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The aim of the present study was to examine how a personal experience of illness and a family history of cardiovascular disease (CVD), adjusted for sex, level of education and nationality, affect risk behaviour. Participants were 1,011 and 1,043, 50-year-old men and women from Sweden and Poland, respectively, who were recruited from a primary health care screening programme. Family history, personal experience of illness and risk behaviour (smoking and exercise habits, BMI level) were self-reported. The results showed that smoking behaviour was affected by a personal experience of illness but not by a family history of CVD. No effects of these variables were found on the remaining risk-related variables tested in this study. These results suggest that individuals with a personal experience of illness may be more inclined to change smoking behaviour than the average person. Smoking prevention strategies may therefore benefit from targeting this group in particular.

The aim of the study was to analyse the self-reported use of health services among the older Estonian population, to explain the predictors of health care utilisation and to study access to health services in comparison with other population groups. In November 2005, a randomly sampled Estonian residents aged 15-64 (n=1264) and 65-74 (n=182) was personally interviewed using structured questionnaires. Of the respondents aged 65-74, 81% reported having visited a general practitioner (GP) or specialist during the previous 12 months. Compared to younger people they used health services more often, except dental care. No significant differences were found in comparison with the waiting times to see the general practitioner or specialist between the younger and older population groups. Compared to the rest of the population people aged 65-74 were more satisfied with their access to health services. The probability of visiting a GP was higher for those respondents who had health problems and lived in rural areas. The presence of chronic illness also had an effect on the use of specialist services and ambulance services. Higher education, living in an urban area and having a family member with a chronic illness predicted the use of ambulance services as well. Younger age, higher income and higher education were predictors of the use of dental services. The availability of and access to health services for older people in Estonia are comparable with other groups of the population.

The aim of this 17-year Cracow (Poland) study was to examine and identify the determinants most responsible for the relationship between self-rated health and mortality in non-institutionalized elderly people. Base-line data were collected in a simple random sample of 2,605 Cracow residents, aged 65 years and over. The vital status of all individuals under study was established by monitoring city records. Death certificates were obtained for the deceased and coded according to the underlying cause of death.
Predictors related to self-rated health, developed using the results of principal component analysis, were modelled on three indexes: individual predisposition (to disease based on family history), caring about health in the past, and attitudes toward health.
Cox multivariate analysis confirmed the significant role of self-rated health in the mortality patterns of women (HR = 1.18). Those who cared greatly about health in the past had a lower mortality risk than those who cared poorly (HR = 1.19). In men, a positive attitude towards health remained an independent predictor of mortality (HR = 1.20). Multivariate regression models found self-rated health to be a significant independent predictor of mortality only in women with a low level of individual predisposition (hazard ratio for self-rated health = 1.35) and in those with a positive attitude towards health (hazard ratio for self-rated health = 1.16).

Objectives: Long-term care for people with chronic illnesses and disabilities present an urgent challenge around the world. Existing systems of care, which typically rely on unpaid family members, are not by themselves enough to meet growing demands. This analysis includes survey on the structure of services provided in selected social facilities in Slovakia.
Methods: The survey on structure of provided services includes social facilities providing services to the target groups involved in this analysis: Elderly people in retirement age; Disabled and chronically ill citizens in working age. For data collection from social facilities we used questionnaire method. The data were obtained from the managements of these facilities (n=405).
Results: In social facilities, the age range of clients was 76-85 years (31%); the length of stay of a patient in a social facility was in 36% patients 11 years and longer. The most frequently performed activities in employees were related to services and activities (31%) and social care (30%). For 52% social facilities is waiting time 1 year and longer. The length of stay of patient in social facilities is affected in 83% by combination of health and social problems and as to the diagnosis structure the most prevalent conditions are ischemic heart diseases, heart attack, hypertension (39%), locomotor disease (36%). In 2006 the budget resources of social facilities were in 72% contributions from the state budget.
Conclusion: Long-term care is closely interlinked with other programmes and systems, which can reduce the need for long-term care or which complement it.

