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Gambling encompasses a wide variety of activities, and the structural characteristics of each form contribute to its potential risk. However, the literature does not fully agree on the risk levels of certain gambling forms. In this study, we classify less risky gambling forms (soft forms) based on public perceptions of their riskiness. We examine the link between gambling experience and problem gambling prevalence. A survey was conducted in a model region of the Czech Republic, a post-socialist country with high gambling availability, with N = 2,498 respondents. A typology of gambling forms (lotteries, betting, and casino games) was created based on perceived risk similarities. Lotteries are the most frequently played gambling form, with 86.3% reporting lifetime participation. Among those who exclusively engage in lottery-type forms, 15 percentage points more women than men participated in the last year, and the gap widens to 31 points over a lifetime. Forms of gambling perceived as more risky show a lower proportion of non-problem gamblers, both for recent and lifetime participation. Furthermore, individuals who gambled within the past month or year are at higher risk of developing gambling problems compared to those whose gambling experiences were less recent.
- MeSH
- dospělí MeSH
- hráčství * psychologie klasifikace epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- návykové chování * psychologie epidemiologie klasifikace MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- riskování * MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Categorization systems for tick-borne encephalitis virus (TBEV) infection lack consistency in classifying disease severity. To evaluate the need for a standard, consensus-based categorisation system for TBEV infection across subtypes, we gathered an expert panel of clinicians and scientists with diverse expertise in TBEV infection. Consensus was sought using the Delphi technique, which consisted of 2 web-based survey questionnaires and a final, virtual, consensus-building exercise. Ten panellists representing 8 European countries participated in the Delphi exercise, with specialities in neurology, infectious disease, paediatrics, immunology, virology, and epidemiology. Panellists reached unanimous consensus on the need for a standardised, international categorisation system to capture both clinical presentation and severity of TBEV infection. Ideally, such a system should be feasible for use at bedside, be clear and easy to understand, and capture both the acute and follow-up phases of TBEV infection. Areas requiring further discussion were (1) the timepoints at which assessments should be made and (2) whether there should be a separate system for children. This Delphi panel study found that a critical gap persists in the absence of a feasible and practical classification system for TBEV infection. Specifically, the findings of our Delphi exercise highlight the need for the development of a user-friendly classification system that captures the acute and follow-up (i.e., outcome) phases of TBEV infection and optimally reflects both clinical presentation and severity. Development of a clinical categorisation system will enhance patient care and foster comparability among studies, thereby supporting treatment development, refining vaccine strategies, and fortifying public health surveillance.
- MeSH
- delfská metoda * MeSH
- klíšťová encefalitida * epidemiologie virologie diagnóza MeSH
- konsensus MeSH
- lidé MeSH
- viry klíšťové encefalitidy * klasifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Various explicit screening tools, developed mostly in central Europe and the USA, assist clinicians in optimizing medication use for older adults. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria set, primarily based on the STOPP/START criteria set, is a current explicit tool originally developed for Eastern Europe and subsequently validated for broader use in Central European settings. Reviewed every three months to align with the latest scientific literature, it is one of the most up-to-date tools available. The tool is accessible via a free mobile app and website platforms, ensuring convenience for clinicians and timely integration of updates as needed. Healthcare providers often prefer to use their native language in medical practice, highlighting the need for prescribing tools to be translated and adapted into multiple languages to promote optimal medication practices. OBJECTIVE: To describe the protocol for cross-cultural and language validation of the TIME criteria in various commonly used languages and to outline its protocol for clinical validation across different healthcare settings. METHODS: The TIME International Study Group comprised 24 geriatric pharmacotherapy experts from 12 countries. In selecting the framework for the study, we reviewed the steps and outcomes from previous research on cross-cultural adaptations and clinical validations of explicit tools. Assessment tools were selected based on both their validity in accurately addressing the relevant issues and their feasibility for practical implementation. The drafted methodology paper was circulated among the study group members for feedback and revisions leading to a final consensus. RESULTS: The research methodology consists of two phases. Cross-cultural adaptation/language validation phase follows the 8-step approach recommended by World Health Organization. This phase allows regions or countries to make modifications to existing criteria or introduce new adjustments based on local prescribing practices and available medications, as long as these adjustments are supported by current scientific evidence. The second phase involves the clinical validation, where participants will be randomized into two groups. The control group will receive standard care, while the intervention group will have their treatment evaluated by clinicians who will review the TIME criteria and consider its recommendations. A variety of patient outcomes (i.e., number of hospital admissions, quality of life, number of regular medications [including over the counter medications], geriatric syndromes and mortality) in different healthcare settings will be investigated. CONCLUSION: The outputs of this methodological report are expected to promote broader adoption of the TIME criteria. Studies building on this work are anticipated to enhance the identification and management of inappropriate medication use and contribute to improved patient outcomes.
