Mental Health Burden of the Russian-Ukrainian War 2022 (RUW-22): Anxiety and Depression Levels among Young Adults in Central Europe

Armed conflicts are public health emergencies that affect human lives at multiple levels. The mental health of adolescents and young adults is at high risk during crisis settings; therefore, this cross-sectional survey-based study aimed to evaluate anxiety and depressive symptoms among university students in the Czech Republic following the Russian-Ukrainian war of 2022 (RUW-22). The study used standardized screening instruments; the Generalized Anxiety Disorder (GAD-7) for anxiety and the Patient Health Questionnaire (PHQ-9) for depression. Of 591 students who participated in this study, 67.7% were females, 68.2% held Czech citizenship, and 63.8% were enrolled in medical or healthcare programs. The participants were highly concerned about the RUW-22 news, with a mean score of 7.17 ± 2.50 (0–10). While 34% and 40.7% of the participants in this study manifested moderate to severe levels of anxiety and depression, respectively, the mental health burden of the RUW-22 was confirmed by the positive correlation between “feeling concerned”, GAD-7 (ρ = 0.454), and PHQ-9 (ρ = 0.326). Female gender, higher frequency of news following, and social media use were associated with higher levels of anxiety and depressive symptoms; thus, proposing them to be risk factors for psychological disorders following the RUW-22.

Generational differences in selected aspects of social situation and health status of foreigners living in the Czech Republic

OBJECTIVES

Demographic differentiation caused by the history of migration in the Czech and Slovak Republics led the authors of this article to analyse generational differences in the groups of foreigners living in the Czech Republic (CR) and the impact of generational differences on selected aspects of their social situation and perceived health. The crucial research question was whether and to what degree do different generations of foreigners vary from each other and what impact this has had on their social situation and health determinants.

METHODS

The main goal was to examine mutual relationships between selected characteristics of social situation and health determinants in various groups of foreigners living in the CR. A total of 1,003 questionnaires among foreigners officially living in the Czech Republic were collected and analysed. In the area of subjective perception of health, a comparison of foreigners with Czech citizens (representative sample of Czech seniors; 1,172 respondents) in the age category 65+ was made in order to find out whether this perception differs between senior foreign nationals and senior Czechs.

RESULTS

Older individuals (50-64 years and 65+ years) appeared to have the best integration into Czech society. This age generation felt positive about stay and migration status in the CR. Older foreigners differ from older Czech citizens who tend to refer to their health as very good to rather good compared to foreigners who described their health as neither good nor bad. The middle generation (30-49 years) of foreigners was characterized by hard work and the initial stages of integration into Czech society. This group also reported positive feelings about living in the CR relative to their home country.

CONCLUSION

The oldest generation of foreigners is the best integrated in the Czech Republic (with regard to selected aspects tested in this article). This generation is able to offer new immigrant effective integration strategies. However, they assess their subjective health one degree worse in comparison with Czech seniors (representative sample), this finding should lead to the setting of preventive programmes related to a healthy lifestyle, including lifestyle for foreigners living in the Czech Republic.

Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF

OBJECTIVE

Achieving targeted disease activity (DA) is the primary therapeutic strategy in RA. Point measurements of DA are done at out-patient visits, however true DA between visits remains unobserved. This study sought to describe and validate a new outcome measure, i.e. time in remission (TIR).

METHODS

Patients were enrolled in the Czech ATTRA-RA registry. TIR was calculated using linear interpolation of the DAS28-ESR determined at outpatient visits. Correlation coefficients were computed between TIR and DAS28-CRP, HAQ, Simple Disease Activity Index (SDAI), patient global assessment (PGA) and physician global assessment (PhGA). Using logistic regression, TIR was used as a predictor of remission (SDAI ≤3.3) and non-disability (HAQ <0.5). The predictive value of TIR was compared with point and sustained remission using the cross-validated area under receiver-operating curves.

