BACKGROUND: Psychotherapy outcomes are typically measured in terms of symptom relief. However, this method might overlook important changes from clients' perspectives when they are asked to report on them. A more client-centred approach might bring a deeper understanding of psychotherapy outcomes. We aimed to evaluate the outcomes identified by clients within qualitative psychotherapy research. METHODS: The PsycArticles, PsycInfo, and MEDLINE Complete databases were searched for English language studies published until Nov 11, 2023. Additional studies were identified through references in the primary studies and previous meta-analyses or systematic reviews. Search terms were related to psychotherapy and counselling, clients' or patients' experiences, psychotherapy outcomes and changes, post-treatment perspectives, and types of qualitative methods. Qualitative studies on client-identified outcomes of individual psychotherapy were included. Findings related to clients' perceptions of psychotherapy outcomes were extracted (by ML and checked by TR and LT) and analysed (by all authors) using the descriptive-interpretative meta-analytic approach. All authors have personally experienced psychotherapy as clients. This study was pre-registered with PROSPERO (CRD42021277330). FINDINGS: We included 177 studies in the qualitative meta-analysis, from 24 countries, including descriptions from 2908 clients. Most of the studies were of good quality; they covered a wide range of therapeutic approaches and diagnoses. The descriptions of psychotherapy outcomes were classified into 60 meta-categories and grouped into ten clusters. These clusters related to clients' relational and social functioning; their emotional functioning; self-awareness, self-understanding, and more adaptive cognitive processing; behavioural functioning; developing their own resources; clients' attitudes towards themselves; generally embracing life; symptom and problem change; and more general wellbeing. The tenth cluster was outcomes that could not be clearly attributed to psychotherapy, which was considered outside the scope of this study. INTERPRETATION: The meta-analysis showed that clients value outcome dimensions beyond symptom reduction, such as deeper self-understanding, enhanced self-agency, and greater social engagement. By examining psychotherapy outcomes across various diagnoses and therapeutic approaches, we highlight limitations in traditional outcome measures, showing the need for more comprehensive, client-centred assessment tools and the value of incorporating qualitative methods into understanding dimensions of change. FUNDING: European Union.

• MeSH
• duševní poruchy terapie   psychologie   MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• psychoterapie * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH

The aim of the present study was to examine gender and age-specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence ("narcoleptic borderland"), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness-induced uncontrolled eating, as self-reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.

• MeSH
• dospělí MeSH
• index tělesné hmotnosti * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• narkolepsie * patofyziologie   MeSH
• poruchy nadměrné spavosti * patofyziologie   epidemiologie   MeSH
• sexuální faktory MeSH
• stravovací zvyklosti MeSH
• tělesná hmotnost MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The formation of memories is a complex, multi-scale phenomenon, especially when it involves integration of information from various brain systems. We have investigated the differences between a novel and consolidated association of spatial cues and amphetamine administration, using an in situ hybridisation method to track the short-term dynamics during the recall testing. We have found that remote recall group involves smaller, but more consolidated groups of neurons, which is consistent with their specialisation. By employing machine learning analysis, we have shown this pattern is especially pronounced in the VTA; furthermore, we also uncovered significant activity patterns in retrosplenial and prefrontal cortices, as well as in the DG and CA3 subfields of the hippocampus. The behavioural propensity towards the associated localisation appears to be driven by the nucleus accumbens, however, further modulated by a trio of the amygdala, VTA and hippocampus, as the trained association is confronted with test experience. Moreover, chemogenetic analysis revealed central amygdala as critical for linking appetitive emotional states with spatial contexts. These results show that memory mechanisms must be modelled considering individual differences in motivation, as well as covering dynamics of the process.