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 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 * epidemiologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie * MeSH
- poskytování zdravotní péče organizace a řízení MeSH
- průzkumy a dotazníky MeSH
- rozhovory jako téma MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- telemedicína * organizace a řízení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: The development of External Quality Assessment Schemes (EQAS) for clinical flow cytometry (FCM) is challenging in the context of rare (immunological) diseases. Here, we introduce a novel EQAS monitoring the primary immunodeficiency Orientation Tube (PIDOT), developed by EuroFlow, in both a 'wet' and 'dry' format. This EQAS provides feedback on the quality of individual laboratories (i.e., accuracy, reproducibility and result interpretation), while eliminating the need for sample distribution. METHODS: In the wet format, marker staining intensities (MedFIs) within landmark cell populations in PIDOT analysis performed on locally collected healthy control (HC) samples, were compared to EQAS targets. In the dry format, participants analyzed centrally distributed PIDOT flow cytometry data (n=10). RESULTS: We report the results of six EQAS rounds across 20 laboratories in 11 countries. The wet format (212 HC samples) demonstrated consistent technical performance among laboratories (median %rCV on MedFIs=34.5 %; average failure rate 17.3 %) and showed improvement upon repeated participation. The dry format demonstrated effective proficiency of participants in cell count enumeration (range %rCVs 3.1-7.1 % for the major lymphoid subsets), and in identifying lymphoid abnormalities (79.3 % alignment with reference). CONCLUSIONS: The PIDOT-EQAS allows laboratories, adhering to the standardized EuroFlow approach, to monitor interlaboratory variations without the need for sample distribution, and provides them educational support to recognize rare clinically relevant immunophenotypic patterns of primary immunodeficiencies (PID). This EQAS contributes to quality improvement of PID diagnostics and can serve as an example for future flow cytometry EQAS in the context of rare diseases.
BACKGROUND: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. OBJECTIVE: To identify how to improve surveillance of movement behaviours, from the perspective of experts. METHODS: This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from 'extremely' to 'not at all' important. Consensus was defined as > 70% rating of 'extremely' or 'very' important. RESULTS: We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research. CONCLUSIONS: This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.
- MeSH
- budování kapacit MeSH
- čas strávený před obrazovkou * MeSH
- celosvětové zdraví MeSH
- cvičení * MeSH
- delfská metoda * MeSH
- dítě MeSH
- konsensus MeSH
- lidé MeSH
- mladiství MeSH
- sedavý životní styl * MeSH
- spánek MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Během těhotenství dochází k významným fyziologickým změnám, které ovlivňují funkci štítné žlázy. Hormony štítné žlázy jsou klíčové pro vývoj plodu, zejména v prvním trimestru, kdy je plně závislý na mateřských hormonech. Poruchy štítné žlázy, jako je hypotyreóza nebo autoimunitní tyreoiditida, mohou negativně ovlivnit fertilitu a průběh těhotenství a jsou v populaci časté. Od roku 2024 byl proto v ČR zaváděn celoplošný screening tyreopatií v těhotenství, díky kterému podstoupí vyšetření štítné žlázy a ultrazvuk štítné žlázy více těhotných žen než dříve. Vedlejším nálezem, na který screening primárně necílí, pak mohou být uzlové změny ve štítné žláze. Převážná část z nich je benigní, ale vzácně může být zachycen i karcinom štítné žlázy. V této stati je prezentována kazuistika pacientky, u které byl v rámci těhotenského screeningu zachycen papilární karcinom štítné žlázy a která podstoupila totální tyroidektomii ve druhém trimestru gravidity.
