The COVID-19 Pandemic contributed to accelerating the process of using information and communication technologies and digital technologies in healthcare management and delivery within healthcare systems. At that time, the Czech healthcare system faced the same problems as other European systems and struggled with a temporary limitation of direct provision of healthcare services. It was solved by switching to telemedicine. The Czech healthcare system used telemedicine to a minimal extent until then. Despite adopting the law on healthcare digitisation, it is still one of the countries with a lower level of digitisation of healthcare processes. The article presents the results of an exploratory expert investigation focused on the implementation and development of telemedicine in the Czech Republic. The conducted research aimed to identify problems related to the implementation of telemedicine in practice, place them in the broader framework of the healthcare system and structure them, propose possible solutions, and identify the future challenges of telemedicine in the Czech Republic. We based our study on the results of a three-phase QUAL-QUAN-QUAL research. Data collection in the first phase took the form of individual semi-structured interviews with patients (25) with practical experience in the field of telemedicine, followed by the second quantitative phase of the questionnaire survey with patients (650). The third qualitative phase included semi-structured interviews with experts (17) with practical experience in telemedicine. The introduction and expansion of telemedicine require several fundamental changes. These include adjustments to the legislative environment and changes to the technological infrastructure, organisation of care and work. Several barriers have been identified at the healthcare system level, healthcare providers, healthcare professionals and patients.

• MeSH
• COVID-19 * epidemiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Pandemics * MeSH
• Delivery of Health Care organization & administration   MeSH
• Surveys and Questionnaires MeSH
• Interviews as Topic MeSH
• SARS-CoV-2 MeSH
• Aged MeSH
• Telemedicine * organization & administration   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Aveir DR (Abbott, Abbott Park, IL) is a dual-chamber leadless pacemaker (LP) system with distinct atrial and ventricular LPs (ALP, VLP) that communicate wirelessly to deliver atrioventricular synchronous pacing. Success rates of these implant-to-implant (i2i) transmissions have not been systematically evaluated. OBJECTIVE: This study aims to evaluate chronic i2i success rates in a clinical setting. METHODS: Patients meeting standard dual-chamber pacing indications were enrolled and implanted with dual-chamber LP systems as part of a prospective international clinical trial (Aveir DR i2i Study). The percent of successful i2i transmissions from ALP-to-VLP (A-to-V) and VLP-to-ALP (V-to-A) were interrogated from LPs in de novo patients using the device programmer at implant, discharge, and at 1, 3, and 6 months postimplant (1M, 3M, 6M). RESULTS: A total of 399 patients completed device implant and i2i diagnostic interrogation (62% male; age 69 years; 65% sinus node dysfunction, 32% atrioventricular [AV] block). Median A-to-V and V-to-A i2i success rates exceeded 90% of beats at all time-points from implant to 6M. The minority of patients with A-to-V or V-to-A i2i success in <70% of beats at implant (A-to-V: 19% of patients, V-to-A: 31% of patients) showed roughly 40% improvement by 1M, with this minority dropping to roughly 5% of patients by 6M. Improvement in i2i communication success may be attributed to reprogramming of i2i setting levels, natural changes in dominant posture, and device stabilization. CONCLUSION: Wireless implant-to-implant communication in the new dual-chamber leadless pacemaker system demonstrated successful transmissions in >90% of beats throughout the 6-month evaluation period. Communication success improved significantly over time postimplant for specific subgroups. CLINICAL TRIAL REGISTRATION: Aveir DR i2i Study, ClinicalTrials.gov ID NCT05252702.

