Central European journal of public health最新文献

Objectives: Smoking remains a significant public health concern in Ukraine. Recent efforts to combat smoking have shown some progress, but Ukraine's current approach largely overlooks the potential benefits of harm reduction strategies. Concurrently, the use of e-cigarettes has been on the rise among Ukrainian adults. Our study aims to estimate the potential impact of e-cigarettes on reducing the mortality rate associated with cigarette smoking in Ukraine.

Methods: We conducted a replication study using a dynamic population simulation model initially developed for the US. We ran simulations for 210 e-cigarette scenarios, varying assumptions on how e-cigarettes may affect smoking behaviour and health outcomes. A sensitivity analysis was performed to test the robustness of the results.

Results: A substantial majority of e-cigarette scenarios (88.10%) resulted in positive life-years saved (LYS). The LYS ranged from -1.13 to 13.11 million, with a median of 3.17 million, accounting for 4.55% of the total life-years lost (LYL) due to smoking. Among the most plausible e-cigarette scenarios, the LYS varied from 2.73 to 4.88 million (3.92% to 6.99% of LYL due to smoking). Furthermore, these scenarios demonstrated that the long-term smoking prevalence would stabilize at around 5.56-6.40%.

Conclusions: Our simulation analysis demonstrates the potential of e-cigarettes to significantly reduce the burden of smoking in Ukraine. Most e-cigarette scenarios result in positive LYS, while scenarios with negative LYS are unlikely. These findings support the idea that the benefits of e-cigarettes outweigh potential harm, aligning with previous studies in other countries.

Objectives: The aim of the study was to evaluate widespread dietary supplements (DSs) use among the military population. There is no recent study to comprehensively evaluate the prevalence of DS use among the military population. Therefore, this systematic review and meta-analysis aimed to present an overview and estimate of the overall prevalence of DSs use among the military population.

Methods: PubMed, Scopus, Web of Science, and Google Scholar databases were searched up to September 2023 using relevant keywords. All original articles written in English evaluating the prevalence of DSs use among the military population were eligible for this study. The risk of bias assessment of the included studies was done using the Joanna Briggs Institute critical appraisal checklist. The meta-analysis was performed utilizing a random-effects model and STATA software.

Results: In total, 32 cross-sectional studies were included in this review. The prevalence rate of DS use in the overall military population was 57% (95% CI: 49-64); this rate was higher in the studies that were carried out in the USA and the studies with a sample size lower than 10,000 members. Eleven studies reported adverse effects (AEs) following DSs use in the military population, the pooled effect size of them was 13.0% (95% CI: 6-20). The most common AEs reported by military personnel were abdominal pain, nausea, vomiting, and diarrhoea, however, they did not include any serious complications.

Conclusion: The findings indicate that the prevalence of DSs use among the military personnel was high. Moreover, some studies reported AEs following DSs use such as gastrointestinal symptoms. Promotion of knowledge and informed attitudes regarding the DSs use in the military population could be useful.

Objectives: The aim of this study is to determine the incidence of Mycoplasma pneumoniae pneumonia (MPP) in children and adolescents in Prague, Czech Republic, between January and July 2024, and to compare the findings with data from the preceding period.

Methods: A retrospective analysis of data of paediatric patients at our single tertiary care facility was conducted. Two distinct patient cohorts were subjected to analysis: the first comprising individuals who had been hospitalised between January 2019 and July 2024, and the second consisting of outpatients who had been treated during the periods of January to July 2023 and January to July 2024.

Results: A 12.3-fold increase in the number of outpatients diagnosed with MPP was observed between January and July 2024 in comparison to the same period in 2023, with 111 cases reported in 2024 versus 9 cases in 2023. A total of 23 patients were hospitalised with MPP between January 2019 and July 2024, with 15 of these hospitalisations having occurred between January and July 2024. The median age was 12 years, with an age range of 1 to 17 years. The majority of cases presented with a high fever, chest pain, and required oxygen support. A failure of the clarithromycin treatment was observed, resulting in 19.48% of doxycycline prescriptions being issued due to a prior failure of clarithromycin treatment. During the monitoring period, no cases of treatment failure with doxycycline were documented.