RESULTS

Since 2010, 2618 RA patients started anti-TNF therapy and were followed until 2020 or until treatment discontinuation. During the first 6 months of therapy, 56% of patients had no remission (TIR = 0), and 22% of patients reached sustained remission (TIR = 1), while 22% of patients had point remissions with 0 < TIR < 1. EULAR good responders and moderate/non-responders spent 64 ± 42% and 6 ± 18% of time in remission, respectively. The mean TIR grew during the follow-up and was correlated with DAS28-CRP, SDAI, HAQ, PGA, and PhGA (P < 0.0001). TIR at 3 and 6 months predicted remission (SDAI ≤3.3) and non-disability (HAQ <0.5) at 13 and 19 months better than point or sustained remission.

CONCLUSIONS

TIR is an intuitive way of estimating unobserved DA between scheduled visits; its calculation only requires two consecutive DA values (https://www.medevio.cz/tir-calculator/). TIR is a valid predictor of RA outcomes.

Redescription of Diastolaimus grossus (Truskova & Eroshenko, 1977) Andrássy, 1984 (Rhabditida, Chambersiellidae) from Europe and comments on its phylogenetic position

Two populations of the species Diastolaimus grossus have been obtained from bark of trees in Bosnia and Herzegovina and the Czech Republic. The species is described and characterized in detail using morphological techniques (light and electron scanning microscopy) and morphometrical (Gower General Similarity coefficient of morphological characters) and molecular analyses, including phylogenetic analysis of all related and already sequenced species of the family Chambersiellidae. Morphological and molecular analyses, based on 18S and 28S ribosomal DNA sequences, show that the family Chambersiellidae is polyphyletic, being the subfamily Chambersiellinae related with Cephalobomorpha and Tylenchomorpha, and the subfamily Macrolaiminae is located into Panagrolaimomorpha. The genus Diastolaimus, previously belonging to Macrolaiminae, is transferred to Chambersiellinae. Diastolaimus mexicanus is proposed as a junior synonym of D. grossus.

The first Czech perinatal hospice: Joint venture or competitive field?

There is no legally established perinatal hospice in the Czech Republic. Several initiatives work towards launching an institution to support parents in the event of a fatal prenatal diagnosis or life-limiting condition in their unborn baby. Parents use the label perinatal hospice as they subvert and transform the narrow legal and strictly medical framework for such institutions. Hospice care became a legitimate sector of care provision only recently. This study analyses four initiatives that strive to establish and formalise perinatal hospices in the Czech Republic, with a focus on the strategies these initiatives engage in to achieve change. A sociological qualitative empirical study (2017-2019) informs the findings. Initiatives vary in approach from cooperation to competition in being recognised as 'the first perinatal hospice'. The study shows how such rhetoric is adopted to attract the funding required for sustainability. Community cooperation and involvement can, then, form a contra position.

The distribution of Dermacentor reticulatus in the Czech Republic re-assessed: citizen science approach to understanding the current distribution of the Babesia canis vector

Background

The range of the ornate dog tick Dermacentorreticulatus is rapidly expanding in Europe. This tick species is the vector of canine babesiosis, caused by Babesiacanis, and also plays a role in the transmission of Theileriaequi and Babesiacaballi in equids.

Methods

The geographic range of D.reticulatus in the Czech Republic was re-assessed, and an up-to-date distribution map is presented based on material and data obtained during a nationwide citizen science campaign. Received and flagged individuals of D.reticulatus were also analysed for the presence of B.canis DNA.

Results

In striking contrast to historical records, D.reticulatus was found in all regions of the Czech Republic, with most reports coming from the southeast and northwest of the country. Between February 2018 and June 2021, the project team received 558 photo reports of ticks and 250 packages containing ticks. Of the former, 71.1% were identified as Dermacentor sp. with the remainder identified as Ixodes sp., Haemaphysalis sp., Argas sp. or Hyalomma sp. The majority of specimens in the subset of ticks that were received (N = 610) were D.reticulatus (N = 568, 93.7%), followed by Ixodesricinus and Hyalomma spp. A total of 783 adult D.reticulatus, either received (568) or collected by flagging (215), were tested for the presence of B.canis DNA using species-specific nested PCR targeting part of the 18S rRNA gene; B.canis DNA was demonstrated in 22 samples (2.81%).