The hepatitis C virus (HCV) is a major public health problem due to its high prevalence, high rate of onward transmission and health complications. As many as 85% of people infected with HCV may go on to become chronic carriers of the disease with the risk of developing liver cancer or cirrhosis. At present, it is the most common cause of chronic liver disease and liver transplantation in a number of countries, with an estimated 250,000 people dying annually from HCV-related causes.
Despite the magnitude of the problem, the virus does not receive adequate attention from either the general public or from health policy-makers. This study assesses HCV prevalence from both estimated totals and undiagnosed cases in selected European countries. Secondary sources were assessed and experts in 17 European countries were interviewed about HCV prevalence, reporting strategies and transmission.
Available data suggest that only between 10% and 40% of people with HCV in Europe are aware of their infection (up to 90% of the prevalent pool are undiagnosed in such countries as Germany or Poland). Though the virus affects people of all ages, races and backgrounds, in Europe, between 20% and 90% of new HCV cases have been identified among past or current injecting drug users (IDUs). It is of the utmost importance to improve both public awareness and access to early testing and counselling, with the goal of prevention of further infections, maintenance of health and provision of treatment to avoid cirrhosis and liver cancer.
Additionally, as previous studies in central and eastern Europe show, evidence-based measures to prevent and manage HCV among IDUs, where most current transmission is concentrated, remain limited. Therefore, there is a strong need for intensified advocacy to put HCV higher on both public health and harm reduction agendas.

Routine vaccination of certain groups of persons, including children and the elderly might provide additional protection to persons at risk for influenza complications and reduce the overall influenza burden.
The aim of the paper was to estimate the influenza vaccine coverage in persons aged 0-4 years and >65 years in Poland in 2004-2007. Official data collected by National Institute of Hygiene, National Institute of Public Health and Central Statistical Office were analyzed. Among vaccinations performed in all persons, the percentage of vaccinations performed in children aged 0-4 years varied from 1.6% to 2.0%. The estimated vaccination coverage in this age group of population was <2%. Among persons aged >65 years the influenza vaccine coverage increased from 7% in 2004 to 14% in 2007. Subjects aged >65 years represented 25-36% of all vaccinated individuals.
The influenza vaccination rates among age-related risk groups in Poland remain low. No or very low increase in a total vaccination coverage rates, as demonstrated in our paper, indicates that meeting the WHO targets concerning influenza vaccination coverage will be very difficult, if no further action is taken concerning vaccine uptake.

In the study the results of the relation between infant (neonatal + post-neonatal) mortality and the gynaecological and unemployment factors are presented. The findings are based on Bayesian modelling and indicate the possible influence of the unemployment situation on mortality, whereas no correlation was found as regards access to the availability of gynaecological health care. The main conclusion is that elevated unemployment which could be referred to a poor socioeconomic situation (amongst other factors) may force pregnant women to pay more attention to improving their life conditions, than to sufficient medical controlling.

The aim of this study was to examine relationship between dietary carbohydrate, glycemic index, glycemic load and gastric cancer risk. This hospital based case-control study was conducted in Niš (Serbia) between 2005 and 2006. Subjects (n=102) with histologically confirmed gastric cancer and controls (n=204) selected from non-cancer patients were interviewed. The structured questionnaire included information on socio-demographic and lifestyle habits. Data from dietary habits were based on Food Frequency Questionnaire (FFQ). We found reductions in gastric cancer risk for diets high in carbohydrate (OR for highest versus the lowest tertile = 0.07, 95% CI: 0.02-0.23) and mono- and disaccharides (OR=0.03, 95% CI: 0.01-0.09) and increased risk (OR=4.13, 95% CI:1.73-9.86) for high polysaccharide intake. Total carbohydrate intake (OR=0.17, 95% CI: 0.04-0.66) and mono- and disaccharides intake (OR=0.06, 95% CI: 0.02-0.20) was associated with a reduction in gastric cancer risk, while polysaccharide intake was associated with an increased risk (OR=4.85, 95% CI: 1.67-14.09) for the diffuse type only. In both histological subtypes, there was not significant association between glycemic index, glycemic load and the risk of gastric cancer. Our results suggest that increased intake of foods rich in carbohydrate, particularly mono- and disaccharides, as well as reduced consumption of food rich in polysaccharides, may lower the risk of diffuse type of gastric cancer. Our data do not support association between glycemic index, glycemic load and the risk of gastric cancer.

