF) is common in industrialized settings, for example from mobile phones or broadcast transmitters. We assessed exposure to RF EMF in volunteers to gain a better understanding of exposure levels and to quantify the contributions of different sources.
Methods: Exposure was assessed using the EME SPY 120 personal exposure meter (Antennessa, Brest, France), which allows separate measurements of the following frequency bands of RF EMF: radio transmitters, television transmitters, TETRA (radio communication for authorities), mobile phone handsets (uplink), mobile phone base stations (downlink), cordless phones and wireless LAN. A total of 34 volunteers living in Basel (Switzerland) and surroundings carried a personal exposure meter during one week and completed a diary of daily activities at the following locations: "at home", "at the working place", "on the way" and "other". Nine persons living close to a mobile phone base station were specifically asked to participate in the study and treated as the highly exposed group. The reference group consisted of 25 unselected volunteers. Measurements were taken every 90 seconds. To allow for values below the detection limit of 0.05 V/m, mean values were calculated by means of the robust ROS method, which assumes that measurements below the detection limit follow a lognormal distribution.
Results: Overall, the mean (range) exposure to RF EMF over the whole week was 0.20 V/m (0.09-0.40 V/m). In the highly exposed group the mean was 0.27 V/m compared to 0.17 V/m in the reference group (Wilcoxon rank-sum test: p = 0.004). Radio transmitters contributed 2%, television transmitters 2%, TETRA 0%, mobile phone handsets 31%, mobile phone base stations 36%, cordless phones 24% and wireless LAN 6%. At home, exposure (mean 0.19 V/m) was mainly due to mobile phone base stations (48%) and cordless phones (36%), at work (mean 0.22 V/m) due to mobile phone handsets (46%) and wireless LAN (26%), and on the way (mean 0.32 V/m) due to mobile phone handsets (68%) and mobile phone base stations (20%). In the reference group, cordless phones were the most important source of exposure at home (60%) for people owning a cordless phone. In the highly exposed group, the mobile phone base stations contributed 65% to their exposure at home and 57% to their total exposure.
Conclusions: The median total exposure (0.20 V/m) is well below the standard limits. Major sources include mobile phone base stations, handsets and cordless phones. This study will be extended to a sample of 200 volunteers to determine the most relevant predictors of total personal exposure, according to different lifestyles. The data will allow modelling of personal exposure in the large-scale QUALIFEX cohort study (see www.qualifex.ch), which will examine non specific symptoms of ill health and exposure to RF EMF.

The prevalence of obesity has reached alarming levels, affecting virtually both developed and developing countries of all socio-economic groups, irrespective of age, sex or ethnicity. Concerning childhood obesity, it has been estimated that worldwide over 22 million children under the age of 5 are severely overweight, and one in 10 children are overweight. This global average reflects a wide range of prevalence levels, with the prevalence of overweight in Africa and Asia averaging well below 10% and in the Americas and Europe above 20%. The proportion of school-age children affected will almost double by 2010 compared with the most recently available surveys from the late 1990s up to 2003. In the European Union, the number of children who are overweight is expected to rise by 1.3 million children per year, with more than 300,000 of them becoming obese each year without urgent action to counteract the trend. By 2010 it is estimated that 26 million children in EU countries will be overweight, including 6.4 million who will be obese. Moreover, in the USA the prevalence of obesity in adolescents has increased dramatically from 5% to 13% in boys and from 5% to 9% in girls between 1966-70 and 1988-91. In this review paper we present the epidemiology of obesity in children and adolescents, including prevalence rates, trends, and risk factors associated with this phenomenon.