• MeSH
• amfetamin farmakologie   MeSH
• amygdala fyziologie   MeSH
• hipokampus * fyziologie   MeSH
• konsolidace paměti * fyziologie   MeSH
• krysa rodu rattus MeSH
• mozek fyziologie   MeSH
• neurony fyziologie   metabolismus   MeSH
• nucleus accumbens * fyziologie   MeSH
• odměna * MeSH
• paměť fyziologie   MeSH
• podněty MeSH
• prefrontální mozková kůra fyziologie   MeSH
• rozpomínání * fyziologie   MeSH
• strojové učení MeSH
• tegmentum mesencephali - area ventralis * fyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Adolescents' movement behaviours (MB) vary between schooldays and weekends, potentially impacting health-related quality of life (HRQoL) and well-being. This study aimed to identify transitions between 24-h MB profiles on schooldays and weekends and examine their associations with HRQoL and well-being. METHODS: This is a cross-sectional study of 1070 Czech adolescents (average age: 13.8 years and standard deviation: 2.2 years; 56% girls). Participants wore accelerometers for 7 consecutive days to assess physical activity (PA) of different intensities, sedentary behaviour (SB) and sleep. A subsample of 451 participants provided data on HRQoL, which was measured using the Paediatric Quality of Life Inventory, and 484 provided valid well-being data measured with the 5-item World Health Organisation Well-Being Index. Latent transition analysis was used on the MB variables to identify transitions across MB profiles, and linear regression was used to examine associations between transitions and HRQoL or well-being. RESULTS: Four MB profiles were identified: Excellent (high PA, low SB and high sleep duration), Good (average MB values), Fair (below-average PA and sleep, above-average SB) and Poor (low PA and sleep, high SB). Most adolescents transitioned to less favourable profiles on weekends. Those remaining in the Excellent profile had higher HRQoL than those transitioning to less favourable profiles. Transitions to the Poor profile were associated with the lowest HRQoL and well-being scores. CONCLUSION: This study underscores the dynamic nature of adolescents' MB and the importance of consistent, healthy routines. Interventions optimizing 24-h MB throughout the week and especially on weekends may enhance adolescent HRQoL and well-being, but further evidence from longitudinal and intervention studies is needed. SUMMARY: We observed a contrast in 24-h MB between schooldays and weekends: 29.7% of adolescents were in the Excellent on schooldays, but only 5.8% did so on weekends, while the prevalence of the Poor profile rose from 1.6% on schooldays to 27.7% on weekends. Adolescents who maintained the Excellent profile across the whole week recorded the highest scores for HRQoL and well-being. Moving into the Poor profile on weekend was associated with about 9 points poorer HRQoL and 14 points lower well-being, compared with peers who remained in the Excellent profile. Behaviour change strategies should target the entire week to preserve PA, reduce SB and protect sleep.

• MeSH
• akcelerometrie MeSH
• časové faktory MeSH
• chování mladistvých * psychologie   fyziologie   MeSH
• cvičení * psychologie   fyziologie   MeSH
• kvalita života * psychologie   MeSH
• lidé MeSH
• mladiství MeSH
• průřezové studie MeSH
• sedavý životní styl MeSH
• spánek fyziologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Kazuistika se zaměřuje na kognitivně-behaviorálně vedenou terapii obsedantně-kompulzivní symptomatologie u chlapce s autismem a dalšími neurovývojovými poruchami v komorbiditě. Popisuje složitý klinický obraz poruchy a dlouhodobě vedenou terapii.

The case report focuses on Cognitive Behavioural Guided Therapy of obsessive­compulsive symptomatology in a boy with autism and other neurodevelopmental disorders in comorbidity. It describes the complex clinical picture of the disorder and long­term therapy.

• MeSH
• antidepresiva aplikace a dávkování   terapeutické užití   MeSH
• behaviorální terapie metody   MeSH
• dítě MeSH
• kognitivně behaviorální terapie metody   MeSH
• lidé MeSH
• neurovývojové poruchy diagnóza   MeSH
• obsedantně kompulzivní porucha * diagnóza   psychologie   terapie   MeSH
• poruchy autistického spektra diagnóza   psychologie   terapie   MeSH
• rodinné vztahy MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