Background: The reliability of retrospective maternal self-reported information regarding smoking and alcohol drinking during pregnancy seemed necessary to be checked.
Methods: Two groups of congenital abnormalities were selected for the study from the population based Hungarian Congenital Abnormality Registry. The prevalence of smoking and drinking during the study pregnancy was measured in the mothers of 81 cases affected with isolated orofacial cleft and 537 cases with congenital limb deficiencies, and in their matched control pairs without any defect by maternal self-reported retrospective information through a mailed structured questionnaire. In the second step the latter data were checked by an independent personal interview of fathers and other family members at the home visit or in our department using the same structured questionnaire.
Results: The family consensus indicated the low reliability of retrospective maternal self-reported information concerning smoking in the mothers of cases but not in mothers of controls. However, the comparison of retrospective maternal self-reported data and information of close relatives indicated a reported bias concerning the drinking of alcohol beverages during pregnancy in both controls and cases.
Conclusions: Since retrospective maternal self-reported data had low reliability, therefore, data of smoking and alcohol drinking were not collected for the data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996.

34th Greek regimen, which was part of the NATO forces, provided medical services to the civilians of Kosovo. We studied epidemiologic data in the population of Kosovo regarding hypertension in order to determine the prevalence and characteristics of hypertension. 830 patients (281 - 33.86% male, 62± 26 yrs and 549 - 66.14% female, 49± 28 yrs) were examined for different diseases. We identified 254 (30.6%) patients with hypertension (188 female and 66 male). According to the international criteria used for the classification of the severity of hypertension, more than half of the patients (51.2%) had severe hypertension, 31.5% modest and 17.3% mild. Statistically significant relation between the severity of hypertension and age or sex was not found out. Increased BMI as well as the presence of proteinuria and rheumatic diseases were significantly related to the severity of the hypertension while the coexistent heart disease, diabetes mellitus and chronic obstructive pulmonary disease (COPD) wasn't. The use of non-steroid anti-inflammatory agents (NSAIDs) was related to the severity of hypertension with a borderline significance. 31.4% of the patients were on treatment with NSAIDs and/or cortisone because of rheumatic disease or obstructive pulmonary disease. Overfunction of the sympathetic system was present in 62.99%. The mean heart rate was greater in women (84/min) than in men (72/min). 28.35% of the patients had secondary hypertension, including the patients on a drug that can elevate the blood pressure and patients with increased activity of the sympathetic nervous system. So, 8.6% of the patients had usual causes of secondary hypertension and 19.6% hypertension secondary related to the use of NSAIDs or cortisone, or due to the increased activity of the sympathetic nervous system. Antihypertensive treatment was started in 248 patients, i.e. in all of them except the ones already on treatment having their blood pressure well controlled. For antihypertensive treatment β-blockers or central adrenergic inhibitors either as monotherapy or in combination with other agents were used most frequently combined with diuretics and Ca antagonists and ACE inhibitors. In conclusion the diagnosis and treatment of hypertension in the population of Kosovo during the post war period had certain particularities.

HIV and hepatitis C virus (HCV) monitoring among prison inmates is instrumental in countries with concentrated HIV/AIDS epidemics. Knowledge on these dynamics in imprisoned women in Portugal is scarce.
The HIV and HCV prevalence was estimated among inmates in the largest Portuguese prison for women, which holds 57% of all female inmates in Portugal, according to sociodemographic and behavioural variables and characterised attitudes towards HIV/AIDS according to serological status.
Collected variables included age, education, country of birth, penal status, and accumulated time in prison. Drug injection and sharing of injection material were inquired, as well as age at first sexual intercourse. Inmates also characterised their attitudes towards HIV/AIDS. A venous blood sample was collected and tested for anti-HIV and anti-HCV antibodies.
In this sample of 445 female inmates, 10% were HIV-positive, while 11% were HCV-positive. Longer imprisonment periods were associated with relatively higher HCV prevalence and women with later ages at first sexual intercourse were less frequently HIV-positive, regardless of drug injecting behaviour. HIV prevalence was 44% in women who had ever injected drugs and 6% in those who had never injected. HCV frequency was 69% among injecting drug users (IDUs) and 4% among non-IDUs. In women who injected drugs both HIV and HCV were more frequent when the number of injections was higher and when women reported sharing of injection material. Similar attitudes towards HIV/AIDS were found for HIV-positive and negative women, but those living with HIV had more tolerant positions.
This study emphasizes the role of injecting drug use in the transmission of HIV and HCV in women in Portuguese prisons and reinforces the need for the systematic adoption of harm reduction measures.