Aim: The purpose of this study was to determine the Environmental Health situation of Izmir's Kemalpaşa county primary school. Material and methods: The investigation of environment quality was performed in of 46 primary schools found in Kemalpasa. Appraisal was completed on the surrounding conditions, toilet hygiene, waste materials, food and water purity. The questionnaires requesting the necessary data were distributed to the school's administrators and they were asked to permit the researchers to observe the premises and subsequently some modifications were adopted.
Findings: Of the 46 primary schools found in Izmir's Kemalpasa county, 9 were located in the city limits, 37 were located in the countryside. The average classroom size of the schools was 10.8±1.4 (1-38), the average number of students was 320.1±55.9. Twenty (43.5%) of the schools were located on a main street with heavy traffic which could be responsible for accident in the school playground, 31 (67.4%) as found with environmental professionals, 33 (71.7%) were completely surrounded by walls. Five (10.9%) of the school's environments were found to be littered by garbage and solid waste heaps. 14 (30.4%) of the schools separated the solid waste materials but only 10 were found with insufficient separation. 28 (60.9%) of the schools were connected to the sewarage system and 31 (67.4%) had the necessary fire protection equipment. Waste baskets were found in the corridors of 12 (26.1%) schools, 35 (76.1%) had waste baskets at each classroom doors. Sixteen (34.8%) schools had canteen, 12 (75.0%) of which did not have a health license, 11 (68.8%) did not do porter inspections, 1 (6.3%) was using food items outdated, 12 (75.0%) had washbasins, 2 (12.5%) with employees personal cleanliness unsatisfactory; in the food preparation area of 15 canteen 3 (20.0%) the hygiene conditions were unsatisfactory. The hygiene of toilets was satisfactory in 22 (47.8%), 37 (80.4%) had sufficient soap, 5 (10.9%) provided paper towels or hand drying systems. After each recess in 22 (47.8%) schools, all the toilets were cleaned, 17 (37.0%) schools had water tanks in case of water cut-offs. 44 (95.7%) of the schools were connected to the drinking water network, 13 (28.3%) had drinking water tanks. At various intervals 44 (95.7%) of the schools analyzed water samples. There was significant difference among the schools in the countryside compared to the schools in the city limits in respect of connection to the sewarage network (p = 0.007), necessary fire precautions (p = 0.021), provision covered waste basket in the corridors (p < 0.001) and making porter examinations to the canteen personels (p = 0.035).
Discussion and conclusions: Even though the social-economic situation of Izmir state improves, the county of Kemalpasa's primary schools have very important environmental health deficiencies. The deficiencies were seen more in Kemalpasa's countryside schools. The health authorities of these schools should follow WHO criteria to get rid of these deficiencies.

Background: Primary prevention of smoking in children is mostly carried out through school education schemes organised by trained teachers. The generally accepted notion is that children's opinions and behaviour are influenced by the school, but mainly by the family and their peers, as well as by the broader society. The primary preventive programme aimed at the first three years of primary schools, called "No Smoking is a Norm" strives to encourage parents to take an active part in the education of their children against smoking, as well as about other aspects of a healthy lifestyle. This paper analyses the data documenting the effectiveness of the programme with respect to children's family smoking history. Methods: The information about smokers in families was collected during enquiries prior to the initiation of the 1st and 2nd stage (in the 1st and the 2nd class), and again after their conclusion. In the first stage, smoking of mothers, fathers, and grandparents was followed separately. In the second stage, the category of smokers that can influence children, included parents, grandparents, siblings, aunts, and uncles, with whom the children are in contact (the so-called "broader family"). Questionnaires answered by children who did not know whether their parents or grandparents smoked were excluded from the survey. The analysis included 1,423 (i.e. 76.6%) from the total number of 1857 children from the programme and control groups. The answers were coded and analysed using the χ²test in EPI INFO software, version 3.3.2.
Results: Approximately 30% of the children's parents are smokers. Almost 60% of the children were exposed to the influence of smoking parents and grandparents, and more than three quarters of the children experienced smoking from the "broader family". The more smokers there are in the family, the more children have the opportunity to handle cigarettes and smoking accessories from an early age: they get, buy, or even light cigarettes. Smoking of parents and other relatives led to a substantial increase in the number of children who were determined to smoke in the future or were considering it. More than half of the eight-year-olds have tasted an alcoholic drink, and significantly more frequently in the families of smokers. 8% of the eight-year-olds have gone through their first smoking attempts and all of them from families with adult smokers. On the other hand, the smoking or non-smoking family environment of the respondents did not influence the knowledge part of the intervention programme. In the study group, in comparison with the control group, there were significantly more children exposed to the influence of smokers in the "broader" family (80.1% vs. 73.0%). This could explain why evaluation of the medium-term efficiency of the programme without consideration of the family environment was highest in the knowledge area, while differences in change of opinions and behaviour were mostly insignificant. Conclusions: Smoking of family members significantly reduces the efficiency of school educational anti-smoking activities aimed at children and young people.

