• MeSH
• Humans MeSH
• Heart Diseases * mortality   prevention & control   MeSH
• Delivery of Health Care organization & administration   trends   MeSH
• National Health Programs organization & administration   statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Newspaper Article MeSH
• Geographicals
• Czech Republic MeSH
• Europe MeSH

• MeSH
• Global Health MeSH
• Nutritional Status MeSH
• Health Promotion MeSH
• National Health Programs statistics & numerical data   MeSH
• Surveys and Questionnaires MeSH
• Diet, Healthy MeSH
• Publication type
• Review MeSH

• Conspectus
• Veřejné zdraví a hygiena
• NML Fields
• veřejné zdravotnictví
• nutriční terapie, dietoterapie a výživa
• NML Publication type
• publikace WHO

In Central and Eastern Europe (CEE), health-mediation programs (HMPs) have become central policy instruments targeting health inequities between segregated Roma and general populations. Social determinants of health (SDH) represent the root causes behind health inequities. We therefore evaluated how an HMP based in Slovakia addressed known SDH in its agenda and its everyday implementation. To produce descriptive data on the HMP's agenda and everyday implementation we observed and consulted 70 program participants across organizational levels and 30 program recipients over the long-term. We used a World Health Organization framework on SDH to direct data acquisition and consequent data content analysis, to structure the reporting of results, and to evaluate the program's merits. In its agenda, the HMP did not address most known SDH, except for healthcare access and health-related behaviours. In the HMP's everyday implementation, healthcare access facilitation activities were well received, performed as set out and effective. The opposite was true for most educational activities targeting health-related behaviours. The HMP fieldworkers were proactive and sometimes effective at addressing most other SDH domains beyond the HMP agenda, especially material conditions and psychosocial factors, but also selected local structural aspects. The HMP leaders supported such deliberate engagement only informally, considering the program inappropriate by definition and too unstable institutionally to handle such extensions. Reports indicate that the situation in other CEE HMPs is similar. To increase the HMPs' impact on SDH, their theories and procedures should be adapted according to the programs' more promising actual practice regarding SDH.

• MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Health Promotion statistics & numerical data   MeSH
• National Health Programs statistics & numerical data   MeSH
• Roma * MeSH
• Social Determinants of Health ethnology   MeSH
• Health Status * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Slovakia MeSH

CONTEXT: Marked unexplained national variations in incidence rates of kidney cancer have been observed for decades in Europe. OBJECTIVE: To investigate geographic variations at the regional level and identify European regions with high incidence rates of kidney cancer. EVIDENCE ACQUISITION: Regional- and national-level incidence data were extracted from the Cancer Incidence in Five Continents databases, local cancer registry databases, and local published reports. World population age-standardised rates (ASRs) were calculated for the periods 2003-2007 and 1988-1992. Rates by period and sex were compared using map visualisation. EVIDENCE SYNTHESIS: During 2003-2007, the highest ASR was found in the Plzen region, Czech Republic (31.4/100,000 person-years in men). Other regions of the Czech Republic had ASRs of 18.6-27.5/100,000 in men, with a tendency for higher rates in regions south of Prague. Surrounding regions, including eastern Germany and regions of Slovakia and Austria, had medium-to-high incidence rates (13.0-16.8/100,000 in men). Three other areas in Europe showed higher incidence rates in men compared with the rest of the continent: Lithuania, Estonia, Latvia, and Belarus (15.0-17.6/100,000); Iceland (13.5/100,000), and northern Italy (up to 16.0/100,000). Similar regional differences were observed among women, with rates approximately half of those observed in men in the same region. In general, these regional geographic variations remained stable over the periods 1988-1992 and 2003-2007, although higher incidence rates were detected in the Baltic countries in 2003-2007. CONCLUSIONS: Several European regions show particularly high rates of kidney cancer incidence. Large variations were observed within countries covered by national health-care systems, implying that overdetection is not the major factor. PATIENT SUMMARY: We present regional geographic variations in kidney cancer incidence rates in Europe. We highlight several regions with high incidence rates where further studies should be conducted for cancer control and prevention.

