Rationale: Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. Measurements and Main Results: A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.
- MeSH
- Antimicrobial Stewardship MeSH
- Guideline Adherence * statistics & numerical data MeSH
- Intensive Care Units standards MeSH
- Humans MeSH
- Hospitals * standards statistics & numerical data MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Sepsis * therapy diagnosis MeSH
- Practice Guidelines as Topic MeSH
- Emergency Service, Hospital standards MeSH
- Quality Improvement * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
Human movement behaviour typically unfolds in 24-h cycles, with children being additionally influenced by their parents. Therefore, the aim of this study was to investigate the adherence of 3-10-year-old children to the World Health Organization's (WHO) 24-h movement behaviour guidelines in relation to the behaviours of their mothers/fathers. Data from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep study included 381 families (with at least one child aged 3-10 years) from urban and rural areas across all three regions of Czechia. Twenty four-hour movement behaviour (sleep, sedentary behaviour, and physical activity) was monitored using ActiGraph accelerometers placed on the non-dominant wrists of children and their parents for seven consecutive days. Children's adherence to the WHO guidelines was analysed using logistic regression analysis. 25.9% of girls and 26.7% of boys simultaneously met all three 24-h movement behaviour guidelines (sleep + sedentary + physical activity), and 44.7% of girls and 46.1% of boys met any combination of two of the three guidelines, regardless of the children's gender, weight, or calendar age. Maternal overweight/obesity significantly (P = .05) decreased the odds of children achieving at least two of the three guidelines, while parental university education and maternal adherence to at least two of the three guidelines significantly (P = .05) increased the odds of children complying with these guidelines. Parents, especially mothers, play an important role in influencing their children in meeting 24-h movement behaviour guidelines and in shaping a healthy lifestyle.
- MeSH
- Exercise * MeSH
- Child MeSH
- Guideline Adherence * statistics & numerical data MeSH
- Adult MeSH
- Humans MeSH
- Mothers MeSH
- Child, Preschool MeSH
- Cross-Sectional Studies MeSH
- Parents * psychology MeSH
- Sedentary Behavior * MeSH
- Sleep * MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
AIM: This study aimed to evaluate the compliance of dentists in Croatia and the Czech Republic with endodontic recommendations and identify the subjective and objective factors influencing their adherence to them. METHODOLOGY: A total of 1386 dentists from Croatia and the Czech Republic participated in an online survey through a self-administered, author-designed questionnaire. After excluding those who did not perform root canal treatments (RCT), 1376 responses (394 from Croatia and 982 from the Czech Republic) were statistically analysed. RESULTS: The median age of respondents was 40 years, with a higher proportion of females in both countries. Croatian dentists treated fewer patients weekly but performed more RCTs and placed more composite fillings than their Czech counterparts. Czech dentists more frequently employed magnification devices, rubber dam (RD), pre-endodontic build-ups, nickel-titanium (NiTi) instruments, irrigant activation, bioceramic sealers, indirect post-endodontic restoration of lateral teeth, and single-visit treatments. These practices were also more common among endodontists than general dental practitioners and other specialists in both countries. Croatian dentists adhered more consistently to the recommended irrigation protocol. In the Czech group, adherence to recommended procedures, such as magnification, RD usage, and irrigation protocol correlated with younger age, smaller weekly number of patients, and preference for treating patients in the supine position. No such correlations were observed among the Croatian dentists. CONCLUSIONS: Despite notable improvements in recent years, dentists still do not fully comply with the recommended RCT working procedures in Croatia and the Czech Republic.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Surveys and Questionnaires MeSH
- Root Canal Therapy * statistics & numerical data MeSH
- Practice Patterns, Dentists' * statistics & numerical data MeSH
- Dentists statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- Croatia MeSH
There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (n = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex-smokers with a body mass index (BMI) of <32 kg/m2 (n = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999-12/2021, n = 541), all patients who underwent transplantation for pulmonary fibrosis (n = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient's medical records (n = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety-six patients were referred to the transplant center, 50% (n = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Adult MeSH
- Idiopathic Pulmonary Fibrosis * surgery MeSH
- Lung Diseases, Interstitial surgery MeSH
- Referral and Consultation * statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Registries MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Lung Transplantation * statistics & numerical data 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
Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents' influence on the child's sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children's female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.