Conclusions

The continuous spread of D.reticulatus in the Czech Republic was documented in this study. In addition, DNA of B.canis was also detected in a number of ticks, suggesting the establishment of B.canis in the Czech Republic. These results suggest that veterinarians need to consider the possibility of canine babesiosis even in dogs without a history of travel.

Graphical Abstract

Analysis of drug-related infectious diseases in people who inject drugs - Pilsen Region, 2003-2018

OBJECTIVES

The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic.

METHODS

In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective.

RESULTS

In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine.

CONCLUSIONS

This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.

Czech and Slovak Dental Students' Oral Health-Related Knowledge, Attitudes, and Behaviours (KAB): Multi-Country Cross-Sectional Study

Dentists play a key role in the primary prevention of oral diseases and related systemic complications; therefore, their views on behavioural interventions need to be aligned with the current agendas for oral health. Likewise, dental students' oral health-related knowledge, attitudes, and behaviours (KAB) are of practical importance, as they are the future opinion leaders for oral health in their respective communities. A cross-sectional survey-based study was designed to evaluate the oral health KAB of dental students in both the Czech Republic and Slovakia. The study utilized translated versions of the Hiroshima University Dental Behavioural Inventory (HU-DBI), and it aimed to recruit students from all Czech and Slovak dental schools. A total of 487 students were included in this study, out of which 372 (76.4%) were females, 271 (55.6%) were enrolled in preclinical years, 68 (14%) reported smoking tobacco at least once a week, and 430 (88.3%) reported problematic internet use. The mean HU-DBI score of Czech and Slovak dental students (8.18 ± 1.80) was comparable with the previously reported scores of dental students in Nordic and Western European countries. Czech students (9.34 ± 1.29) had a significantly higher score than their Slovak counterparts (7.56 ± 1.73). In both countries, preclinical students (8.04 vs. 8.35), the students who reported tobacco smoking (7.63 vs. 8.27), and those who reported problematic internet use (8.11 vs. 8.70) had significantly lower HU-DBI scores than their counterparts, respectively. In the Czech Republic, the significant increases in HU-DBI scores occurred after the first academic year when the students received preventive dentistry courses; therefore, one can put forward that early implementation of preventive elements in undergraduate dental curricula may yield better and more sustainable oral health gains for the students. Future research on Czech and Slovak dental curricula need to re-evaluate the oral hygiene and anti-smoking components and their impact on students' views and attitudes.

Forest Attendance in the Times of COVID-19-A Case Study on the Example of the Czech Republic

The COVID-19 pandemic affected people all over the world, including the Czech Republic (CZ). In the CZ, a number of measures were applied in 2020 to reduce the contact between people and their mobility. This article dealt with the importance of forests during the pandemic. Data from 2019 and 2020 were compared. The qualitative data were obtained from two nationwide surveys, the first focused on forest attendance and forest fruit collection (about 1000 respondents per year), the second on the motivation to visit the forests (about 3700 respondents per year). The quantitative data were obtained on the regional level by analysing data from mobility counters. The impact of government restrictions was assessed. Findings: (1) there was a significant increase in the number of people who frequently visited the forest in 2020; (2) in 2020, the amount of households that collected forest fruits increased and was the highest for the monitored period; (3) the increased forest attendance significantly corresponded to the government restrictions. The analysis confirmed the great importance of forests for the citizens and, at the same time, the increased pressure on the forests’ use—forest attendance and forest crops picking—(especially suburban ones) in times of COVID-19 restrictions.

