Central European journal of public health最新文献

Objective: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged.

Methods: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively.

Results: Of the patients, 121 (58.5%) were male. Mean age was 80.36 ± 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barré syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples.

Conclusion: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.

Objective: The main objective is to confirm a hypothesis that atherosclerosis, through various mechanisms, considerably influences cognitive impairment and significantly increases the risk for developing dementia. Complete sample should be 920 individuals. The present study aimed to analyse epidemiological data from a questionnaire survey.

Methods: The work was carried out in the form of an epidemiological case control study. Subjects are enrolled in the study based on results of the following examinations carried out in neurology departments and outpatient centres during the project NU20-09-00119 from 2020 to 2023. Respondents were divided into four research groups according to the results of clinical examination for the presence of atherosclerosis and dementia. The survey was mainly concerned with risk factors for both atherosclerosis and dementia. It contained questions on lifestyle factors, cardiovascular risk factors, leisure activities, and hobbies.

Results: Analysis of the as yet incomplete sample of 877 subjects has yielded the following selected results: on average, 16% of subjects without dementia had primary education while the proportion was 45.2% in the group with both dementia and atherosclerosis. Subjects with dementia did mainly physical work. Low physical activity was more frequently noted in dementia groups (Group 2 - 54.4% and Group 3 - 47.2%) than in subjects without dementia (Group 1 - 19.6% and Group 4 - 25.8%). Coronary heart disease was more frequently reported by dementia patients (33.95%) than those without dementia (16.05%).

Conclusion: Cognitively impaired individuals, in particular those with vascular cognitive impairment, have poorer quality of life and shorter survival. Risk factors contributing to such impairment are similar to those for ischaemic or haemorrhagic stroke. It may be concluded that most of the analysed risk factors play a role in the development of both atherosclerosis and dementia.

Objective: Medical students usually do not meet the recommendations on the minimum level of physical activity, despite knowing the impact that physical activity has on the prevention and treatment of various diseases. Medical students are considered to be insufficiently physically active. The aim of this study is to determine the prevalence of physically active fifth-year medical students at five universities in Serbia, as well as to identify factors associated with insufficient physical activity of students.

Methods: A cross-sectional study was performed in the population of fifth-year medical students from five different universities in Serbia. The research instrument was a questionnaire specially designed based on similar research. Descriptive and analytical statistics methods were used in statistical analysis.

Results: The study included a total of 573 fifth-year medical students from five universities in Serbia: 311 (54.3%) Belgrade; 86 (15.0%) Kragujevac; 58 (10.1%) Nis; 66 (11.5%) Kosovska Mitrovica; 52 (9.1%) Novi Sad. Insufficient physical activity was statistically significantly associated with studying at the University of Kosovska Mitrovica (OR = 3.98, 95% CI: 1.83-8.57). There was a statistically significant difference in the frequency of anti-anxiety medications use in the last 12 months between students with sufficient and insufficient physical activity (p = 0.040) as well as in the average number of cigarettes smoked per day between students with sufficient and those with insufficient physical activity (2.82 ± 6.35 vs. 4.50 ± 8.29, p = 0.043). There was also a statistically significant difference in the average score on the Beck's depression scale between students with sufficient and students with insufficient physical activity (6.51 ± 6.59 vs. 10.03 ± 9.37, p < 0.001) and in the average score on Zung's anxiety scale (34.86 ± 8.18 vs. 38.07 ± 8.71, p = 0.003).

Conclusion: A high percentage of medical faculty students (86.6%) are physically active. Differences in the level of physical activity were observed between students of these five universities as well as between students with different levels of physical activity.

Objective: Cardiovascular diseases are the leading global cause of death. Due to the disparities in cardiovascular risk factors between rural and urban populations, this study aims to assess the differences in the prevalence of risk factors in urban and rural areas of eastern Croatia.

Methods: The cross-sectional study included 280 participants (140 from urban and 140 from rural areas) registered at studied general practice offices. Methods included e-health records, questionnaire, physical examination methods, and blood sampling for laboratory tests.

