Central European journal of public health最新文献

Objectives: Cervical cancer represents a significant public health concern worldwide, particularly among women of reproductive age. According to data from the Cancer Registry of the Republic of Serbia for the year 2022, cervical cancer is the fourth most common cancer in women, with an age-standardized incidence rate (ASIR) of 24.8/100,000 and the fourth leading cause of mortality, with an age-standardized mortality rate (ASMR) of 10.2/100,000. This study aimed to analyse the association between socio-demographic factors, unmet healthcare needs, and cervical cancer screening use among women in Serbia.

Methods: Research was conducted as a cross-sectional study on a sample of 3,980 women aged 25-64 in Serbia. Three types of questionnaires were used as a research instrument. The association of missed cervical smear tests in the last 3 years with independent variables was examined by univariate and binary logistic regression model.

Results: According to socio-demographic characteristics, the likelihood of missing a cervical smear test in the last 3 years increased with age, being highest among older women (OR = 1.91, 95% CI: 1.88-1.94), lower-income categories (OR = 1.76, 95% CI: 1.74-1.78), and women with the lowest levels of education (OR = 1.49, 95% CI: 1.47-1.52). The logistic regression model revealed significant territorial disparities, with the highest predicted probability for women from South and East Serbia (OR = 1.73, 95% CI: 1.70-1.76). Additionally, distance/transportation and financial constraints were significantly associated with missed cervical smear tests in the last 3 years (OR = 2.05, 95% CI: 1.99-2.11; OR = 1.10, 95% CI: 1.08-1.12, respectively).

Conclusions: Socioeconomic disparities in cervical cancer screening remain a challenge. This study highlights the need to allocate resources to areas in need of improvement and also to conduct comprehensive evaluations of screening systems, which can lead to significant reductions in cervical cancer incidence and mortality.

Objectives: Given the widespread use of macrolide antibiotics and growing concerns over antimicrobial resistance, this study aimed to investigate recent trends in macrolide consumption in Slovakia and to determine the corresponding changes in Streptococcus pneumoniae resistance in a paediatric cohort.

Methods: We conducted a retrospective analysis of 1,083 nasal swab cultures from children with recurrent respiratory infections and atopy, comparing two distinct 5-year periods: 2008-2012 and 2019-2023. Consumption data was based on the European Centre for Disease Prevention and Control reports.

Results: National data confirmed that Slovakia has one of the highest consumption rates of macrolides, lincosamides, and streptogramins (ATC group J01F) in Europe. The comparative analysis of patient samples revealed a statistically significant 11% increase in erythromycin-resistant S. pneumoniae (p < 0.001) and a 5% increase in clindamycin-resistant strains (p < 0.001) between the two study periods.

Conclusions: The concurrent rise in macrolide consumption and S. pneumoniae resistance in Slovakia highlights a significant public health threat. These findings underscore the urgent need for robust antibiotic stewardship programmes and the promotion of rational prescribing practices to preserve the efficacy of macrolides.

Objectives: No research among Finnish universities grouped students into clusters, based on their lifestyle behavioural risk factors (BRFs), and appraised relationships of the clusters with self-reported burdens, adjusting for confounders. The aim of the study was to undertake this task.

Methods: Students (N = 1,169) at Turku University completed online questionnaire comprising socio-demographic variables (age, sex, income, social support), 18 burdens, and 4 BRFs (smoking, alcohol, drug use, food habits). Factor analysis reduced burdens into factors; cluster analysis of BRFs categorized students into clusters. Regression models appraised associations between socio-demographics and clusters with burdens.

Results: Mean age was 23 ± 5 years, with 70.4% females, 23.4% smokers, 28.8% problematic drinkers, 21.1% illicit drug/s users, and mean dietary guideline adherence 4.84 ± 1.57 (maximum score of 8 points). Factor analysis of burdens generated four factors: 'Studies' - 3 items; 'Future' - 3 items; 'Relationships' - 7 items; and 'Needs' - 5 items. Cluster analysis produced four BRFs clusters with significantly different BRFs and socio-demographics. Cluster 1 exhibited less risk-taking behaviours, cluster 4 comprised more risk-taking, and the other two clusters fell in between. Regression showed that females were more likely to report all four burdens; higher social support was associated with less burdens generally; older age was associated with less 'Studies' + 'Future' + 'Relationships' burdens; and sufficient income was associated with less 'Studies' + 'Future' burdens. Compared to cluster 1, cluster 3 and 4 membership was more likely to feel 'Needs' burdens; cluster 2 and 3 was more likely to report 'Relationships' burdens (p-range: < 0.05 to < 0.001 for all).

Conclusion: Controlling for socio-demographics, cluster membership was more influenced by students' perceptions of 'Relationships' + 'Needs', rather than academic difficulties of 'Studies' or unsecure 'Future'. Risk taking was more likely with relationship difficulties, isolation, and day-to-day problems (housing, financial situation, health) rather than academic load or concerns for future prospects. Preventive and intervention efforts tackling students' lifestyle behaviours need to consider programmes aimed at better relationship building/maintenance to prevent isolation, while mitigating 'on-the-ground' everyday challenges that students face.