Control Centre for Intensive Care as a Tool for Effective Coordination, Real-Time Monitoring, and Strategic Planning During the COVID-19 Pandemic

In the Czech Republic, the strategic data-based and organizational support for individual regions and for providers of acute care at the nationwide level is coordinated by the Ministry of Health. At the beginning of the COVID-19 pandemic, the country needed to very quickly implement a system for the monitoring, reporting, and overall management of hospital capacities. The aim of this viewpoint is to describe the purpose and basic functions of a web-based application named "Control Centre for Intensive Care," which was developed and made available to meet the needs of systematic online technical support for the management of intensive inpatient care across the Czech Republic during the first wave of the pandemic in spring 2020. Two tools of key importance are described in the context of national methodology: one module for regular online updates and overall monitoring of currently free capacities of intensive care in real time, and a second module for online entering and overall record-keeping of requirements on medications for COVID-19 patients. A total of 134 intensive care providers and 927 users from hospitals across all 14 regions of the Czech Republic were registered in the central Control Centre for Intensive Care database as of March 31, 2021. This web-based application enabled continuous monitoring and decision-making during the mass surge of critical care from autumn 2020 to spring 2021. The Control Center for Intensive Care has become an indispensable part of a set of online tools that are employed on a regular basis for crisis management at the time of the COVID-19 pandemic.

Impact of the COVID-19 Pandemic on Construction Companies in the Czech Republic

The global COVID-19 pandemic has been a part of our lives for the second year in a row and it has affected the activities of all economic entities across individual fields and industries. This article deals with research into the impact of the COVID-19 pandemic on construction companies in the Czech Republic. The research presented in this paper consists of several consecutive steps: designing a research plan, performing data collection and analysis and compiling research results. Qualitative approaches to data collection and evaluation, especially in-depth interviews and the coding method, were used for contextual understanding and comprehension of the situation in the companies under research. Open questions (topics) related to the respondents’ experience, perceptions and opinions were created as a part of the preparation process. The aim was to obtain reliable and relevant answers to the questions asked. The research, which lasted for 5 months, involved 16 medium-scale and large companies from the Czech Republic. The aim of the research described in this article was to find out about the development of construction companies in the first half of 2021 and to specify their results in selected areas of activity.

Remediation of the uranium industry in the Czech Republic: regulation aspects and main technologies

There is a long history of uranium mining and milling in what is now the Czech Republic, with the main exploitation beginning in the second half of the 19th century. The greatest expansion was during the Cold War, which was then reduced after political changes in eastern Europe in the 1990s. Thereafter, almost all uranium work was stopped, the mines and mills were closed, and plans for decommissioning and remediation of sites and facilities were initiated. The paper describes the application of the regulatory framework for the decommissioning and remediation of the uranium waste sites and facilities in the Czech Republic, illustrated by examples of deep and surface mining,in-situleaching sites, and ore processing facilities. It builds on information provided as a case study for the Nuclear Energy Agency's Expert Group on Legacy Management. Some practical experience and lessons learned are presented. The sharing of the lessons and experience is noted as an important mechanism for avoiding the creation of future legacies.

Microbial Contamination of Photographic and Cinematographic Materials in Archival Funds in the Czech Republic

In this study we investigated the microbial contamination of 126 samples of photographic and cinematographic materials from 10 archival funds in the Czech Republic. Microorganisms were isolated from the light-sensitive layer by swabbing it with a polyurethane sponge. Microbial isolates were identified by MALDI-TOF MS (bacteria) or by phenotype testing and microscopy (fungi). Bacterial contamination was more abundant and more diverse than fungal contamination, and both were significantly associated with archives. The most frequently isolated fungal genera were Cladosporium, Eurotium, Penicillium, Aspergillus and Alternaria. The most frequently isolated bacteria were Gram-positive genera such as Staphylococcus, Micrococcus, Kocuria, Streptococcus and Bacillus. This bacterial and fungal diversity suggests that air is the main vehicle of contamination. We also analysed the impact of the type of material used for the carrier (paper, baryta paper, cellulose acetate and nitrate or glass) or the light-sensitive layer (albumen, gelatine, collodion and other) on the level and diversity of microbial contamination. Carriers such as polyester and cellulose nitrate may have a negative impact on bacterial contamination, while paper and baryta paper may have a partially positive impact on both fungal and bacterial contamination.