Introduction: The health parameters of the Roma minority appear to differ significantly from other population groups. Information about the health of Roma is only available from a few scientific studies, because in general the indication of ethnicity is not allowed to be entered in governmental health statistics.
Objective: The aim of this study was to compare the reproductive parameters of Roma and non-Roma populations when controlling for mother's age and socio-economic status.
Material and methods: The data from cross-sectional study (947 Roma and 2,713 Non-Roma) were derived from maternal and newborn obstetrics reports and personal mother's interview. Newborn medical reports included data about birth weight, birth length, chest and head circumference, and Apgar score. Maternal reports included reproductive parameters (e.g. type of delivery, gestation age, spontaneous abortion, mother's weight increase) as well as socio-demographic and health data (education, employment, marital status, smoking, coffee and alcohol abuse). To analyse the data t-test, linear regression and logistic regression were used. Statistical model of linear model included regression of birth weight and gestational age. Results: Between Roma and non-Roma significant differences were found regarding reproductive characteristics. Roma had more deliveries (p < 0.001) and lower mother's weight increase (p < 0.001). Significant differences were also found regarding newborn parameters, in particular birth-weight (on average 401 grams less in Roma, p < 0.001), birth-length (1.30 cm less in Roma, p < 0.001), chest and head circumference (both p < 0.001). Linear regression model for low birth weight showed as the most important social factors: education, smoking and single marital status; for low gestational age smoking, education and employment.
Conclusions: The results show great differences between Roma and non-Roma in reproductive and newborn characteristics. There still remain questions, however, about whether these differences are caused by lower socio-economic status or ethnicity - suggesting the need for developing lower birth-weight and birth-length standards for Roma.

Objective: Through series of multinational collaborative projects WHO has developed a methodology for indicator-based assessment and reporting on environmental health situation and relevant policies in Europe. A significant outcome is the baseline assessment of the children's health and the environment with regards to four regional priority goals of CEHAPE (Children's Environment and Health Action Plan for Europe).
Methods: A set of 26 indicators encompasses children's health and most relevant environmental risks of water-borne diseases and unsafe sanitation, injuries, respiratory health and air quality, hazardous chemicals and radiation. They were selected on the basis of policy relevance and scientific reliability, and the availability and accessibility of necessary data. Analyzed were time and space patterns for each indicator and potential health benefits of interventions. The information provided by each of the indicators, along with its scientific basis and policy context, was presented in the form of standardized "fact sheets", accessible on the web site http://www. enhis.org. The "baseline assessment" integrates the information providing a first evaluation of the status and trends in the first half of the current decade of the priority environmental health (EH) issues specified by the CEHAPE.
Results: Health-related water problems, fatalities from road traffic accidents, unintentional injuries and infant respiratory disease mortality showed a clear West-East European regional gradient. The lack of harmonized water-borne diseases surveillance hampered the assessment of children's health related to water quality indicators. Outdoor air pollution remains a problem and asthma and allergic symptoms tend to increase throughout the WHO European Region. Environmental tobacco smoke continues to be the most significant indoor air health problem and smoking bans in bars and restaurants is still insufficient. Among the current chemical risks in food, heavy metals and persistent organic compounds cause presently concern in Europe. Excessive UV radiation is an important risk factor for severe diseases which is largely preventable by simple measure. For several indicators, in particular those related to hazardous chemicals, only surveys limited to selected parts of country population were available restricting possibility for country-wide assessments. Conclusions: The information on health effects related to the environment, environmental issues affecting children's health, and actions aiming at reduction, or prevention of the health risks enables policy-makers to monitor situation and trends in the countries and evaluate relevant policy effectiveness. Systematic approach to regular indicator reporting can help resolving information and knowledge gaps. Opportunities and challenges, and actions needed to advance the environmental health information system in Central and Eastern Europe will be highlighted. Setting a participatory process involving all relevant parties is essential for system development, strengthening country capacity and information sharing.