Results: The most common risk factors among participants were elevated total cholesterol (83.6%), elevated LDL cholesterol (81.8%), increased body mass index (75.0%), increased waist-hip ratio (82.9%), increased waist circumference (63.2%), and arterial hypertension (70.1%). The rural participants had a significantly higher prevalence of arterial hypertension (p = 0.023), increased body mass index (p = 0.004), increased waist circumference (p = 0.004), increased waist-hip ratio (p < 0.001), and increased LDL cholesterol (p = 0.029), while the urban participants had a significantly higher prevalence of insufficient physical activity (p < 0.001).

Conclusions: In the examined sample, the prevalence of cardiovascular risk factors is generally high. Participants from rural areas are significantly more susceptible to cardiovascular risk factors than participants from urban areas.

Objective: This article briefly summarizes the results of existing research on metabolically healthy obesity in the context of health risks.

Methods: The PubMed database was searched for relevant meta-analyses addressing metabolically healthy obesity in the context of health risks.

Results: We included a total of 17 relevant meta-analyses in this review. The results of the studied meta-analyses showed that metabolically healthy obesity may be only a transient condition associated with an increased risk of developing metabolic abnormalities in the future. People with obesity without metabolic abnormalities have an increased risk of type 2 diabetes, cardiovascular disease, cancer, chronic kidney disease, and depressive syndrome. In addition, all people with obesity are at risk of pathogenesis resulting from the mechanical stress caused by presence of abnormal adipose tissue, such as sleep apnoea syndrome or skin problems.

Conclusion: Based on the results of meta-analyses, we recommend motivating all obese patients to change their lifestyle regardless of the presence of metabolic defects.

Introduction: The global burden of chronic diseases, including cardiovascular disease, remains a significant public health challenge. The Life's Simple 7 (LS7) score was developed as a tool to evaluate cardiovascular health behaviours and habits and identify high-risk individuals. The present study aimed to assess the distribution of LS7 scores among educational strata.

Methods: The study population consisted of 3,383 asymptomatic individuals screened for colorectal cancer at a single centre in Austria. We split patients into lower (n = 1,055), medium (n = 1,997), and higher (n = 331) education, based on the International Standard Classification of Education (ISCED). Cox regression models were utilized to determine the association between education and mortality over a median follow-up period of 7 years.

Results: Individuals with higher educational status had a significantly higher prevalence of ideal cardiovascular health metrics, as defined by the LS7 score, compared to those with medium and lower educational status: n = 94 (28%) vs. n = 347 (17%) and n = 84 (8%), respectively, (p < 0.001). In the Cox regression analysis, both medium (HR = 0.61, 95% CI: 0.43-0.84, p < 0.001) and higher educational status (HR = 0.44, 95% CI: 0.19-1.01, p = 0.06) were associated with all-cause mortality, as was the LS7.

Conclusion: Our findings highlight a significant association between lower educational status and poorer cardiovascular health, as assessed by LS7, which persisted even after multivariable adjustment. Additionally, both educational status and LS7 were associated with increased mortality, underscoring the significance of our results. These findings have important implications for public health, as screening and prevention strategies may need to be tailored to meet the diverse educational backgrounds of individuals, given the higher prevalence of unhealthy lifestyle behaviours among those with lower educational status.

Objective: The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019.

Methods: А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted.

Results: The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period.

Conclusion: Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

Objective: Trace elements are essential for the biochemistry of the cell. Their reference values have been found to differ considerably in pregnant women stratified by age, place of residence, anthropometric status, and length of pregnancy. In optimal amounts, these elements reduce the risk of pregnancy complications. Subclinical hypothyroidism in pregnancy is associated with adverse maternal and neonatal outcomes. The aim of the study was to determine the effects of zinc (Zn), copper (Cu), magnesium (Mg), and rubidium (Rb) on pregnant women in an iodine deficiency region and find the relationship with the thyroid status and nutrition.

Methods: We evaluated the iodine status of 61 healthy pregnant women from an iodine deficient region in Bulgaria. Thyroid stimulating hormone (TSH) and thyroxin free (FT4) levels were measured using ELISA.