The perception of a voice in the absence of an external auditory source-an auditory verbal hallucination-is a characteristic symptom of schizophrenia. To better understand this phenomenon requires integration of findings across behavioural, functional, and neurochemical levels. We address this with a locally adapted MEGA-PRESS sequence incorporating interleaved unsuppressed water acquisitions, allowing concurrent assessment of behaviour, blood-oxygenation-level-dependent (BOLD) functional changes, Glutamate + Glutamine (Glx), and GABA, synchronised with a cognitive (flanker) task. We acquired data from the anterior cingulate cortex (ACC) of 51 patients with psychosis (predominantly schizophrenia spectrum disorder) and hallucinations, matched to healthy controls. Consistent with the notion of an excitatory/inhibitory imbalance, we hypothesized differential effects for Glx and GABA between groups, and aberrant dynamics in response to task. Results showed impaired task performance, lower baseline Glx and positive association between Glx and BOLD in patients, contrasting a negative correlation in healthy controls. Task-related increases in Glx were observed in both groups, with no significant difference between groups. No significant effects were observed for GABA. These findings suggest that a putative excitatory/inhibitory imbalance affecting inhibitory control in the ACC is primarily observed as tonic, baseline glutamate differences, rather than GABAergic effects or aberrant dynamics in relation to a task.

• MeSH
• cingulární gyrus metabolismus   patofyziologie   MeSH
• dospělí MeSH
• GABA * metabolismus   MeSH
• glutamin metabolismus   MeSH
• halucinace * metabolismus   patofyziologie   MeSH
• kognice * fyziologie   MeSH
• kyselina glutamová * metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladý dospělý MeSH
• psychotické poruchy * metabolismus   patofyziologie   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Chronic bronchitis is increasingly reported as a healthcare challenge in clinical settings partially due to the disease's bad prognosis and unresponsiveness to therapy, including the ineffectiveness of glucocorticoids. The ineffectiveness could have a link with genetic polymorphism of receptor genes resulting in inappropriate glucocorticoid pharmacodynamics. We sought to identify the role of gene polymorphism in the response of patients with chronic bronchitis to prednisolone therapy. To do so, a total of 60 newly diagnosed chronic bronchitis patients enrolled in the present study. Prednisolone at a dose of 30mg/day for two weeks was given and respiratory parameters [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC were measured before and after therapy. Blood samples were withdrawn for genetic profiling of genes involved in glucocorticoids pharmacodynamics, including BCII (rs41423247), N363S (rs56149945), and ER22/23EK (rs6189/rs6190) measured for their homozygous versus heterozygous gene splice variants.Results: Gene splice variants for BCII (rs41423247), N363S (rs56149945), and ER22/23EK (rs6189/rs6190) homozygous (73.3%, 98.7%, and 95%) represented a higher percentage than heterozygous (26.7%, 1.7%, and 5%). The respiratory parameters FEV1, FVC, and FEV1/FVC have shown significantly (p<0.05) better values at baseline in homozygous versus heterozygous, correspondingly, the responsiveness to therapy has shown significantly (p<0.05) better values in homozygous versus heterozygous.Conclusion: The study has provided a good template for genetic behaviour toward individualised medicine in our locality providing that these genes could be a cornerstone for discovering issues related to the pharmacodynamics profiling of drugs in clinical settings.