The aim of this study is to provide an easy tool to identify patients with a high cardiovascular risk, especially those qualifying for lipid-lowering treatment. The decision to treat with lipid-lowering drugs was assessed with five new risk algorithms. The Five Risk algorithm (5R) takes into account male gender, high systolic blood pressure, high total cholesterol, smoking and high blood sugar as independent risk factors. Patients with three independent risk factors qualify for lipid-lowering treatment. Compared to the Framingham Risk Score, the 5R has a Kappa coefficient of 0.62. Compared to the SCORE, the Six Risk algorithm (6RDF) has a Kappa coefficient of 0.70. The 6RDF uses only four independent risk factors (male gender, high systolic blood pressure, high total cholesterol and smoking) but having diabetes or a family history of premature coronary heart disease are exclusion criteria for which treatment with lipid-lowering drugs is always indicated.

In our study we monitored plasmatic levels of sarin and changes in cholinesterase activities in rats after exposure to sarin vapors at low concentration. Rats were exposed to sarin in inhalation chamber at concentration 1.25 or 2.5 μg/l for 60 minutes. The acetylcholinesterase activity was measured in erythrocytes and in different brain regions (frontal cortex - FC, pontomedullar area - PM, basal ganglia - BG). Butyrylcholinesterase activity and sarin levels were measured in plasma. Acetylcholinesterase activity in erythrocytes as well as butyrylcholinesterase activity in plasma were significantly decreased in both groups of animals after intoxication with sarin. In brain, the significant decrease in acetylcholinesterase activity was measured in FC and PM for both groups. In group exposed to higher concentration of sarin vapors, the plasmatic level of sarin was nearly 2x higher than in group exposed to sarin at concentration 1.25 μg/l. The linear dependence between plasmatic levels of sarin and AChE activity was assayed in FC region of brain and in erythrocytes, exponential relationship in PM region of brain and for BuChE activity in plasma.

Objective: To investigate the effects of moderate-intensity and low frequency exercise on resting serum testosterone and cortisol levels, resting heart rate, and isokinetic strength among healthy sedentary young men. Design: A randomized controlled study. Forty sedentary young men aged 18 to 25 years old, pedaled 50 minutes on a bicycle ergometry at 60% of maximal effort once a week for 12 weeks in an exercise group. Outcome measures: Resting total and free serum testosterone, serum cortisol, anthropometric data, resting heart rate, and isokinetic strength during shoulder and knee extensions. Results: Resting serum total and free testosterone, as well as cortisol did not differ significantly between groups. Neither group showed any significant changes in anthropometric data and isokinetic strength at the end of study. However, the resting heart rate of the exercise group reduced significantly after the training (p<0.05). Also, the isokinetic strength of shoulder and knee significantly increased (p<0.05). Conclusions: Twelve weeks of moderate-intensity and low frequency training had no effect on resting serum testosterone, but were sufficient to increase aerobic fitness among sedentary young men. The type of exercise training may encourage sedentary individuals to participate regularly in the program on physical activity.