Hepatitis E - epidemiology and clinical course in the largest cohort in the Czech Republic

INTRODUCTION

The majority of hepatitis E (HE) reports come from Western Europe. The aim of the study was to describe the typical epidemiological and clinical characteristics of HE in the Czech Republic.

METHODS

A retrospective analysis of 173 patients with HE.

RESULTS

At least 90% of cases were autochthonous (HEV-3 genotype). Seventeen patients were treated with ribavirin. Five underwent liver transplants because of fulminant HE. We noted neurological symptomatology in 9 cases. Six patients developed chronic HE.

CONCLUSIONS

There is a possibility of severe health complications caused by the hepatitis E virus in the Czech Republic.

Incidence of tuberculosis among HIV-positive persons in the Czech Republic between 2000 and 2020

AIM

The aim is to characterize in more detail the group of HIV-positive persons in the Czech Republic diagnosed with tuberculosis (TB) in 2000-2020.

MATERIAL AND METHODS

Data sources were mainly the national online TB register (RTBC), which is part of the information system of the Public Health Service, and the national electronic register of HIV-positive persons (RHIV) maintained by the National Reference Laboratory for HIV/AIDS of the National Institute of Public Health.

RESULTS

Of 3,763 TB cases reported to the RHIV since 1985 and 16,212 TB cases reported to the RTBC since 2000, 91 occurred in 88 HIV-positive persons (69 males and 22 females) between 2000 and 2020. Sixty-five (74%) of the 88 HIV-positive persons were foreign born. Twenty-six per cent of TB cases were screened for HIV. The mean age of patients with TB/HIV coinfection was 35 years. The largest number of coinfected persons (35 cases) were from the capital city of Prague. Pulmonary TB was detected in 84 cases. Ninety-two per cent of the TB cases were bacteriologically confirmed, and 10 cases were multidrug-resistant TB. At the time of TB diagnosis, the median CD4+ lymphocyte count was 91.5 cells per mm3 of blood. TB was the most common reason for HIV testing in the analysed cohort (23 cases). The most common mode of HIV transmission was sexual intercourse (heterosexual in 39 cases and homosexual in 13 cases). Treatment success at 12-month follow-up was only recorded in 32% of cases of culture-positive pulmonary TB in HIV-positive patients.

CONCLUSIONS

TB/HIV co-infection remains a serious health concern, especially in the foreign-born residents of the Czech Republic. Of foreign-born persons with TB, 42% were tested for HIV over the 21-year study period, with their percentage increasing over the years. Almost 6% of them tested HIV positive. The most relevant finding is that treatment success was only recorded for less than one third of HIV-positive persons with culture-positive pulmonary TB and that every fourth patient with TB/HIV died before or during TB treatment.

Overview of basic epidemiological characteristics and descriptive analysis of the incidence of human yersiniosis in the Czech Republic in 2018-2020

OBJECTIVE

The aim was to provide an overview of the basic epidemiological characteristics of human yersiniosis and to analyze the reported epidemiological data on the incidence of this disease in the Czech Republic (CZ) in 2018-2020.

METHODS

A descriptive analysis was performed of cases of yersiniosis captured in the Infectious Disease Information System (ISIN) in the CZ in 2018-2020. MS Excel 2010 was used for data processing and sorting.