• MeSH
• Time Factors MeSH
• Incidence MeSH
• Humans MeSH
• Kidney Neoplasms diagnosis   epidemiology   etiology   prevention & control   MeSH
• National Health Programs statistics & numerical data   trends   MeSH
• Risk Factors MeSH
• Sex Factors MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Geographicals
• Europe MeSH

BACKGROUND: Invasive pneumococcal disease (IPD) is caused by Streptococcus pneumoniae and mostly presents as pneumonia, sepsis or meningitis. A notable portion of IPD cases is vaccine preventable and the pneumococcal conjugate vaccine (PCV) was introduced into the routine childhood immunization programs in many countries during the last decades. OBJECTIVES: Before PCV introduction in the Czech Republic in 2010, a national surveillance system for IPD was implemented in 2008 and further improved in 2011. In this study, we describe the new surveillance system for the first time and measure its sensitivity between 2010 and 2013 using the capture-recapture method. Furthermore, we describe the recent epidemiological trend of IPD, taking sensitivity estimates into account. RESULTS AND CONCLUSIONS: Between 2010 and 2013 the estimated sensitivity of the overall IPD surveillance increased from 81% to 99%. The sensitivity of individual reporting sources increased from 72% to 87% for the laboratory system and from 31% to 89% for the epidemiological notification system. Crucial for this improvement was the introduction of quarterly report reminders in 2011. Due to positive source dependency, the presented sensitivity estimates are most probably overestimated and reflect the upper limit of reporting completeness. Stratification showed variation in sensitivity of reporting particularly according to region. An effect of the PVC vaccination in the Czech Republic is visible in the incidence of IPD in target age groups (<5 y). This influence was not evident in the total IPD incidence and may interfere with increasing sensitivity of reporting. In 2013, an increase in the IPD incidence was observed. This finding requires further observation and a detailed vaccine impact analysis is needed to assess the current immunization strategy.

• MeSH
• Biostatistics MeSH
• Epidemiological Monitoring MeSH
• Mass Vaccination statistics & numerical data   MeSH
• Incidence MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Immunization Programs statistics & numerical data   MeSH
• Immunization Schedule MeSH
• Pneumococcal Infections epidemiology   prevention & control   MeSH
• Pneumococcal Vaccines administration & dosage   MeSH
• National Health Programs statistics & numerical data   MeSH
• Vaccines, Conjugate administration & dosage   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Substance Abuse Treatment Centers statistics & numerical data   MeSH
• Criminal Behavior MeSH
• Drug Trafficking * statistics & numerical data   MeSH
• Substance-Related Disorders * epidemiology   prevention & control   therapy   MeSH
• National Health Programs economics   statistics & numerical data   legislation & jurisprudence   MeSH
• Drug Users * statistics & numerical data   MeSH
• Government Programs MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Diabetes Mellitus * MeSH
• Diabetes Complications economics   epidemiology   prevention & control   MeSH
• Humans MeSH
• Patient Care methods   trends   MeSH
• Self Care trends   MeSH
• National Health Programs * statistics & numerical data   utilization   MeSH
• Vital Statistics MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Cost Allocation * economics   statistics & numerical data   MeSH
• Humans MeSH
• Local Government MeSH
• Costs and Cost Analysis * economics   statistics & numerical data   MeSH
• Health Care Costs statistics & numerical data   MeSH
• Behavior, Addictive economics   prevention & control   MeSH
• Health Maintenance Organizations economics   MeSH
• Substance-Related Disorders * economics   prevention & control   MeSH
• Primary Prevention economics   statistics & numerical data   MeSH
• National Health Programs economics   statistics & numerical data   MeSH
• Regional Medical Programs economics   statistics & numerical data   MeSH
• Catchment Area, Health economics   statistics & numerical data   MeSH
• State Government MeSH
• Criminal Law economics   MeSH
• Government Programs economics   MeSH
• Policy Making MeSH
• Check Tag
• Humans MeSH
• Publication type
• Statistics MeSH
• Tables MeSH