Introduction: HIV infection is the major public health, social and economic problem in Georgia. Although the HIV epidemic is in its nascent phase in the country, the potential risk for development of a wide spread HIV epidemic is very high.
The aim of this study is to evaluate the effectiveness of ARV treatment principles in Georgia, including treatment and monitoring methods. Materials and Methods: The study included 985 people living with HIV/AIDS in Georgia registered at Infectious Disease, AIDS and Clinical Immunology Research Center since 2004. To ensure universal access to ARV therapy all HIV/AIDS individuals included in the study were investigated by special algorithm, all identified patients requiring ARV therapy were offered treatment and monitored during therapy on treatment effectiveness and side effects.
HIV-1 RNA in plasma was measured by quantitative Polymerase Chain Reaction. For determination of percentages and absolute count of Tlymphocyte subpopulations single-platform immunophenotyping technique using the Becton-Dickinson FACSCalibur flow cytometer was applied. For resistance testing TRUGENE HIV-1 Genotyping Kit with the OpenGene DNA Sequencing System (Siemens) was used. Reasons of treatment failure and mortality rate among ARV treated patients were analyzed.
Results and Conclusions: Treatment was offered to 398 HIV/AIDS patients. 397 patients started treatment, 1 patient refused. Out of 397 HIV/AIDS patients treated 21 patients discontinued, 54 patients died and 322 patients are currently on ARV treatment. Out of the treated patients 281 adults and 11 children are receiving first-line treatment, 27 adults and 2 children are on second-line treatment and 1 adult is receiving salvage regimen. Treatment failure was defined in 52 cases. Among them immunological failure was observed in 7 cases, clinical failure in 1 case and virologic failure in 44 cases. Prevalence of drug resistance among virologic failure cases accounted for 73% and inadequate adherence for 27% cases. Out of drug resistance cases 3% has three-class drug resistance, 84% - two-class drug resistance and 13% found to be resistant to one class. In ARV naive patients the prevalence of drug resistance to any class was 4.33%. The majority of death cases among ARV treated patients was due to non-AIDS related or incurable conditions, while deaths due to AIDS related conditions were mainly associated with delayed referral of patients in already advanced stage of disease. It's worth to mention that the highest number of death cases was due to liver failure in HIV/HCV and/or HBV co-infected patients.

The present overview is the result of our scrutiny of data concerning the presence of viruses in the water of diverse European rivers. These data were assembled from the published literature - articles, doctoral theses and reports from investigations conducted by environmental virologists beginning during the final years of the sixth decenium of the twentieth century, first in France, Czechoslovakia, Romania, Ukraine, U.S.A. then in other European and countries worldwide. The overview covers the methodology referring both to water sampling (by gauze pads or by grab procedures), and to virus detection methods, including virus concentration from large volumes of water and the inoculation of virus concentrates on cell cultures and/or into suckling mice. Other more recently elaborated methods of virus detection and identification, consisting of immunological tests, as the enzyme immunoassay (EIA), immunofluorescence (IF), or the genetic techniques, as the molecular hybridization and flow cytometry (FC), were also applied. The obtained results refer to the virus positivity with the specification of virus types and various virus contamination levels of these waters. Finally, the ways by which the viral contamination of the searched river waters might be demonstrated and, ways by which the human body can be contaminated by the virus polluted river waters are discussed, and some conclusions and recommendations are formulated.

The computer program with the acronym TICKPRO (tick prognosis) facilitates medium-range forecasts of the level of host-seeking activity in ticks within a 1-4 day horizon. The program is based on the medium-range weather forecast routinely produced at the Czech Hydrometeorological Institute (CHMI), as well as on previously developed mathematical models describing the correlation of meteorological factors with the host-seeking activity of Ixodes ricinus. These models are based on a 6-year whole-season monitoring of I. ricinus host-seeking activity on experimental fields in the Central Bohemia Region in a typical habitat, oakhornbeam forest, where tick-borne encephalitis (TBE) virus and Borrelia burgdorferi s.str., B. afzelii, and B. garinii have been found. Meteorological data provided by the CHMI meteorological station in Prague-Libuš were used, and during the development of the forecasting algorithm micrometeorological data have been collected directly at the tick monitoring sites under selected synoptic weather situations. In the TICKPRO program, the two most successful models utilized ambient air temperature, quantity of atmospheric precipitation, and relative air humidity. The prediction determines 5 levels of risk of attack according to the current proportion of host-seeking ticks, and thus determines the risk of TBE infection. The levels of risk defined by the TICKPRO program are supplemented by instructions on how to prepare oneself for entering sites with potential tick occurrence, how to move around once there, and how to behave on returning home. This warning system is weekly published on websites of National Institute of Public Health and CHMI, Prague, over entire season (March-November).