RESULTS

In the CZ, a total of 1,686 cases of yersiniosis were reported in 2018-2020 (average annual incidence of 5/100,000 population). The highest average age-specific incidence was recorded in the age group 1-4 years (31.3/100,000), followed by 0-year-olds (26.9/100,000). In the study period, 942 cases were male and 744 cases were female, with the respective incidences of 6.0 /100,000 and 4.6/100,000. By administrative region, the highest average annual incidences were recorded in the South Moravian (9.1/100,000) and Moravian-Silesian (7.5/100,000) Regions. Hospital admission was required for 14.3% (n = 241) of reported cases. No death or outbreak was reported during the study period. A total of 31 cases were imported from usual recreational destinations. No seasonality was detected in the CZ; however, more cases always occur in January and in the second half of the year. Over the last three years, a stagnant trend in the incidence of the disease has been observed in the CZ.

CONCLUSIONS

In 2018 and 2019, yersiniosis (caused by Y. enterocolitica and rarely Y. pseudotuberculosis) was the fourth most commonly reported zoonosis in humans in the European Union (EU), with a stable trend in 2014-2019. The CZ reports an incidence up to three times higher but a 2.5 lower share of hospitalized patients compared to the EU average, which probably indicates that the CZ has an effective surveillance system in place. The trend in the incidence of the disease has stagnated in the CZ and the EU in recent years. The most common vehicle for transmission of yersiniosis to humans is contaminated food, especially undercooked pork, less often vegetables or water. Contamination of products from home slaughtered animals intended for private consumption is likely and would also explain the increased incidence of the disease, particularly in the winter months.

The position and importance of pharmacovigilance in the Czech Republic and in the world

Pharmacovigilance is an integral part of medicine. There is always a risk of side effects when using medication; these can be completely trivial, but there are side effects that can be life-threatening or fatal. Pharmacovigilance practices should prevent such side effects, or at least reduce their incidence, especially by developing preventive measures that are based on adverse drug reaction (ADR) data and the evaluations of these. This article discusses the general concept of pharmacovigilance and compares individual pharmacovigilance systems of several countries and regions.

A new report of adult Hyalomma marginatum and Hyalomma rufipes in the Czech Republic

Hyalomma marginatum and Hyalomma rufipes are important vectors of Crimean-Congo Hemorrhagic Fever Virus (CCHFV) in North Africa and Southern Europe. They are occasionally also reported from Central and Western Europe where they are likely introduced from their natural range by migratory birds. In this study, we report findings and molecular identification of adults and one nymph of H. marginatum and H. rufipes, primarily from horses from different regions of the Czech Republic. While the number of the reported ticks is small, this is likely to be an underrepresentation of the actual number. Due to their vector competence for CCHFV and potential expansion into new areas with a changing climate, surveillance programs in Europe are warranted.

Regeneration of Post-Agricultural Brownfield for Social Care Needs in Rural Community: Is There Any Transferable Experience?

In the 21st century, rural communities face many challenges, including implications of dynamic population aging, a lack of social care services, and the occurrence of abandoned post-agricultural brownfields. This paper is methodologically based on the findings derived from a set of qualitative in-depth interviews with the key rural stakeholders, explores the decisive factors and limits, accelerators, and barriers governing successful regeneration of the post-agricultural brownfield in the post-socialist environment. We are using the case of the regeneration project of a large-scale former communist agricultural cooperative, located in Vranovice, the Czech Republic, to illuminate how complex and challenging the redevelopment of a post-agricultural brownfield into a social care facility for elderly people is. A wide agreement among the experts in the field of community development exists that this regeneration project can serve as a model example for other rural municipalities that are sharing similar local development issues. Our findings illustrate how important and challenging at the same time are the matters of good governance, the active and long-term participation of stakeholders in the regeneration project, and the real-life introduction of the public–private partnership concept, particularly in immensely transforming the post-socialist countryside.

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician's vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection.