Conclusion: The present study demonstrates an emerging trend of increased incidence of Mycoplasma pneumoniae pneumonia in the paediatric population during the initial seven months of 2024 in the Czech Republic. Doxycycline has been demonstrated to be the optimal antibiotic for the treatment of MPP and in accordance with the prevailing practice in other states it should be included in the therapeutic regimen even in children under the age of eight. The authors put forward recommendations for the implementation of measures aimed at reducing the negative impact of MPP on public health.

Objectives: Having adequate level of health literacy is a very powerful tool of improving health. "Emerging adulthood" is described as a period between age of 18-25 years, characterized by changing life circumstances, developing personality and exploring possibilities. The aim of this study was to establish the relationship between health literacy and socioeconomic status of young adults in Serbia and their individual influence on the reproductive health and sexual behaviour.

Methods: This research was conducted as observational, cross-sectional study. We used STOFHLA to assess the health literacy level of young people and general information questionnaire for demographic, social and economic characteristics of respondents, health knowledge and behaviour in the area of reproductive health. Chi-square test was performed to assess the existence of association between categorical variables using the Statistical Package for the Social Sciences (SPSS).

Results: Results of our research found significant connection between levels of health literacy and age groups, marital status, but also connection with living in rural place. Socio-demographic factors and health literacy levels had significant impact on various aspects of sexual behaviour and reproductive health knowledge.

Conclusion: The importance of this research is reflected in its contribution to a clearer understanding of the impact of health literacy and socioeconomic status on the reproductive health of young people in Serbia, with the aim of improving public policies, health interventions and educational programmes, which would contribute to reducing health inequalities, improving health outcomes, and developing targeted educational initiatives.

Objectives: The aim of this study was to examine the frequency of fatalities in injuries in traffic accidents in Montenegro, identify contributing risk factors, and determine the most vulnerable participants in these accidents.

Methods: The research was designed as a retrospective descriptive study. Participants were people admitted to the Urgent Centre of Clinical Centre of Montenegro due to injuries in traffic accidents that resulted in serious bodily injury or death in the period from 2011-2020. We presented data using descriptive statistics. The square test was used to examine the association between the outcome of traffic injury with sex, age, category of injury, type of traffic participant, and injury localisation. Additionally, we used logistic regression to estimate the best predictor value of these variables for outcome.

Results: It was found that 44.7% of injured people died, the most frequent fatal outcome was registered in patients with central nervous system injuries (73.2%), then in patients with asphyxia (47.0%), and patients with bleeding (40.5%), χ² = 27.530, p < 0.001. The most frequently injured traffic participants were drivers, but the highest number of deceased were among cyclists. Also, logistic regression showed that the category of injury was the most predictive impact on outcome in traffic-injured correspondents (p < 0.001).

Conclusion: Among the injured, the highest number are drivers, and the fatal outcome mostly depends on the injury category. Nearly half of those injured in traffic accidents die, especially those with central nervous system injuries and cyclists. Therefore, special attention should be given during public health campaigns related to traffic accident prevention, focusing on this injury and this category of traffic participants.

Objectives: This study aimed to evaluate the beliefs about third-hand tobacco smoke (THS) among administrative and academic staff at a university. THS is a residual pollutant from tobacco smoke that lingers on surfaces and poses health risks, particularly to children. The study also aimed to understand these beliefs in relation to socio-demographic factors.

Methods: A cross-sectional survey was conducted with 332 university employees aged 18 and over. Data were collected between September and December 2023 through face-to-face and online questionnaires. The survey included the Beliefs About Third-hand Smoke (BATHS-T) Scale and questions on socio-demographic characteristics, second-hand smoke exposure, and attitudes towards a smoke-free campus. Beliefs About Third-hand Smoke Scale total and sub-dimension scores increase, it is understood that the participant's belief in the negative effects of third-hand tobacco exposure on persistence and health increases.

Results: The average age of participants was 36.1 years, with 38.3% being administrative personnel and 61.7% academic personnel. About 40.5% of the participants used tobacco products. The mean total BATHS-T score was 35.6, with health and persistence subscale scores averaging 19.9 and 15.7, respectively. Non-smokers had significantly higher BATHS-T scores than smokers. The participants with children scored higher on the health sub-dimension. Additionally, 78.9% supported a smoke-free campus, and those supporting it had higher BATHS-T scores. Awareness of the harms of second-hand smoke correlated with higher BATHS-T scores.