We analyzed the occurrence of healthcare-associated infections (HAI) at intensive care unit of the Department of Anesthesiology and Intensive Medicine of Martin Faculty Hospital in 2008. We performed a retrospective-prospective observation according the protocol of European HELICS (Hospital in Europe Link for Infection Control and Surveillance) system. We found 11 HAI (4.45%) which on average prolonged the length of hospitalization by 6 days. The most frequent localisation of HAI was the respiratory tract. By our own observation we found the same number of HAI cases as it had been reported officially but the observed and reported cases do not match. The surveillance system HELICS uses definitions slightly different from those used in Slovakia. The severity of health status of a patient at admission influences the risk of HAI. We suggest a continuing collaboration on HELICS system with further involvement of all departments of Martin Faculty Hospital and creation of a hospital infection control team. We also suggest an improvement in testing for etiologic agents of HAI and an introduction of methods of molecular epidemiology in diagnostics, as well as quantification of costs related to occurrence of HAI and to assess an implication of automated monitoring system in HAI surveillance.

The objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in 174 Roma children and adolescents (88 males and 86 females) aged 7-18 in 3 Central Slovakian cities (44 from Žilina, 39 from Banská Bystrica and 91 from Rimavská Sobota). Venous blood samples were drawn in the morning, after a 12 hour overnight fast for biochemical analysis. Total cholesterol (TC) and triglycerides (TG) were determined enzymatically. HDL-cholesterol (HDL-C) after selective precipitation lipoproteins containing apolipoprotein B and LDL-cholesterol (LDL-C) was calculated by the Friedewald Formula. Serum levels of apolipoproteins (apo A, apo B) were analyzed immunochemically. Concentration of lipoprotein a [Lp(a)] was analyzed by immunonephelometric method (Beckman-Coulter System). Anthropometric measurements, including weight, height, waist and hip circumference were used to calculate the sum of the body mass index (BMI) and waist to hip ratio (WHR). Measured blood pressure (BP) was used to classify for hypertension. Significant differences were determined in serum levels of LDL-C (p<0.05; by Tukey HSD test multiple comparison more significant difference was determined between Žilina and Rimavská Sobota p<0.046), TG (p=0.008), apo A (p<0.001), Lp(a) (p=0.042), WHR (p<0.001), BMI (p<0.001), sBP (p<0.001) and dBP (p=0.012) in Roma individuals of all locality groups. The Roma population from Rimavská Sobota had (in comparison to the examined populations) statistically higher values of TC, TG, LDL-C, lower HDL-C. The population showed significant relation of TG and stress at home (p=0.03) and at school (p=0.01), HDL-C and cigarette smoking (p=0.004), apo A and cigarette smoking (p=0.02) and socioeconomic status (p=0.006), WHR and cigarette smoking (p=0.02). Risk values of WHR, apo B and Lp(a) were mostly determined in Žilina's population (WHR significantly connected with family history CVD p=0.03, cigarette smoking p=0.02 and leisure time physical activity p<0.001) and BMI, apo A and BP in Banská Bystrica. WHR was positively correlated to BP and negatively to HDL-C and TG only in Roma participants from Rimavská Sobota. BMI was positively correlated to systolic BP in populations from Banská Bystrica and Rimavská Sobota. The results of the study should improve the paediatric health treatment and prevention of CVD risk predictors for Roma from different cities.