Biomonitoring of 89 POPs in blood serum samples of Czech city policemen

In this biomonitoring study, we evaluated the concentrations of 8 polychlorinated biphenyls (PCBs), 11 organochlorinated pesticides (OCPs), 33 brominated flame retardants (BFRs), 7 novel brominated and chlorinated flame retardants (novel FRs) and 30 per- and polyfluoroalkylated substances (PFAS) in human serum samples (n = 274). A total of 89 persistent organic pollutants (POPs) were measured in blood serum samples of city policemen living in three large cities and their adjacent areas (Ostrava, Prague, and Ceske Budejovice) in the Czech Republic. All samples were collected during the year 2019 in two sampling periods (spring and autumn). The identification/quantification of PCBs, OCPs, BFRs, novel FRs and PFAS was performed by means of gas chromatography coupled to (tandem) mass spectrometry (GC-MS/(MS)) and ultra-high performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry (UHPLC-MS/MS). The most frequently detected pollutants were perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorooctanesulfonate (PFOS), perfluorohexanesulfonate (PFHxS), 2,2',3,4,4',5'-hexachlorobiphenyl (CB 138), 2,2',4,4',5,5'-hexachlorobiphenyl (CB 153), 2,2',3,3',4,4',5-heptachlorobiphenyl (CB 170), 2,2',3,4,4',5,5'-heptachlorobiphenyl (CB 180), hexachlorobenzene (HCB), and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) quantified in 100% of serum samples. In the serum samples, the concentrations of determined POPs were in the range of 0.108-900 ng g^-1 lipid weight (lw) for PCBs, 0.106-1016 ng g^-1 lw for OCPs, <0.1-618 ng g^-1 lw for FRs and <0.01-18.3 ng mL^-1 for PFAS, respectively. Locality, sampling season, and age were significantly associated with several POP concentrations. One of the important conclusions was that within the spring sampling period, statistically significant higher concentrations of CB 170 and CB 180 were observed in the samples from Ostrava (industrial area) compared to Prague and Ceske Budejovice. Older policemen had higher concentrations of five PCBs and two OCPs in blood serum.

Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe

Cardiovascular rehabilitation (CR) is an effective secondary preventive model of care. However, the use of CR is insufficient, and the reasons for this are not well-characterized in East-Central Europe. This prospective observational study psychometrically validated the recently translated Cardiac Rehabilitation Barriers Scale for the Czech language (CRBS-CZE) and identified the main CR barriers. Consecutive cardiac in/out-patients were approached from January 2020 for 18 months, of whom 186 (89.9%) consented. In addition to sociodemographic characteristics, participants completed the 21-item CRBS-CZE (response options 1-5, with higher scores representing greater barriers), and their CR utilization was tracked. Forty-five (24.2%) participants enrolled in CR, of whom 42 completed the CRBS a second time thereafter. Factor analysis revealed four factors, consistent with other CRBS translations. Internal reliability was acceptable for all but one factor (Cronbach's alpha range = 0.44-0.77). Mean total barrier scores were significantly higher in non-enrollers (p < 0.001), decreased from first and second administration in these enrollers (p < 0.001), and were lower in CR completers (p < 0.001), supporting criterion validity. There were also significant differences in barrier scores by education, geography, tobacco use, among other variables, further supporting validity. The biggest barriers to enrolment were distance, work responsibilities, lack of time, transportation problems, and comorbidities; and the greatest barriers to adherence were distance and travel. Several items were considered irrelevant at first and second administration. Other barriers included wearing a mask during the COVID-19 pandemic. The study demonstrated sufficient validity and reliability of CRBS-CZE, which supports its use in future research.