- MeSH
- Accelerometry * instrumentation MeSH
- Exercise * MeSH
- Child MeSH
- Guideline Adherence * statistics & numerical data MeSH
- Adult MeSH
- Sleep Quality MeSH
- Humans MeSH
- Child, Preschool MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- Parents MeSH
- Sedentary Behavior * MeSH
- Sleep * physiology MeSH
- Parent-Child Relations * MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Cíl: Jednou z potenciálních překážek pro implementaci vysoce kvalitní péče o jedince s bolestí zad je nenásledování klinických doporučených postupů. Cílem této práce bylo zmapování adherence ke klinickým doporučeným postupům u kliniků/ček léčících jedince s nespecifickou bolestí zad v ČR. Soubor a metodika: Fyzioterapeuté/ky a lékaři/ky, kteří v ČR aktivně léči dospělé jedince s bolestí zad, vyplnili sebe-reportující dotazník ohledně preferovaného výběru intervencí a edukačních výroků na základě doporučení pro klinickou praxi a kazuistiky reprezentující jedince s nespecifickou bolestí zad společně s e sběrem demografických údajů a kulturně adaptovaným dotazníkem Fear-Avoidance Beliefs Tool. Výsledky: Do analýzy bylo zahrnuto 344 účastníků. Celková adherence ke klinickým doporučeným postupům byla pouze 52 % a byla negativně asociována s ženským pohlavím (b = –1,04; p = 0,006), fyzioterapeutickou profesí a nižším stupněm vzdělání (b = –2,51; p = 0,006), více lety praxe (b = –0.04; p = 0,02) a vyšším skórem v dotazníku Fear-Avoidance Beliefs Tool-CZ (b = –0,2; p < 0,001). Model vysvětlil 25 % z celkové variance (R2 = 0,25). Závěr: Naše zjištění naznačují, že adherence ke klinickým doporučeným postupům s ohledem na výběr léčebných intervencí a edukačních výroků je v ČR nízká. Pro podporu vysoce hodnotné péče o jedince s bolestí zad v ČR by měly být v budoucnu vytvořeny vysoce kvalitní lokální doporučené postupy a dále by měly být zkoumány v rámci kvantitativního i kvalitativního výzkumu různé překážky a podpůrné mechanizmy k jejich adherenci tak, aby bylo možné se účinně zaměřit na nejdůležitější faktory.
Aim: One of the potentially important barriers to the implementation of high-value care for individuals with low back pain is non-adherence to clinical practice guidelines. The aim of this study was to explore adherence to clinical guidelines in clinicians treating individuals with non-specific low back pain in the Czech Republic. Subjects and methods: Physiotherapists and physicians actively treating adult individuals with low back pain in the Czech Republic completed a self- -reported clinical behavior questionnaire regarding intervention recommendations and educational statements selection based on clinical practice guidelines following a vignette representing an individual with non-specific low back pain together with demographic data collection and cross-culturally adapted Fear-Avoidance Beliefs Tool. Results: 344 participants were included in the analysis. Overall self-reported adherence to clinical guidelines was only 52% and was negatively associated with female sex (b = –1.04; P = 0.006), physiotherapy profession and lower education level (b = –2.51; P = 0.006), more years of practice (b = –0.04; P = 0.02) and higher Fear-Avoidance Beliefs Tool-CZ score (b = –0.2; P < 0.001). Our model explained 25% of the variance (R2 = 0.25). Conclusion: Our findings suggest that adherence to clinical guidelines regarding recommendations against inappropriate interventions and the promotion of unhelpful narratives is low in the Czech Republic. To facilitate high-value care for individuals with low back pain in the Czech Republic, local high-quality clinical practice guidelines should be developed in the future and different barriers and facilitators to its adaption and adherence should be further examined in quantitative as well as qualitative research so that the most important factors could be effectively targeted.