Objectives: Various tools and methods have been proposed to measure physical activity, with the International Physical Activity Questionnaire (IPAQ) being one of the most popular self-reported tools. The study's aim was to test the validity of IPAQ-SF among Greek male and female adults, aged 18-65 years.

Methods: A total of 134 adults (98 males) were randomly selected and participated in the study. The mean age of participants was 37.9 years (SD = 11.6), with 73.1% being male. Translation and back-translation was performed to ensure cultural adaptation. The validity of IPAQ-SF was ascertained using fitness measures (maximum oxygen uptake, VO2 max, velocity of VO2 max, maximum heart rate, and heartbeat at 1 min).

Results: Based on the IPAQ-SF, participants engaged in vigorous physical activity for an average of 3 days per week (mean = 68.8 minutes/day), moderate activity for 2.6 days per week (mean = 56.2 minutes/day), and walking for 3.7 days per week (mean = 24.4 minutes/day). The median total MET-minutes/week was 2,751. IPAQ-SF demonstrated moderate validity as modest positive correlations were observed between MET-minutes/week and VO2 max (rho = 0.3096, p < 0.001), and vVO2 max (rho = 0.2511, p = 0.008). IPAQ-SF demonstrated higher validity among females and individuals with BMI ≥ 25 kg/m², with correlations reaching 0.5201 (p < 0.001) for VO2 max in participants with overweight/obesity.

Conclusion: The present validation study suggests IPAQ-SF utility for monitoring physical activity levels in populations with overweight or obesity, while further refinement may be necessary to improve its applicability across all demographic groups.

Objectives: The primary aim of this study is to detect and quantify the presence of Sildenafil (SDF) and Tadalafil (TDF) in dietary supplements marketed as natural sexual enhancers in Bosnia and Herzegovina. Additionally, the study seeks to utilize these findings to inform relevant authorities, enabling further testing in reference laboratories and prompting the necessary actions to remove these adulterated products from the market.

Methods: Using high-performance liquid chromatography with diode array detection (HPLC-DAD), 20 samples were analysed for the PDE-5 inhibitors.

Results: The analysis revealed that seven of the samples contained either SDF or TDF, with mean concentrations ± standard deviation (SD) ranging from 2,075.57 ± 0.47 µg/g to 33,808.857 ± 99.43 µg/g, and TDF concentrations ranging from 24.16 ± 0.11 µg/g to 3,994.66 ± 6.95 µg/g.

Conclusion: These findings indicate a significant health risk posed by the adulteration of these products. The widespread presence of these active pharmaceutical ingredients (APIs) in products falsely labelled as natural underscores the urgent need for stringent regulatory oversight and enhanced quality control measures to protect consumer safety. This study adds to the growing body of evidence concerning the adulteration of dietary supplements and emphasizes the critical importance of regulatory compliance and monitoring in safeguarding public health.

Objectives: Instrumental work diagnostic examinations can be used for capability assessment in evaluating work suitability, job selection, complex and occupational rehabilitation, and career counselling. According to the literature, assessments performed with work simulators and the International Classification of Functioning, Disability and Health (ICF) are suitable for monitoring changes in functional capacity. We propose that instrumental work diagnostic measurements - specifically, measurements conducted on the ErgoScope work simulator - along with the ICF, can be effectively used for the objective assessment of functional capacity and tracking changes over time.

Methods: At the request of an insurance company, a targeted examination was performed using the ErgoScope work simulator to determine the extent of force exertion. The measurement plan, evaluation of results, and ICF coding were prepared based on a methodology developed in our previous research with qualified assessors.

Results: The measurement results were recorded in an examination report. The examined individual was able to complete all tasks. If there was a difference in exertion between the two hands, the right hand/arm was always weaker.

Conclusion: Based on our experience, determining ICF qualifiers requires not only measurement data but also precise, documented observations from the examiner. Our study suggests that the measurement results obtained from ErgoScope work simulator examinations, along with ICF categories assigned by qualified assessors, are suitable for tracking changes in functional capacity. This methodology supports medical professionals in insurance medicine and occupational health services in making objective, data-driven decisions.

Objectives: Screening of asymptomatic patients upon hospital admission became a key strategy to prevent nosocomial transmission of SARS-CoV-2 during the COVID-19 pandemic, particularly in facilities treating immunocompromised patients. Rapid antigen tests (RATs) were widely used due to their speed, but their reliability in detecting potentially infectious individuals remained debated. In parallel, the role of immunosuppression, especially in solid organ transplant (SOT) recipients, as a risk factor for asymptomatic positivity and prolonged viral shedding raised additional concerns. The aim of the study was to evaluate the diagnostic performance of rapid antigen testing compared to RT-PCR in asymptomatic patients admitted to a high-risk hospital, and the difference in SARS-CoV-2 PCR positivity between asymptomatic patients with and without a history of solid organ transplantation.