In recent years, tobacco use and its control have become increasingly the focus of attention of policy-makers and researchers due to ill health effects of smoking on both smokers and non-smokers. This paper contributes to a neglected research area by focusing on tobacco use and its regulation in Croatia. In particular, this study uses recent survey information to analyze the tobacco use patterns in Croatia and influence of tobacco campaigns and to compare these patterns to other EU candidate nations and the EU as a whole.
Overall the results show that in some aspects of tobacco use and regulation Croatia fares better than other European countries, while in other aspects it is somewhat lagging. For instance, on the positive side, more Croat smokers and ex-smokers were exposed to anti-smoking campaigns than smokers in other countries. However, the effectiveness of such exposure is modest in terms of the percentage of smokers who wanted to quit smoking and the relatively low share of population which claims protection from second-hand smoke. Croatia also has to further strengthen the country's compliance with international tobacco control mandates in terms of enforcement of existing tobacco consumption restrictions. Besides shedding light on the effectiveness of tobacco control policies, the findings of this study have some implications for Croatia's accession to the EU.

Various foreign bodies (FB) may be ingested. Most of them harmlessly pass through the anus but sharp or pointed ones are likely to cause complications. Although FB's ingestion is commonly seen by the emergency room personnel, a case of an ingested tongue-ring in the stomach of a female adolescent has not been reported. A 16-year-old female was referred to us for swallowing a tongue-ring while eating, a day after she had swallowed its clip. After finishing her meal, she had replaced the ingested tongue-ring with a similar one! She had a history of accidental swollowing the clip during breakfast a day before as well. She had no history of mental illness, alcohol or drug abuse. An abdominal X-ray confirmed their presence in the gastrointestinal tract. On endoscopy, an intact esophagus' mucosa, a stomach filled with food, her tongue-ring in its greater curvature and a patulous pyloric channel were observed. She was turned in the right lateral position and small amounts of water were carefully used in order to shift the food residues to the antrum. The slippery object was grasped by a biopsy forceps and it was pulled out gently. The procedure was uneventful and she was discharged home on the same day. Our case of a tongue-ring ingested by an adolescent demonstrates a troublesome and possibly dangerous consequence of certain fashion accessories' easy adoption especially by younger subjects. It does not only send a social message, but it also might represent the first example of a potentially emerging medical condition.

Introduction: Adolescents often look to mass media for information regarding issues of sexuality. As one form of media, teenage magazines have long constituted a pervasive and effective element of adolescent media exposure. Teenage magazines discuss a number of aspects concerning adolescent sexuality. Considering their potential impact on health related behaviors, the information they provide and the message(s) they send warrant attention.
Aim/Purpose: The aim of this study is to perform a content analysis of sexual development and behavior information presented in Polish teenage magazines. Social Cognitive Theory was used as a theoretical basis for this analysis.
Methods and Materials: The media chosen for this study were general-themed publications targeting an adolescent female audience: Bravo Girl!, Filipinka and Dziewczyna. Each entry was analyzed using a structured key. The specific categories of behavior and development used for this study are: biological information, pedagogic instruction, topics of moral-ethical concern, results of sexual activity, and interpersonal relationships. Each category was then subdivided into separate units.
Results: The findings indicate that Polish teenage magazines predominantly focus on relationships, contraception and sex education. Relationships were most often of a romantic nature and discussed sexual activity or the potential of sexual activity. Non-prescription contraceptive methods were most often discussed, with attention given to pregnancy prevention. Sex education offered detailed information on sexual practices and behaviors with much discussion on losing one's virginity.
Conclusions: The general approach of the analyzed magazines is that adolescents currently are, or soon will be, sexually active. As a result, certain sexual behavior and development issues are discussed in great detail, while other topics are somewhat neglected. Accepting informationseeking during adolescence as commonplace, these findings suggest that teenage magazines hold the potential for influencing adolescent sexual behavior and development.