• MeSH
• Wireless Technology MeSH
• Equipment Design * MeSH
• Cardiac Pacing, Artificial methods   MeSH
• Pacemaker, Artificial * MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Prospective Studies MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

BACKGROUND: To predict worsening heart failure hospitalizations (WHFHs), the HeartInsight multiparametric algorithm calculates a heart failure (HF) Score based on temporal trends of physiologic parameters obtained through automatic daily remote monitoring of implantable cardioverter-defibrillators (ICDs). OBJECTIVE: We studied the association of the baseline HF Score, determined at algorithm activation, with long-term patient outcomes. METHODS: Data from 9 clinical trials were pooled, including 1841 ICD patients with a preimplantation ejection fraction ≤35%, New York Heart Association class II/III, and no long-standing atrial fibrillation. The primary end point was a composite of death or WHFH. RESULTS: After a median follow-up of 631 days (interquartile range, 385-865 days), there were 243 WHFHs in 173 patients (9.4%) and 122 deaths (6.6%), 52 of which (42.6%) were cardiovascular. The primary end point occurred in 265 patients (14.4%). A multivariable time-to-first-event analysis showed that a high baseline HF Score (>23, as determined by a time-dependent receiver operating characteristics curve analysis) was significantly associated with the occurrence of the primary end point (adjusted hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.54-2.71; P < .0001), all-cause death (HR, 2.37; CI, 1.56-3.58; P < .0001), cardiovascular death (HR, 2.19; CI, 1.14-4.22; P = .019), and WHFH (HR, 1.91; CI, 1.35-2.71; P = .0003). In a hierarchical event analysis of all-cause death as the outcome with highest priority and WHFHs as repeated event outcomes, the win ratio was 2.47 (CI, 1.89-3.24; P < .0001). CONCLUSION: Based on a retrospective analysis of clinical trial data with adjudicated events, baseline HF Score derived from device-monitored variables was able to stratify patients at higher long-term risk of death or WHFH.

• MeSH
• Algorithms MeSH
• Time Factors MeSH
• Defibrillators, Implantable * MeSH
• Clinical Trials as Topic MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Aged MeSH
• Heart Failure * therapy   physiopathology   mortality   MeSH
• Remote Sensing Technology methods   MeSH
• Stroke Volume physiology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: This study examines the perspectives of individuals with coronary heart disease (CHD) on a nurse-led eHealth cardiac rehabilitation (NeCR) program, which included a website, tele-monitoring device, and social media chatroom. METHODS: Using a descriptive qualitative approach, semi-structured interviews were conducted with 18 participants to capture their feedback and experiences with the NeCR program. RESULTS: Participants found the NeCR program valuable in addressing gaps in cardiac rehabilitation services in China, empowering them to make behavioral changes and enhancing their social motivation. However, they also highlighted the need for a more user-friendly website, better symptom management during exercise, and stronger privacy protections in the peer networking chatroom. The study concludes that the NeCR program is feasible in providing accessible rehabilitative services at home post-discharge. Recommendations include improving the self-monitoring platform for ease of use, incorporating immediate symptom management guidance during exercise, and ensuring a secure environment for online peer support. CONCLUSIONS: These findings offer crucial insights for developing patient-centered eHealth cardiac rehabilitation services, emphasizing the importance of user-friendly design, effective symptom management features, and privacy protection in promoting participant engagement with e-platforms. TRIAL REGISTRATION: ChiCTR1800020411 (http://www.chictr.org.cn/showprojen.aspx?proj=33906).

• MeSH
• Adult MeSH
• Cardiac Rehabilitation * methods   MeSH
• Coronary Disease rehabilitation   nursing   MeSH
• Qualitative Research * MeSH
• Middle Aged MeSH
• Humans MeSH
• Interviews as Topic MeSH
• Aged MeSH
• Telemedicine * MeSH
• Feedback MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• China MeSH

Promoting healthy aging through physical activity (PA) is crucial as the global population grows older. Traditional interventions often fail to engage older adults, underlining the need for personalized, timely approaches. Smartphone-delivered PA interventions can offer personalized support during opportune moments for behavioral change. The current study examined whether the receptivity of inactive older adults influences compliance with mHealth walking suggestions after inactivity, and explored their experiences with it. Thirty healthy older adults (mean age 73.9 years) participated in the study and answered event-based EMA questionnaires via HealthReact after each 30-minute inactivity period. Emotions, physical complaints, intention, self-efficacy, perceived walking, and environmental permissiveness were assessed. Walking suggestions followed each EMA, and semi-structured interviews were conducted post-study. Multilevel logistic regressions in R were applied, and qualitative data were thematically analyzed using NVivo. Results show that higher intention, self-efficacy, and environmental permissiveness positively correlated with compliance, while higher perceived walking negatively correlated. Participants generally found the suggestions motivating and well-timed, but some reported increased alertness and pressure. Consequently, tailoring interventions to individual needs and targeting receptive moments can enhance compliance and promote healthier aging through increased PA. Future mobile interventions should consider self-efficacy, intention, prior activity, and environmental conditions to improve effectiveness.