The comet assay is a widely used test for the detection of DNA damage and repair activity. However, there are interlaboratory differences in reported levels of baseline and induced damage in the same experimental systems. These differences may be attributed to protocol differences, although it is difficult to identify the relevant conditions because detailed comet assay procedures are not always published. Here, we present a Consensus Statement for the Minimum Information for Reporting Comet Assay (MIRCA) providing recommendations for describing comet assay conditions and results. These recommendations differentiate between 'desirable' and 'essential' information: 'essential' information refers to the precise details that are necessary to assess the quality of the experimental work, whereas 'desirable' information relates to technical issues that might be encountered when repeating the experiments. Adherence to MIRCA recommendations should ensure that comet assay results can be easily interpreted and independently verified by other researchers.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Comet Assay methods standards MeSH
- Consensus MeSH
- Laboratories MeSH
- Humans MeSH
- Research Design * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
OBJECTIVE: The aim of the study was to examine the availability of clinical practice guidelines for malnutrition in hospitals over a period of 6 y and the subsequent use of nutritional interventions in malnourished patients. METHODS: This study was conducted as a secondary data analysis of data that were collected from 2012 to 2017 in a quantitative, cross-sectional, multicenter study called the National Prevalence Measurement Quality of Care (LPZ). Data from 15 hospitals and 5650 participating patients were analyzed. RESULTS: The availability of clinical practice guidelines for malnutrition at the institutions increased from 6.7% in 2012 to 100% in 2017 (P < 0.001). The control of compliance to the guidelines increased from 28.6% to 85.7% (P < 0.001) and the documentation of malnutrition risk improved from 63.1% to 87.5% (P = 0.008). In 2017, the intervention "referral to dietitian" was used 8.3% more often (P < 0.001). The number of patients who did not receive any intervention decreased from 70% in 2012 to 55.6% in 2017 (P < 0.001). CONCLUSIONS: The availability of guidelines on malnutrition increased in participating hospitals over the 6-y study period. Regular controls of adherence to the guidelines positively correlated with their availability. More interventions to treat malnutrition were carried out in 2017. The use of clinical practice guidelines in this study was associated with more interventions treating malnutrition.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Risk Assessment standards MeSH
- Nutrition Assessment MeSH
- Quality of Health Care statistics & numerical data MeSH
- Humans MeSH
- Hospitals standards MeSH
- Nutrition Therapy standards MeSH
- Malnutrition * MeSH
- Prevalence MeSH
- Cross-Sectional Studies MeSH
- Health Care Surveys MeSH
- Practice Guidelines as Topic * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
OBJECTIVE: The study evaluates compliance with declared hygienic standards carried out by healthcare professionals in clinical practice within their scope of direct patient care and the maintenance of medical tools and devices in healthcare facilities in the Czech Republic. METHODS: Cross-sectional questionnaire study focused on the standards of safe health care. All 80 addressed healthcare providers were also involved in the 2018 Adverse Event Reporting System (AERS) pilot project. Responses were scored on a 6-level scale, from "always" (100 points) to "never" (0 points). The evaluation was performed according to the frequency of responses and the average index (max. 100 points). Data analysis was performed using IBM SPSS Statistics version 22 (level of significance 1% and 5%). RESULTS: There were statistically processed 2,016 questionnaires (100%). Most respondents stated their job classification as non-medical healthcare professionals (NHP) working at a patient's bedside (73%), physicians (16%), or other NHP (11%). As per their medical specialty, 43% of the respondents practice internal medicine, 28% surgery, 14% psychiatry, 9% long-term inpatient care, and 6% stated other fields of medicine. The lowest declared compliance was registered in the statement "I use a face mask when exposure to air-transmitted pathogens is anticipated" (rating index 80 points). The highest compliance (99.4 points) was registered in the statement: "I discard used sharp materials into sharps containers." CONCLUSION: In the surveyed healthcare facilities within the Czech Republic, overall compliance with hygiene standards is at a good level. Declared differences in compliance with hygiene standards in the selected items of the questionnaire are influenced by multiple factors. Generally, a higher level of compliance is linked to increasing age, years of practice, and a higher level of education. When comparing professional groups, a higher level of compliance with hygiene standards was registered in the NHP group.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Health Care Surveys MeSH
- Practice Guidelines as Topic * MeSH
- Health Facilities MeSH
- Health Personnel psychology statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
The Framework Convention on Tobacco Control (FCTC) developed by the State Parties to the World Health Organization was ratified in Slovakia in 2004 and in Finland in 2005. The aim of this study was to explore and compare compliance with the FCTC in Finland and Slovakia. This is a two-country comparative study of tobacco control policy based on implementation of the FCTC in Slovakia and Finland. Compliance with the FCTC was measured similarly in Slovakia and Finland in terms of their institutional structure supporting a smoking free environment and implementation of selected articles of the FCTC. In Finland the responsibilities for anti-tobacco policy are clearly assigned. Slovakia does not have specifically responsible institutions. Finland has a clear plan for achieving the goal of a smoking-free country based on empirical evidence. Slovakia meets only the minimum standard resulting from its commitment as ratified in the FCTC and data are out of date or missing completely.
- MeSH
- Guideline Adherence statistics & numerical data MeSH
- Drug and Narcotic Control legislation & jurisprudence MeSH
- Smoking legislation & jurisprudence MeSH
- International Cooperation MeSH
- Smoking Prevention * MeSH
- Cross-Cultural Comparison MeSH
- World Health Organization MeSH
- Nicotiana MeSH
- Tobacco Products * MeSH
- Tobacco Industry * MeSH
- Government Regulation MeSH
- Tobacco Smoke Pollution legislation & jurisprudence prevention & control MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Finland MeSH
- Slovakia MeSH