Mental Health and Quality & Safety of Care in Czech Residential Institutions during the COVID-19 Pandemic: A Mixed-Methods Study

Long-stay institutions have been considerably affected by the COVID-19 pandemic. We aimed to assess the mental health of clients and staff as well as quality and safety of care in long-stay institutions during the state-of-emergency in the Czech Republic in response to COVID-19 pandemic. We found a high prevalence of poor mental health outcomes in clients (46% poor well-being, 58% depression, 45% anxiety) and staff (17% poor well-being, 22% depression, 14% anxiety). In clients, COVID-19 health-related and economic worries were associated with depression (1.79, 95% CI = 1.14; 2.8 and 2.28, 95% CI = 1.27; 4.08 respectively) and anxiety (1.63, 95% CI = 1.11; 2.4 and 1.85, 95% CI = 1.2; 2.85 respectively) and in staff with any mental health outcome (1.92, 95% CI = 1.33; 2.77 and 1.75, 95% CI = 1.15; 2.66 respectively). Lack of information and communication from authorities, lack of protective equipment and logistic difficulties were reported as challenges. Delivery of care was mostly disrupted as well as admission and discharge processes. Other reported issues included lack of staff, lack of activities for patients or an increase in usage of restrictive measures. Best practices and key future measures were identified by each institution, a summary of which is presented in the article.

Experiences and Lessons Learned from COVID-19 Pandemic Management in South Korea and the V4 Countries

In the first year and a half of the COVID-19 pandemic, South Korea suffered significantly less social and economic damage than the V4 countries (Czech Republic, Hungary, Poland, and Slovakia) despite less stringent restrictive measures. In order to explore the causes of the phenomenon, we examined the public health policies and pandemic management of South Korea and the V4 countries and the social and economic outcomes of the measures. We identified the key factors that contributed to successful public health policies and pandemic management in South Korea by reviewing the international literature. Based on the analysis results, South Korea successfully managed the COVID-19 pandemic thanks to the appropriate combination of non-pharmaceutical measures and its advanced public health system. An important lesson for the V4 countries is that successful pandemic management requires a well-functioning surveillance system, a comprehensive testing strategy, an innovative contact tracing system, transparent government communication, and a coordinated public health system. In addition, to develop pandemic management capabilities and capacities in the V4 countries, continuous training of public health human resources, support for knowledge exchange, encouragement of research on communicable disease management, and collaboration with for-profit and non-governmental organizations are recommended.

Predictors of Short- and Long-Term Mortality in Ischemic Stroke: A Community-Based Study in Brno, Czech Republic

BACKGROUND AND OBJECTIVE

Short- and long-term mortality following ischemic stroke (IS) and their predictors have not been defined in the Czech population, and studies on long-term mortality are largely missing for the populations of Central Europe.

METHODS

Using the National Register of Hospitalized Patients and the Czech National Mortality Registry, we analyzed data on 1-month, 1-year, and 3-year all-cause mortality for patients admitted with IS to any of the 4 hospitals with a certified stroke unit in Brno, Czech Republic, in 2011. We reviewed discharge summaries and recorded potential factors impacting mortality after the index stroke event. Using univariate and multivariable analyses, we identified predictors of mortality at all 3 time points.

RESULTS

In our multivariable model, statin use (odds ratio [OR] 0.095, p < 0.0001), age at stroke (OR 1.03, p = 0.0445), and admission National Institutes of Health Stroke Scale (NIHSS) score (OR 1.16, p < 0.0001) predicted 1-month mortality, while statin use (OR 0.43, p = 0.0004), history of cardiac failure (OR 2.17, p = 0.0137), age at stroke (OR 1.07, p < 0.0001), and admission NIHSS score (OR 1.14, p < 0.0001) predicted 1-year mortality. Statin use (OR 0.54, p = 0.0051), history of cardiac failure (OR 2.13, p = 0.0206), age at stroke (OR 1.07, p < 0.0001), and admission NIHSS score (OR 1.11, p < 0.0001) also predicted 3-year mortality.

CONCLUSIONS

Our study is the first to report data on short- and long-term mortality rates and their predictors in patients hospitalized with IS in the Czech population. Our results indicate that mortality rates and predictors of mortality are consistent with those reported in studies from other populations throughout the world.