Conclusion: The study highlights that non-smokers and those with children are more aware of THS risks. There is strong support for a smoke-free campus among university staff. The findings suggest a need for increased education on THS, especially targeted at smokers and those without children. Universities can play a crucial role in promoting smoke-free environments and raising awareness about the health risks associated with THS.

Objectives: The aim of the study was to analyse the role of conservative treatment and regional differences in 30-day hospital mortality for acute myocardial infarction (AMI) patients in the Czech Republic.

Methods: Using administrative data from Czech health insurance companies for 2018-2020, we employed a probit model to examine factors influencing mortality across 13 complex cardiovascular centres, calculating average marginal effects to ensure interpretable results.

Results: Conservative treatment was associated with a 4.7 percentage point increase in 30-day mortality compared to percutaneous coronary intervention (PCI) treatment (95% CI: 3.6-5.7). This effect varied significantly across different types of AMI and healthcare providers, with regional variations in mortality ranging from 0 to 4.3 percentage points relative to the best-performing centre.

Conclusions: Higher proportions of conservative treatment significantly contribute to increased 30-day mortality in complex cardiovascular centres. The persistent regional variations after controlling for patient characteristics suggest the need for standardized treatment protocols and improved data collection systems to reduce disparities in outcomes.

Objectives: Chronic back pain is the most common cause of incapacity for work. The purpose of the study was to determine the effectiveness for activating the function of the deep stabilization system (DSS) in patients with chronic low back pain.

Methods: The effectiveness of three different methods was compared: Pilates method (PM), dynamic neuromuscular stabilization and balance aids on deep stabilization system function and pain perception in the lumbar spine. The group consisted of 75 patients.

Results: The results show differences in the effectiveness of the methods depending on the observed characteristics. The least significant differences were observed when comparing the Pilates method to balance aids. No statistically significant difference was observed in four out of five areas. The only area where a statistically significant effect of the exercise method got recorded was the intra-abdominal pressure test (p < 0.05). The lowest change was recorded in the measured values using the intra-abdominal pressure test at PM, and the highest change was recorded in Thomayer's values at dynamic neuromuscular stabilization.

Conclusion: By comparing the three methods it was noted that each of them has its own positive reaction to the pain and the muscular apparatus. The most appropriate method to affect DSS function appears the dynamic neuromuscular stabilization (DNS) concept, where was the most significant improvement in DSS activation and the most significant reduction in chronic low back pain.

Objectives: Medical students experience worse psychological well-being than the general population. Social determinants of health (SDOH) relate to conditions in which people live, work, and age and significantly influence mental health. This study examines the association between depressive symptoms and SDOH in medical students from four countries: Czechia, Iran, Kenya, and Venezuela.

Methods: An online cross-sectional survey was conducted in the spring of 2022. The questionnaire focused on depressive symptoms (using a validated psychiatric scale DASS-21 to assess mental health) and various SDOHs.

Results: A total of 2,033 medical students participated in the survey, with a median age of 23.0 years; 64.8% were females; 60.8% of respondents had some degree of depressive symptoms (mild-to-moderate 32.5%, severe-to-extremely severe 28.3%). Several SDOHs, such as low engagement in social life, low personal funds, and low social class, were strongly associated with severe-to-extremely severe depressive symptoms (p < 0.001), and the associations differed among countries. The prevalence of severe-to-extremely severe depressive symptoms varied significantly across the four countries, with Iran having the highest prevalence (OR = 2.1 compared to Czechia), followed by Czechia (OR = 1, reference value), Kenya (OR = 0.9), and Venezuela (OR = 0.6).

Conclusion: The study demonstrates the high prevalence of depressive symptoms among medical students from four global regions and the significant association with specific SDOH. Notably, the variation in prevalence across countries and differential relationships with SDOH underscore the importance of considering transcultural factors in research and management to improve mental health among medical students.

Objective: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure.

Methods: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax.

Results: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH.

Conclusions: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.