Metallurgical industry workers in developing countries are often exposed to high concentrations of dusts and fumes that affect pulmonary function. The aim of this cross-sectional study is to assess the prevalence and severity of chronic obstructive pulmonary disease (COPD), the prevalence of symptoms, as well as, the link between work-place air pollution and COPD. A standardized questionnaire was used to collect data about smoking and socioeconomic status, past history of pulmonary diseases, current respiratory symptoms, education, and other variables. We have identified and assessed all risk factors and also have performed measurements of dynamic pulmonary function in 459 subjects - 90% of iron-steel and ferrochrome industry workers. The prevalence of COPD oscillated from 19.6% up to 25.7% while severity varied from mild to very severe. Symptoms: prevalence varied from 12.0% to 46.3% while relative risk for developing COPD was 2.1-5.5 that of non-industry controls. Exposure markers' concentrations: for total suspended particles (TSP) oscillated from 0.375-25.5 mg/m³, particulate matter (PM₁₀) from 0.25 to 10.5 mg/m³, and sulfur dioxide from 0.19-18.69 mg/m³. In majority of cases its average exceeded threshold limit values. Our conclusion was that COPD prevalence and its symptoms are high in the population studied, and that there exists a well established occupational risk between work-place air pollution and COPD.

EuroSIDA is a pan-European observational study that follows 14,265 HIV-infected patients from 31 European countries, Israel and Argentina, of which 2,560 are patients from eastern Europe (EE). The study group has performed several analyses addressing regional differences in the HIV-epidemic across Europe, where all countries were divided into five regions: south, west central, north, east central Europe and EE. Significant regional differences in patients' characteristics and pattern of AIDS diagnoses were documented. More patients from EE were diagnosed with tuberculosis compared to other regions. Significantly fewer HIV-infected patients in EE, who fulfilled the criteria for starting combination antiretroviral therapy (cART), actually received cART as compared with other regions of Europe. Those, receiving cART in EE had a lower initial virologic response rate irrespectively of the regimen used, although it has improved within years. Besides, treatment failure was more common in this region. Thus, improvements in the clinical management of HIV patients in EE are urgently needed. Strategies include creating scientific collaborations for HIV clinicians as well as teaching clinicians about the most advanced HIV management at clinically oriented courses held in eastern Europe.

The aim of this study is to evaluate the relation between a sense of coherence and intensity of health-related behaviour among 521 Polish university students. The study was conducted using validated instruments with two questionnaires: Antonovsky's SOC-29 and the Inventory of Health-Related Behaviour. The mean value of SOC amounted to 125.2. More than half of the studied group were characterized by the average level of SOC. No statistical differences were found between the faculty of study and SOC (p=0.107). A low intensity of health-related behaviour characterized a large group of students. Students of particular faculties differ among themselves in a statistically significant way in the level of health-related behaviour (p=0.015). SOC is related to healthy behaviour (p<0.001). University students are often characterized by an average level of SOC and a low intensity of health-related behaviour. Medical students are characterized by higher level of health-related behaviour in comparison with humanistic and science students. SOC correlates positively with a tendency to health-related behaviour. The higher the level of coherence, the higher is the tendency towards pro-health behaviour.

Tobacco use prevalence in Europe is characterized by large disparities, with Western nations reporting smoking rates generally below 25%, while Eastern nations have smoking rates usually above 30%. Albania provides a distressing case study for Eastern Europe in which the exposure to the West after the fall of the communist regime dramatically increased the availability of Western-type cigarettes, while adoption of counterbalancing tobacco control measures lagged far behind.
Results based on the representative Albanian Adult Tobacco Survey (AATS) conducted in 2007 suggest that smoking is a major problem, with a 64% smoking prevalence among Albanian men. It is becoming an increasingly greater concern among women, whose smoking prevalence more than doubled since 1990, reaching 19% in 2007. Young women living in urban areas are particularly susceptible to tobacco use; about one-third of them reported that they smoke. About 85% of current smokers smoke daily and with very high intensity, which further increases their risk of dying of smoking-attributable diseases. Smoking and secondhand exposure kill about 3,800 Albanians per year, about one-fifth of all deaths in the country. In addition, tobacco use imposes opportunity costs on Albanian households, which spent $358.6 million on cigarettes in 2007, or about 6% of the gross domestic product (GDP).
To reduce the health and economic burden caused by tobacco use, the Albanian government should implement and enforce evidence-based tobacco control policies such increasing cigarette taxes; promoting cessation, particularly via the health care system; and enacting stricter clean indoor air laws.