Methods: We retrospectively analysed 17,086 paired RAT and RT-PCR tests collected from 11,858 asymptomatic patients admitted to a tertiary care hospital between October 2020 and October 2022. Viral load was assessed via PCR cycle threshold (Ct) values. The sensitivity and specificity of RATs were calculated using PCR as the reference (Ct < 28).

Results: RATs showed a sensitivity of 83.5% and a specificity of 99.3% in detecting patients with high viral loads (Ct < 28). False negatives occurred predominantly in cases with low viral loads (Ct ≥ 28). SARS-CoV-2 PCR positivity was significantly higher in SOT patients (5.4%) than in non-transplant patients (3.2%) (p < 0.001), a difference that was consistent across viral variants.

Conclusions: RATs reliably identified the majority of asymptomatic patients with high viral loads who pose a risk of in-hospital transmission. SOT recipients represent a high-risk subgroup for asymptomatic SARS-CoV-2 carriage, underscoring the importance of rigorous admission screening protocols in specialized healthcare settings.

Objectives: This is the first study in Montenegro to assess food safety knowledge, hygiene practices, and perceived barriers among childcare centre employees (N = 972) with both direct and indirect contact with food. It aimed to identify high-risk practices through structured observation and evaluate the need for targeted educational interventions in preschool institutions in Podgorica. Two hypotheses were tested: H1: there is a difference in knowledge and practices between employees with direct and indirect food contact. H2: socio-demographic characteristics influence the knowledge and practices of employees involved in food handling.

Methods: Data were collected using a structured questionnaire and an observation checklist covering food safety knowledge, self-reported and observed practices, and perceived barriers.

Results: Food safety knowledge scores were high (mean = 84.15 ± 6.22), while observed hygiene practices were substantially lower (53.09 ± 1.71%) compared to self-reported ones (78.52 ± 1.08%), revealing a marked discrepancy between knowledge and actual practices. Statistically significant differences were found between employees based on their role (direct vs. indirect contact with food), education level, prior work experience, training frequency, and presence of the Hazard Analysis and Critical Control Points (HACCP) systems (p < 0.05 to p < 0.001). Although a weak but statistically significant correlation between knowledge and practice was identified (r = 0.16, p < 0.001), it suggests that knowledge alone does not reliably predict hygiene practices. Reported barriers included time constraints, inadequate equipment, and limited workspace.

Conclusions: The findings emphasize the need for practical, job-specific training programmes and improved working conditions to effectively translate knowledge into safe hygiene practices. This evidence supports the development of context-specific policies and interventions aimed at enhancing food safety and safeguarding children's health in preschool settings. Both study hypotheses were confirmed.

Objectives: Dietitians are well qualified to work as nutrition professionals on interprofessional healthcare teams and to provide education to health professionals at academic institutions. However, opportunities for the knowledge and utilization of dietitians in health care are different around the world. With rising global rates of nutrition-related diseases and the availability of university-based dietetic programmes, it is important to consider factors that may impact opportunities for dietitians in different countries. Thus, this study aimed to explore perceptions about the role of dietitians in medical care and medical education in the Czech Republic.

Methods: Thirty-six students and faculty members from a Czech medical school participated in semi-structured interviews focusing on the role of dietitians. Interviews were transcribed, coded, and analysed using thematic analysis.

Results: From the central theme regarding the perceived role of dietitians in medical care and education, three sub-themes emerged: limited awareness and interaction in the clinical setting; importance in interprofessional care; and essential member of the medical school faculty.

Conclusions: Participants expressed support for dietitians in interprofessional collaboration and medical education but identified that they had limited interaction clinically and a lack of awareness about their role as nutrition experts in medical care. To support dietitians' involvement in interprofessional collaboration and to combat and improve outcomes for nutrition-related diseases, additional research is needed to recognize possible barriers along with identifying and assessing strategies to increase awareness and recognition among medical students and faculty about the role of dietitians in medical care.

Objectives: The aim of the study was to evaluate the feasibility and acceptability of remote prenatal care using a smartphone application for women with low-risk pregnancies, and to compare outcomes with standard in-person care.

Methods: A prospective observational study was conducted at the Institute for Maternal and Child Care in Podolí, Prague. A total of 225 pregnant women were enrolled: 119 received combined telemedicine and standard in-person follow-ups (W-DF group), while 106 received only standard in-person care (W-PF group). Data on patient satisfaction across various domains of care were collected and analysed.

Results: Women in the W-DF group reported significantly higher satisfaction with information adequacy, confidentiality, and understanding of test results (p < 0.001). Conversely, the W-PF group showed greater satisfaction in childbirth preparedness, access to community programmes, and lifestyle guidance (p < 0.05). Overall satisfaction scores were comparable between the two groups (W-DF mean = 263.0, W-PF mean = 275.1; p = 0.263).

Conclusions: Telemedicine in prenatal care offers advantages such as reduced time and logistical burdens and improved personalization of care. However, psychosocial and lifestyle support remains stronger in traditional models. A hybrid model that integrates telemedicine with periodic in-person visits may provide more comprehensive support. Further large-scale studies are needed to optimize implementation.