• MeSH
• Patient Compliance * psychology   MeSH
• Walking * psychology   MeSH
• Smartphone MeSH
• Exercise psychology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Health Promotion * methods   MeSH
• Self Efficacy MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Telemedicine MeSH
• Intention MeSH
• Healthy Aging * psychology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Tento článek zpracovává téma nových trendů a technologií v urologii, a to konkrétně v oblasti telemedicíny a umělé inteligence. Nejprve stručně pojednává o přínosech telemedicíny a jak mění pohled na vztah mezi lékařem a pacientem. Podrobněji se pak text věnuje především umělé inteligenci, jež se v současnosti dostává do popředí zájmu laické i odborné veřejnosti. Její potenciál v urologii je testován v mnoha studiích, především se zaměřením na uroonkologii, v menší míře pak také v oblasti benigních urologických onemocnění. Článek se snaží identifikovat nejvýznamnější pokroky v této rychle se rozvíjející oblasti, a zároveň předkládá současné limity jejího zapojení do klinické praxe.

This article explores the emerging trends and technologies in urology, focusing on telemedicine and artificial intelligence. It provides a brief overview of the benefits of telemedicine and its impact on the patient-physician interactions. The article subsequently explores in detail the use of artificial intelligence, which is currently gaining considerable interest from both general public and medical professionals. Its potential in urology has been tested in a number of clinical studies, particularly in the field of uro-oncology and, to a lesser extent, in benign urological diseases. The aim of this article is to identify the key advances in this rapidly evolving field, while also highlighting the current limitations of its implementation into clinical practice.

• MeSH
• Deep Learning MeSH
• Humans MeSH
• Robotic Surgical Procedures MeSH
• Machine Learning MeSH
• Telemedicine MeSH
• Artificial Intelligence MeSH
• Urologic Neoplasms diagnosis   therapy   MeSH
• Urology * trends   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Publikace obsahuje úplné znění aktuálních českých zákonů a právních předpisů, které se zaměřují na různé poplatky. Určeno odborné veřejnosti.

• MeSH
• Fees and Charges MeSH
• Radio MeSH
• Forensic Sciences MeSH
• Television MeSH
• Geographicals
• Czech Republic MeSH

• Conspectus
• Veřejné finance
• NML Fields
• právo, zákonodárství
• ekonomie, ekonomika, ekonomika zdravotnictví
• NML Publication type
• zákony
• právní předpisy

BACKGROUND: The online environment provides adolescents with vast amounts of health-related information; however, navigating this effectively requires high levels of eHealth literacy to avoid misinformation and harmful content. Parental guidance is often considered a crucial factor in shaping adolescents' online health behaviors; however, there is limited longitudinal research examining how parental eHealth literacy mediation influences adolescents' development of eHealth literacy over time. OBJECTIVE: This study aims to examine the reciprocal relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. It also investigates whether parental education moderates this relationship, specifically exploring whether higher levels of parental education enhance the effectiveness of eHealth literacy mediation in improving adolescents' eHealth literacy. METHODS: A 3-wave longitudinal study was conducted, collecting data from 2500 adolescent-parent pairs. A random intercept cross-lagged panel model was applied to assess the reciprocal effects between parental eHealth literacy mediation and adolescents' eHealth literacy across the 3 waves. Parental education was included in the model as a potential moderating variable to examine whether it influences the strength of the relationship between parental eHealth literacy mediation and adolescents' eHealth literacy. RESULTS: The findings revealed no significant within-person effects, indicating that changes in parental eHealth literacy mediation over time did not lead to corresponding changes in adolescents' eHealth literacy (T1→T2 β=-.03, P=.65; T2→T3 β=.01, P=.84), and vice versa (T1→T2 β=.02, P=.71; T2→T3 β=-.07, P=.19). Furthermore, the data did not support a moderating effect of parental education, suggesting that higher educational attainment does not enhance the impact of parental eHealth literacy mediation. However, a significant between-person association was observed: adolescents with higher levels of eHealth literacy tend to have parents who engage more frequently in eHealth literacy mediation (r=0.30, P<.001). CONCLUSIONS: This study contributes to the understanding of parental involvement in shaping adolescents' eHealth literacy. Contrary to expectations, parental eHealth literacy mediation does not appear to have a significant longitudinal impact on the development of adolescents' eHealth literacy, nor does higher parental education strengthen this relationship. These findings suggest that additional factors beyond parental mediation and education may play a critical role in supporting adolescents' ability to navigate online health information effectively.

• MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Adolescent MeSH
• Parents * MeSH
• Telemedicine * MeSH
• Parent-Child Relations * MeSH
• Health Literacy * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Obezita je chronické, relabující a progredující onemocnění s rostoucí prevalencí, které významně ovlivňuje zdraví a kvalitu života i u dětí. Je spojena se zvýšeným rizikem metabolických a kardiovaskulárních onemocnění, jako je inzulinová rezistence, diabetes mellitus 2. typu, hypertenze, dyslipidémie a metabolicky asociovaná steatóza jater. Obezita dále může vést k rozvoji syndromu spánkové apnoe, ortopedickým a psychickým komplikacím. Základem terapie je edukace zdravého životního stylu celé rodiny, která však často naráží na překážky, jako jsou časová náročnost, omezená dostupnost specialistů a nízká dlouhodobá adherence rodin. Telemedicína nabízí inovativní přístup ke zlepšení léčby obezity dětí prostřednictvím digitálních nástrojů, online konzultací, chytrých aplikací a nositelných technologií. Umožňuje efektivnější monitorování stravovacích a pohybových návyků, podporu psychického zdraví i snížení časové a finanční zátěže pro rodiny. Výsledky studií ukazují, že kombinace prezenční a distanční podpory a aktivní zapojení rodinných příslušníků vede k vyšší úspěšnosti v redukci tělesné hmotnosti a udržení zdravého životního stylu. Článek se zaměřuje na využití telemedicíny v léčbě obezity u dětí, přehled metod, které byly v této oblasti aplikovány, a jejich účinnost v kontextu současných vědeckých poznatků.

Obesity is a chronic, relapsing, and progressive disease with increasing prevalence, that significantly impacts health and quality of life, even in children. It is associated with an increased risk of metabolic and cardiovascular diseases such as insulin resistance, type 2 diabetes mellitus, hypertension, dyslipidemia, and metabolic dysfunction-associated steatotic liver disease. Additionally, obesity can lead to the development of sleep apnea syndrome, orthopedic issues, and psychological complications. The cornerstone of the care is educating the whole family about a healthy lifestyle; however, this may often be challenging due to obstacles such as time constraints, limited access to specialists, and low long-term adherence of families. Telemedicine offers an innovative approach to improving obesity treatment in children through digital tools, online consultations, smart applications, and wearable technologies. It enables more effective monitoring of dietary and physical activity habits, supports mental health, and reduces time and financial burdens for families. Studies indicate that combining in-person and remote support, along with active involvement of family members, leads to higher success rates in weight reduction and a healthy lifestyle maintenance. This article focuses on the use of telemedicine in the treatment of obesity in children, providing an overview of the methods applied in this field and their effectiveness in the context of current scientific knowledge.

• MeSH
• Child MeSH
• Humans MeSH
• Pediatric Obesity * therapy   MeSH
• Motor Activity MeSH
• Psychosocial Intervention methods   MeSH
• Preventive Health Services methods   MeSH
• Feeding Behavior psychology   MeSH
• Telemedicine * MeSH
• Life Style MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

• Keywords
• DentalMonitoring,
• MeSH
• Quality of Health Care MeSH
• Humans MeSH
• Monitoring, Physiologic methods   MeSH
• Orthodontics * methods   MeSH
• Artificial Intelligence MeSH
• Medical Informatics Applications MeSH
• Remote Patient Monitoring * methods   MeSH
• Check Tag
• Humans MeSH