Podle Světové zdravotnické organizace byla v letech 2003-2005 Evropa regionem s nejvyšší mírou konzumace alkoholu na světě, přičemž Česká republika zaujala v tomto žebříčku spotřeby druhé místo (s 16,51 na osobu a rok). Rizikové vzorce užívání řadí alkohol mezi nejškodlivější psychoaktivní látky. Díky kombinaci vysokého stupně potenciální škodlivosti a vysoké míry rozšíření jeho užívání je uplatřtování pragmatického harm reduction a risk reduction (programy a intervence minimalizující rizika a škody) přístupu u alkoholu nanejvýš žádoucí. Minimalizace rizik a škod spojených s užíváním alkoholu je také v posledních letech prioritou WHO a Evropské unie. Článek přináší přehled těchto intervencí, které systematizuje dle úrovní pusobení. Na strukturální úrovni jsou diskutovány intervence v podobě licencování výroby a d distribuče alkoholu, regulace ceny ve formě zvláštního zdanění, kontrola dostupnosti omezením proděje (věkově, místně a časově), regulace marketingu a propagace a situační omezení konzumace. Na komunitní úrovni jsou v textu uvedeny intervence omezení prodeje či konzumace alkoholu, lokální kontrola dodržování zákonů a vyhlášek, podpora a zajištění bezpečnějšího prostředí pro konzumaci alkoholu a podpora bezpečného návratu domů. Na individuální úrovni se harm reduction zaměřuje jak na bezpečné užívání bezproblémových konzumentů alkoholu, tak i na kontrolované pití uživatelů se škodlivým užíváním alkoholu. Z hlediska nákladové ef ektivity odborníci doporučují zejména kontrolu výroby a zdanění alkoholu, věkové a místní omezení dostupnosti, situační omezení konzumace a kontrolu jeho dodržování, a konečně plošné zavedení a podporu krátké intervence.

According to the World Health Organisation, in 2003-2005 Europe was the region with the highest level of alcohol consumption in the world, and the Czech Republic ranked second (with 16.5 litres per person per year). With its negative impact on individuals and society, alcohol belongs among the most harmful psychoactive substances. Its high level of potential for harm, combined with its widespread use, makes the application of pragmatic harm reduction and risk reduction (programmes and interventions to minimise risk and damage) approaches to alcohol most appropriate. The reduction of the risks and harm associated with alcohol use has also been a priority of the WHO and the European Union in recent years. The article presents an overview of these interventions systematised according to levels of functioning. At the structural level, interventions involving the licensing of the production and distribution of alcohol, the regulation of prices by means of special taxes, access control using sales restrictions (in terms of age, place, and time), the regulation of marketing and promotion, and situational restrictions on consumption are discussed. At the community level, the text highlights intervention involving restrictions on the sale or consumption of alcohol, the local monitoring of compliance with laws and regulations, support for, and the provision of, a safer environment for alcohol consumption, and the promotion of a safe return home. At the individual level, harm reduction focuses on safe use on the part of unproblematic drinkers and on controlled drinking among individuals engaging in harmful alcohol use. In terms of cost-effectiveness, experts especially recommend controlling the production and taxation of alcohol, restricting availability as regards age, place, and consumption situations, checking compliance with such measures, and supporting brief interventions.

• Keywords
• programy minimalizace rizik a škod, veřejné zdraví, drogová politika, nákladová efektivita,
• MeSH
• Financing, Organized MeSH
• Community Health Planning economics   organization & administration   MeSH
• Humans MeSH
• Alcohol Drinking epidemiology   psychology   adverse effects   MeSH
• National Health Programs economics   organization & administration   statistics & numerical data   MeSH
• Harm Reduction MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Národní program screeningu kolorektálního karcinomu probíhá v ČR od roku 2000. V roce 2006 byla vytvořena databáze screeningových kolonoskopií, díky které lze detailně hodnotit program na základě mezinárodně respektovaných indikátorů kvality. Dle takto hodnocených ukazatelů dosahuje úroveň kolonoskopií provedených v rámci screeningu nadprůměrných výsledků. Hlavním úkolem do budoucna je etablovat program na populační úrovni tak, aby byl program kvalitní i v dlouhodobém měřítku.

The National Colorectal Cancer Screening Program in the Czech Republic was introduced in the year 2000. Based on the scree­ning colonoscopy database established in 2006, a precise program evaluation can be performed using internationally respected quality indicators. According to these measures, colonoscopies performed within the screening program have achieved above-average results. The main task for the future is to establish the program on the population level, so the quality can stay at a long-lasting level. Key words: colorectal neoplasms – colonoscopy – mass screening – occult blood The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers. Submitted: 26. 9. 2012 Accepted: 4. 10. 2012

• Keywords
• kolorektální karcinom, colorectal neoplasms,
• MeSH
• Carcinoma diagnosis   epidemiology   prevention & control   MeSH
• Colonoscopy statistics & numerical data   utilization   MeSH
• Colorectal Neoplasms * diagnosis   epidemiology   prevention & control   MeSH
• Humans MeSH
• Occult Blood MeSH
• Mass Screening * organization & administration   statistics & numerical data   utilization   MeSH
• National Health Programs statistics & numerical data   utilization   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Geographicals
• Czech Republic MeSH