It has been noted that great socioeconomic and lifestyle changes have triggered an epidemic of obesity among Eastern Europeans. The objective of this study was to assess the change of adult obesity in Estonia by socioeconomic status and the use of outpatient healthcare services among obese individuals over time. It can be maintained that obesity distribution in Estonia in 1990-2004 developed similarly to an average Western country and, regardless of an increasing level of male obesity, obesity prevalence for 16-64 year-olds was on the average level in Europe in 2004-14.0% for men and 14.9% for women. Change in obesity prevalence correlates quite well with changes in the economy in Estonia. From studied socioeconomic variables only age and education (among women) strongly affect the change in obesity level. Obese individuals used outpatient medical care slightly differently compared to individuals with a normal BMI.

The aim of this review is to explain short life expectancy in Romanies. Romanies represent the second largest minority in Slovakia (about 7%). Most of them exist on the fringes of the majority society. Their general situation worsened after the fall of communism in 1989. In a market oriented society the unemployment of Romanies further increased due to their poor education and lack of skills. Romany general health is substantially worse than that of the majority population: They have high prevalence of communicable diseases due to poor sanitary and living conditions. Furthermore, epidemiological and metabolic studies revealed in Romanies high prevalence of obesity associated with increased cardiovascular risk. There is no explanation for this seemingly paradoxical phenomenon, in a population living in poor economic conditions. It is possible that in the course of the many generation-long migration from India to Europe, pregnant Romanies and their fetuses sufferred excessive nutritional deficiency. This might have induced adaptive metabolic and genetic changes aimed at optimum utilization of scarce food supply. There is a hypothetical possibility that in them "thrifty gene" was formed. Arrival of Romanies to Europe resulted in somewhat better nutrition, along with sharply reduced physical expenditure. The consequence is a metabolic syndrome with type 2 diabetes and increased cardiovascular mortality. Such unique metabolic feature in Romanies will undoubtedly stimulate further research in molecular biology that may ultimately clarify the role of "thrifty genes".

Aims: The purpose of this paper is to highlight some of the benefits and challenges when undertaking research across several countries comprising diverse ethnic, lingual and historically different communities.
Methods: Literature review and experiences of the researchers who participated in the Students' Health Inquiry, as regards the benefits and the challenges that can emerge when conducting collaborative research. The Delphi technique was employed to reach consensus on and prioritise the emerging challenges and suggested solutions.
Results: Challenges of research consortia include the preparatory work before the study, the ownership of the data and dissemination of results, as well as methodological, financial, operational, and structural challenges. These are described, each challenge is further broken down in its subcomponents, examples are given, and potential solutions are suggested.
Conclusions: If challenges can be prevented or solved, the benefits of research consortia include greater generalisability of findings, and more comprehensive understanding of the issues than would be possible with a single-site study. There is also an increased probability to bring about policy changes and programmatic adjustments. Cross-national research consortia can contribute to reduction in the inequality of resources and research opportunities in the collaborating countries. Research consortia deserve the attention of funding agencies. They are capable of bringing about synergies that result from working collaboratively together of large multi-disciplinary team of investigators who share their strengths, disciplines and expertise in order to bear on the same research issue in multiple countries and diverse populations.

This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Croatia. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) accession 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 Croatia has made good progress in adopting legislation, it needs to strengthen its efforts both in terms of enforcement and increased taxation of cigarettes.

More data regarding prevalence and correlates of active travel to school are needed from different parts of the world. The purpose of this study was to examine prevalence and correlates of active travel to school among adolescents in Cyprus. A cross-sectional study was conducted among 1966 adolescents attending grade 6, grades 7-9, grades 10-12 and technical/vocational schools in Cyprus. Overall prevalence of active travel to school was 19.4%. Parental perceptions of safe route to school, other children walking to school from the child's neighborhood and school location (urban versus rural) were associated with active travel across different levels of education. Having enough time to walk to school in the morning was the most consistent correlate of active travel. Low prevalence estimates of active traveling to school among adolescents in Cyprus raise the need to promote this source of daily physical activity.