This review article describes different forms of tobacco usage and its direct relationship with the prevalence of dental caries. Smoking along with co-existing factors like old age, bad oral hygiene habits, food habits, limited preventive dental visits and over all health standards, can be associated with high caries incidence. However, a direct etiological relationship is lacking. Environmental tobacco smoke (ETS) causes dental caries in children but no studies have been reported in adults. Existing findings are not sufficient and conclusive enough to confirm that ETS causes dental caries. Oral use of smokeless tobacco (ST), predominantly tobacco chewing, is presumably a positive contributing factor to higher incidence of dental caries. Unfortunately, published studies are not converging towards one single factor through which tobacco usage can have direct relationship to dental caries.

Background. Public health research is concerned with population health, determinants of health, health systems research, health promotion, environmental health, health protection, disease prevention and research in other fields of public health. During the last decades, non-governmental organisations (NGOs) are more often entering the field of public health research. This paper presents results of work within SPHERE (Strengthening Public Health Research in Europe), a European Commission funded study aimed to gather information and produce knowledge on the state of public health research in Europe.
Methods. A questionnaire survey was developed and conducted among NGOs enrolled in a database held by the European Public Health Alliance (EPHA). There were 80 replies, and the response rate for NGOs that were members of EPHA was 53%.
Results. There were no significant statistical differences in the responses when analysed for three European groups ['old' member states (EU 15), accession members states in 2004 (EU 10) and EU-associated countries]. The NGOs reported a relatively large international experience, expressed by participation in international public health research, and more often practice work. The main research priorities reported were general public health, environmental health, ADHD, obesity, nutrition, tobacco control. NGOs showed low correlation between their work field and their proposed public health research priorities.
Conclusion. There are growing numbers of NGOs in Europe concerned with public health. This survey indicates their interest also in public health research priorities.

We used data from a behavioural survey of Ukrainian men and women aged 14-24 to examine the relationship between nine potential risk factors and two HIV risk outcomes: non-use of condom at last sex, and multiple sexual partnerships. Younger age at first sex was positively associated with both health risk outcomes, and condom non-use at first sex was associated with subsequent non-use of condoms at last sex. There were regional differences in frequencies of both HIV risk behaviours. Compared with those who reported living in the place they were born, not living permanently at the current place of residence was associated with a fivefold increase in the odds of multiple partnership for women but not for men. Alcohol and drug use were associated with higher odds of multiple partnership and the effect was greater among women than among men. The data analysed are cross-sectional so cannot establish causality. More studies are needed to confirm these results and investigate causal relationships between the possible risk factors and the two health risk behaviours.

The aim was to study the time-of-day variations of cortisol, fatigue and sleep disturbances in sound engineers in relation to job task and shift work. The concentration of saliva cortisol and feeling of stress, sleepiness and fatigue were followed at three hour intervals in 21 sound engineers: 13 sound engineers, aged 45.1 ± 7.3 years, broadcasting in a life show during fast forward rotating shifts and 8 sound engineers, aged 47.1 ± 9.8 years, making records in a studio during fast rotating day shifts. Cortisol concentration was assessed in saliva with radioimmunological kits. The participants reported for stress symptoms during the shifts and filled sleep diary. The data were analyzed by tests of between-subjects effects (SPSS). A trend for higher cortisol was found with the group broadcasting in a life show. The sound engineers broadcasting in a life show reported higher scores of stress, sleepiness and fatigue, but no significant differences concerning the sleep disturbances between the groups were found. In conclusion our data show moderate level of stress and fatigue with the studied sound engineers, higher with the subjects broadcasting in a life show. The quality of sleep showed no significant differences between the studied groups, an indication that the sound engineers were able to tolerate the fast forward rotating shifts.