• MeSH
• chronická bronchitida * diagnóza   genetika   MeSH
• glukokortikoidy farmakologie   MeSH
• lidé MeSH
• polymerázová řetězová reakce metody   MeSH
• polymorfismus genetický genetika   MeSH
• prednisolon farmakologie   terapeutické užití   MeSH
• protein - isoformy genetika   MeSH
• receptory glukokortikoidů * genetika   účinky léků   MeSH
• respirační funkční testy metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• klinická studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: Understanding population health trends and their key determinants is essential for planning health services and implementing effective interventions. One of these determinants may be national cultural characteristics that are related to various health outcomes and health-related behaviours. However, little is known about their potential association to overall burden of disease. Thus, this study examined whether cultural characteristics expressed by Hofstede indexes are associated with the burden of disease. METHODS: We used data from open-source databases - Hofstede's Cultural Index, the Global Burden of Diseases (GBD) and the Human Development Index (HDI). The final sample comprised 69 countries covering all the continents. The burden of disease was measured using disability-adjusted life years (DALYs), years lived with disabilities (YLD), and years of life lost (YLL). National cultural characteristics were measured using Hofstede's dimensions. Bayesian correlation analyses were conducted to assess the relationships between cultural dimensions and health outcomes, stratified by countries' HDI levels. RESULTS: In countries with a very high HDI, there was strong evidence (Bayes Factor > 10) of a positive correlation of Power distance with the total disability-adjusted life years (r = 0.448) and years of life lost (r = 0.528), and Individualism (r = 0.667) and Indulgence (r = 0.494) with years lived with disabilities. In contrast, Long-term orientation negatively correlated of with years lived with disabilities (r = -0.527) and Indulgence with disability-adjusted life years (r = -0.437) and years of life lost (r = -0.537). Further, Power distance and Indulgence were correlated with the majority of the GBD indicators and Individualism with a few GBD indicators. In countries with a high and medium HDI, strong evidence of the associations was found in only a few cases. CONCLUSION: We found a correlation between national cultural characteristics and burden of disease. Policy-makers should consider integrating cultural factors into public health strategies to better align healthcare interventions with the local population's values and behaviours. Moreover, cross-cultural research and collaboration should increase to understand how cultural influences can be used to mitigate disease burdens and improve health outcomes globally. This study also opens a potentially new research area within population health research.

• MeSH
• Bayesova věta MeSH
• globální zátěž nemocemi * MeSH
• kulturní charakteristiky * MeSH
• lidé MeSH
• osobní újma zaviněná nemocí * MeSH
• počet let života s onemocněním MeSH
• zdravotní stav populace * statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Cíl: Cílem longitudinální studie bude zjistit rozdíly v 24hodinovém pohybovém chování (24hMB) (tj. spánku, sedavém chování (SB) a pohybové aktivitě (PA)) u českých dětí po jejich přestupu z mateřské do základní školy (ZŠ) (resp. z první/druhé třídy ZŠ do vyšších ročníků ZŠ) s ohledem na socioekonomické zázemí rodin, výskyt nadměrné tělesné hmotnosti účastníků či účasti v organizované PA. Metodika: 24hMB bude monitorováno po dobu 7 dnů pomocí akcelerometrů ActiGraph u rodin z městských a venkovských obcí z regionů Čech, Moravy a Slezska, jejichž členové dokončili první etapu výzkumu v období března 2022 až května 2023. Celkem 260 rodin, které dokončily první etapu výzkumu, poskytlo v rodinném deníku kontaktní údaje a nevyloučilo možnost pokračovat ve výzkumu ve druhé etapě v roce 2025/2026. Rodinný deník bude kromě informací o každodenním času uléhání/vstávání, době trávené před obrazovkou/monitorem/displejem obsahovat i informace o účasti v organizované PA, antropometrická data a údaje o rodinném zázemí. Výsledky: Z první etapy výzkumu vyplynulo, že celkem 25,9 % dívek a 26,7 % chlapců splnilo všechna tři doporučení ke spánku, PA a SB současně a dalších 44,7 % dívek a 46,1 % chlapců dosáhlo alespoň kombinaci dvou z těchto tří doporučení, bez rozdílů mezi pohlavím, věkovou kategorií nebo úrovní tělesné hmotnosti dětí. Nadměrná tělesná hmotnost matek významně (p < 0,05) snížila šanci dětí dosáhnout alespoň dvou ze tří doporučení, zatímco vysokoškolské vzdělání rodičů a dodržování alespoň dvou ze tří doporučení matkami významně (p < 0,05) zvýšilo pravděpodobnost, že také děti doporučení dodrží. Účast dětí v organizované PA významně (p < 0,05) zvyšuje jejich šanci na dosažení alespoň dvou ze tří doporučení k 24hMB. Závěry: První etapa longitudinálního výzkumu poukázala na stěžejní rodinné faktory (úroveň vzdělání rodičů, matčina úroveň tělesné hmotnosti a míra dosažení doporučení k 24hMB, podpora aktivní účasti dětí v organizované PA) zvyšující šanci dětí ke splnění zdravotních doporučení pro 24hMB.