Results: We found elevated levels of copper that differed the most between the first and second trimesters; Cu and TSH were found to be positively correlated (р < 0.05). Lower Cu levels were found in pregnant women consuming pulses more than 2-3 times a week (р = 0.033). The women consuming fish more than 2-3 times a week had higher levels of Rb. We found a pronounced iodine deficiency in more than half of the examined women in the first to third trimesters, without any effect of pregnancy on the ioduria (р=0.834). All second and third trimester cases were associated with severe ioduria (< 150 µg/L).

Conclusion: The high Cu levels were associated with subclinical hypothyroidism (SCH) and less pulse consumption during pregnancy in an iodine deficiency endemic area. SCH was found in 24% of the pregnant women in such an area while in 13% of them SCH had progressed to overt hypothyroidism.

Objectives: The purpose of this quantitative study is to assess the impact of fine particles air pollution in major cities of Slovakia. The study aims to estimate number of premature deaths from long-term exposure to fine particles PM_2.5 in eight regional capitals of Slovakia in the period 2016-2020. Consequently, the study aims to conduct a comparative analysis using secondary derived indicators.

Methods: For calculations of estimated premature deaths from long-term exposure to fine particles PM_2.5 air pollution we used standardized methodology developed by the World Health Organization and the European Environment Agency.

Results: The annual average of estimated premature deaths from PM_2.5 air pollution in the studied period was in Bratislava 353, Košice 219, Prešov 84, Žilina 90, Banská Bystrica 76, Nitra 73, Trnava 59, and Trenčín 52. In relative terms per 1,000 inhabitants Bratislava had annual average 1.14 of estimated premature deaths, Košice 1.32, Prešov 1.38, Žilina 1.61, Banská Bystrica 1.35, Nitra 1.35, Trnava 1.27, and Trenčín 1.31. Bratislava as the largest city in Slovakia recorded the smallest relative number of estimated premature deaths. The worst results were recorded by the city of Žilina.

Conclusions: The estimated number of premature deaths from long-term exposure to particulate matter air pollution in the regional capitals decreased in the given period. The most of the regional capitals with the exception of Bratislava and Žilina, showed similar levels of estimated premature deaths. However, the current geopolitical situation and rising energy prices threaten return to solid fuel burning which is the largest source of particulate matter air pollution in Slovakia and thus reversing positive trends.

Last time the world faced a deadly pandemic was the H1N1 Spanish flu in 1918, which affected almost one-third of the world's population (500 million people). Since then, almost 100 years later, we are now facing another pandemic of the SARS-CoV2 virus (COVID-19), which is still endemic to this day. As the technology evolved during those 100 years, an effective vaccine for COVID-19 was produced within only a year, a huge feat. But, unfortunately, due to its fast development, another force would arise limiting the impact of the vaccine: vaccine hesitancy and anti-vaxxers, which John Hopkins and the World Health Organization call the biggest current threat to global health. From politics to social media, it is clear that there has been a rapid spread of misinformation, resulting in hesitancy, especially from sociopolitically motivated people popularly referred to as anti-vaxxers. However, a second group of vaccine-hesitant people have also emerged, who are uneducated and remain undecided about vaccination mostly due to safety concerns. They come under the massive influence of anti-vaxxers and anti-vaccine propaganda through social media and politicians, which often make bold claims and huge headlines. To combat vaccine hesitancy, it is crucial that we debunk these conspiracy theories and misinformation that so many believe in, with factual, data-based information. Actively spreading correct information about the vaccines, such as disclosing the rigorous developmental processes and validation of safety data by the Food and Drug Administration (FDA), assurance for the unlikeliness of getting a lethal side effect along with tremendous health benefits, will encourage people for safe vaccination against COVID-19 and other potential infectious diseases in the future. This article discusses the role of anti-vaxxers and vaccine-hesitant groups, electronic social media, and politics in vaccine hesitancy among people. It describes the strategies to combat the roadblocks in the vaccination programmes and health benefits, offered by recent advances in scientific and technological developments.