This article explores the historical development of medical sociology and analyses the social problems that have had impacted the changes of health care institutionalization particularly in Lithuania during the Soviet and post-soviet period. Approaching the interaction between sociology and public health sciences, it is intended to apply the concept of medical sociology and its determinants in the context of health care and education systems. By analyzing the case past of medical sociology in Lithuania, we claim that its prospects should be associated with the study of new challenges in the biomedical sciences. In order to improve the importance of medical sociology in developing democracies we should focus on the questions, for instance, to what extent modern biotechnologies should be applied, how to improve the situation with patients' rights, and how to combine the knowledge of social sciences and biomedicine in order to improve the quality of healthcare services and to ensure better functioning of the healthcare system in particular district.

Background: The term vulvar intraepithelial neoplasia (VIN) was introduced by the International Society for the Study of Vulvovaginal Disease (ISSVD) in 1986 and incorporates three grades of usual VIN (u-VIN I-III) and the differentiated VIN (d-VIN). While u-VIN is associated with the human papillomavirus (HPV) infection, d-VIN belongs to the HPV negative pathway of vulvar carcinogenesis. In the revised ISSVD 2004 classification, the u‑VIN I category was abandoned and u-VIN II and III were merged. Further, an alternative Bethesda-like terminology presenting the term vulvar intraepithelial lesion (VIL) was proposed. To analyze the validity of the newly introduced classifications of vulvar precancerous lesions and to assess the presumable efficacy of the prophylactic HPV vaccination, we correlated histopathological features and HPV profiles of various vulvar non-neoplastic, precancerous and neoplastic lesions.
Materials and Methods: The total of 269 vulvar excisions representing lichen sclerosus (n=35), lichen simplex chronicus (n=14), condylomata accuminata (CoA; n=57), d-VIN (n=12), all grades of u-VIN (n=82) and squamous cell carcinomas (SCC; n=69) were subjected to the HPV typing by use of GP5+/6+ PCR and reverse line blot hybridization. Detected HPV types were stratified into lowrisk (LR), high-risk (HR), probably high-risk and undetermined-risk groups. Histopathological categorization of vulvar lesions was correlated with their HPV profiles.
Results: High prevalence of HPV DNA was found in CoA (94.7%) and u-VIN (98.8%) being lower in SCCs (42%). While LR-HPV types prevailed in the HPV positive CoA (96.3%), HR-HPV types (especially HPV 16, 33 and 45) were detected in the majority of the HPV positive u-VIN (97.6%) and SCCs (93.1%). A tendency to the multiple-type HPV infection was observed in CoA (17.5%) and u-VIN II (41.7%). Importantly, our results showed differing HPV profiles, as well as the frequency of multiple-type HPV infection and the age structure in patients with u-VIN II and III. The biological heterogeneity within the u-VIN II group was also demonstrated. U-VIN I was distinguished as a rare disorder associated with HR-HPV.
Conclusions: The ISSVD 1986 terminology seems to be optimal for the classification of vulvar precancerous lesions. The spectrum of HPV types found in vulvar SCCs indicates that the efficacy of HPV vaccination in the prevention of vulvar cancer might be decreased in the studied population, because prophylactic vaccines are targeted against a limited number of HPV types.

When the HIV epidemic officially hit western Europe in the early 1980s, central and eastern Europe were almost completely spared due to the isolation of the Soviet Union. However, in the mid-1990s, reported new cases of HIV in eastern European countries began to increase exponentially. While there have been many declarations and strategies addressing HIV/AIDS, today the goal is universal access to HIV/AIDS prevention, treatment, care and support services by 2010. The articles included in this thematic issue of the Central European Journal of Public Health on HIV/AIDS reflect this, while the ten priorities listed below are immediate and sometimes innovative research needs in the context of preventing HIV among the most-at-risk populations. While by no means exhaustive, they are intended to point out gaps in existing knowledge and thus serve as inspiration for future research efforts.