Objective: The aim of this longitudinal study will be to investigate the differences in 24-hour movement behaviour (24hMB) (i.e., sleep, sedentary behaviour (SB) and physical activity (PA)) in Czech children after their transition from kindergarten to primary school (or from first/second grade to upper grades of primary school) with respect to the socioeconomic background of families, the prevalence of overweight participants or participation in organised PA. Methods: 24hMB will be monitored for seven days using ActiGraph accelerometers in families from urban and rural areas in the Bohemia, Moravia and Silesia regions, whose members completed the first phase of the study between March 2022 and May 2023. The 260 families who finished the first phase of the research provided their contact details in the family diary and have not ruled out the possibility of participating in the second phase in 2025/2026. The family diary will include information on daily bedtime and wake-up times, screen time, and participation in organised PA, as well as anthropometric data and family background information. Results: The findings from the first phase of the research showed that a total of 25.9% of girls and 26.7% of boys met all three guidelines on sleep, PA and SB simultaneously, and 44.7% of girls and 46.1% of boys achieved at least a combination of two of the three guidelines. No differences were observed between gender, age, or body weight levels of the children. Maternal excess body weight significantly (p < 0.05) decreased the odds of children achieving at least two of the three guidelines, whereas parental higher education and maternal adherence to at least two of the three guidelines significantly (p < 0.05) increased the odds that children also complied with the guidelines. Children’s participation in organised PA significantly (p < 0.05) increased their chances of achieving at least two of the three 24hMB guidelines. Conclusions: The first phase of the longitudinal research highlighted key family factors (parental education level, mother’s body weight, adherence to 24hMB guidelines, and support for children’s active participation in organised PA) that increase children’s chances of meeting guidelines for 24hMB.

• Klíčová slova
• studie FAMIPASS,
• MeSH
• akcelerometrie MeSH
• dítě MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• pohybová aktivita * MeSH
• předškolní dítě MeSH
• sedavý životní styl * MeSH
• spánek MeSH
• vztahy mezi rodiči a dětmi MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

V České republice je zneužívání γ-hydroxybutyrátu (GHB) či jeho prekurzoru 1,4-butanediolu (1,4-BD) pro jejich euforizačně sedativní efekt nejspíše okrajovou záležitostí. V dostupné literatuře není evidován počet intoxikací GHB či počet hospitalizací nebo úmrtí po požití GHB. Práce podává základní údaje o farmakokinetických a farmakodynamických vlastnostech GHB a 1,4-BD a klinickém dopadu užívání těchto látek. Připojena je kazuistika mladého muže, který byl dvakrát hospitalizován pro poruchy chování v rámci intoxikace GHB.

In the Czech Republic, the abuse of γ-hydroxybutyrate (GHB), or its precursor 1,4-butanediol (1,4-BD), for euphoric and sedative effects is presumably uncommon. Among existing literature there are no statistics on intoxication, hospitalization, or fatality after ingestion of GHB. This report concerns the pharmacokinetic and pharmacodynamic background of GHB and 1,4-BD, as well as the clinical impact of their abu- se. Also included is a case report documenting a young man who was hospitalized twice for behavioural anomalies due to GHB intoxication.

• MeSH
• analýza vlasů metody   MeSH
• benzodiazepinony aplikace a dávkování   MeSH
• butylenglykoly * aplikace a dávkování   farmakologie   otrava   škodlivé účinky   MeSH
• hypnotika a sedativa aplikace a dávkování   farmakologie   otrava   škodlivé účinky   MeSH
• lidé MeSH
• mladiství MeSH
• otrava alkoholem etiologie   farmakoterapie   patologie   MeSH
• otrava etiologie   farmakoterapie   patologie   MeSH
• oxybát sodný analýza   farmakologie   metabolismus   otrava   MeSH
• poruchy spojené s užíváním psychoaktivních látek * etiologie   farmakoterapie   patologie   MeSH
• poruchy způsobené alkoholem etiologie   farmakoterapie   patologie   MeSH
• toxikologické jevy MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• přehledy MeSH