National and international experts in cervical cancer prevention met at the International Workshop on Human Papillomaviruses and Consensus Recommendations for Cervical Cancer Prevention to review the current evidence and assess the potential for improvement in cervical cancer prevention and to develop plans for implementation of cervical cancer prevention programmes in Croatia. Key recommendations were developed and adopted during the course of the meeting. The process of bringing national experts together with internationally recognized experts in an open forum for the development of consensus recommendations could serve as a model for other countries seeking to implement or improve cervical cancer prevention programmes.

The steep rise in the incidence of tick-borne encephalitis (TBE) in the 1990s and its subsequent high level in the Czech Republic are not even over the whole territory. It is manifested markedly in the Czech-Moravian Highland region. In the decades of 1971 through 1992, TBE incidence in the Highland Region did not reach the countrywide average. The rise has been noted only since 1997; in the year 2006 TBE incidence in that administrative region was more than double the countrywide average. Analysis of the situation have not found any socio-economic shifts or land-use changes, or in the numbers of game animals, that could have had an effect on TBE incidence. The rise of infections in localities 500 m above sea level (a.s.l.) and more was markedly steeper than that below that altitudinal limit. At those altitudes there has been found an increase in average monthly temperatures exceeding countrywide averages namely in the period of maximum Ixodes ricinus activity (May-August). Detailed analysis of meteorological conditions and comparison with a long-term study of the influence of modifications of the mountain climate in the Krkonoše Mts. on I. ricinus tick distribution and the pathogens transmitted by them, have led to the conclusion that likewise in the Czech-Moravian Highland a marked warming had influenced the local population of the vector I. ricinus, caused an activation of foci of TBE, increased contacts of humans with the vector, consequently giving rise to an apparent increase in the incidence of human cases of TBE.

The article will briefly explain the processes of organized screening in the NHS Cervical Screening Programme (NHSCP). Quality control is well established and monitored by regional quality assurance reference centres. The final outcome of screening is also monitored by national cervical cancer mortality and incidence rates: data will be presented for rates of in situ and invasive cervical carcinoma before and after the introduction of organized screening. The NHSCSP is using the introduction of liquid-based cytology as a platform for modernization, which is planned to include high-risk human papillomavirus (HR HPV) testing for low-grade cytology triage as well as a test of cure after treatment. Trials of computer-assisted screening are also in progress. High standards of quality control will be needed in the era of vaccination, when prevalence of preinvasive and invasive cervical cancer will decline. The NHSCSP is well placed to take on these challenges, if necessary by introducing primary HR HPV testing so that cytology screening can be concentrated on women who are genuinely at risk.

Objectives: The aim of this study was to explore the influence of sick leave frequency determinants on in terms of age and profession homogeneous groups in two socio-economically comparable, but socio-culturally different regions in the Netherlands, i.e. Utrecht (mean frequency 1.10 spells) and South Limburg (mean frequency 1.92 spells). In addition, to get an idea of the study's topical interest, a literature review on sick leave frequency determinants covering the past few decades was performed.
Material and methods: 184 participants in the Utrecht and South Limburg regions were interviewed on work, individual and health characteristics. Sick leave frequency data were obtained from a social fund. For the literature review (inter)national scientific journals, academic theses and Medline were consulted.
Results: A comparison of sick leave frequency in the two regions showed that, in South Limburg, the determinants called 'opinion on socialmedical support during sick leave', 'type of appointment' and 'annual number of visits (family doctor)' were associated with sick leave frequency whereas this was not the case in Utrecht. The literature review presented a highly consistent picture of determinants of sick leave frequency over the last few decades.
Conclusions: In the two regions studied, different determinants appeared to be associated with sick leave frequency. This phenomenon is attributed to the different socio-cultural characters of the regions. As per region different determinants appeared to be associated with sick leave frequency, nationwide interventions to reduce sick leave frequency should take into account the potential influence of regional differences in determinants that predict sick leave frequency. Sick leave frequency determinants have not changed in the past few decades. Although the study was performed in the nineties, its results are still relevant.