During pregnancy, significant physiological changes occur that affect thyroid function. Thyroid hormones are crucial for fetal development, especially in the first trimester when the fetus is fully dependent on maternal hormones. Thyroid disorders such as hypothyroidism or autoimmune thyroiditis can adversely affect fertility and the course of pregnancy and and are commonly found in the population. Therefore, since 2024, a nationwide screening for thyroid disease in pregnancy has been introduced in the country, which will result in more pregnant women undergoing thyroid screening and thyroid ultrasound than before. A secondary finding not primarily targeted by screening may be nodular changes in the thyroid gland. The majority of these (99%) are benign, but rarely thyroid cancer may be detected. In this article, we present a case report of a patient who was found to have papillary thyroid carcinoma during pregnancy screening and who underwent total thyroidectomy in the second trimester of pregnancy.
Onemocnění způsobené virem dengue, přenášené komáry rodu Aedes, se vyskytuje především v tropech a subtropech. Celosvětově se jedná o jednu z nejčastějších arbovirových infekcí vůbec. Studie Světové zdravotnické organizace (WHO) Global Burden of Disease) uvádí, že výskyt horečky dengue roste rychleji než kteréhokoli jiného přenosného onemocnění, přičemž za pouhých 13 let (2000-2013) došlo k nárůstu počtu infikovaných o 400 %. Nejvíce je zasažen asijský kontinent, následují země Latinské Ameriky a Afrika. Rychlé geografické šíření viru dengue a jeho vektorů spolu s civilizačními faktory přenáší tento problém i na americký a evropský kontinent. Pro onemocnění jsou typické jak mírné formy infekce, tak smrtelné šokové syndromy. Základem léčby většiny symptomatických pacientů stále zůstává intravenózní hydratační terapie. Vyvíjejí se však nové rychlé diagnostické testy, stejně jako se velmi intenzivně hledají biomarkery pro spolehlivou předpověď rozvoje závažných forem nemoci. První vakcína proti horečce dengue byla licencována v roce 2015. Rychlá diagnostika, účinná vakcína a programy kontroly vektorů viru jsou jedinou možnou účinnou cestou, jak čelit aktivnímu celosvětovému šíření této infekce.
Dengue virus disease, transmitted by Aedes mosquitoes, occurs mainly in the tropics and subtropics. Worldwide, it is one of the most common arboviral infections ever. The World Health Organization's Global Burden of Disease study reports that dengue is increasing faster than any other communicable disease, with a 400% increase in infections in just 13 years (2000-2013). The Asian continent is the most affected, followed by Latin American countries and Africa. The rapid geographic spread of dengue virus and its vectors, together with civilisational factors, is bringing the problem to the American and European continents. The disease is characterised by both mild forms of infection and fatal shock syndromes. The mainstay of treatment for most symptomatic patients still remains intravenous hydration therapy. However, new rapid diagnostic tests are being developed, as well as a very intensive search for biomarkers to reliably predict the development of severe forms of the disease. The first dengue vaccine was licensed in 2015. Rapid diagnostics, an effective vaccine and viral vector control programmes are the only possible effective way to counter the active global spread of this infection.
Kontaminace pitných vod původci virové gastroenteritidy (př. noroviry, rotaviry, adenoviry) představuje ve vodním hospodářství výzvu, zejména při ochraně zdrojů surové vody a dezinfekci pitné vody. V této práci mapujeme výskyt a možnosti odstraňování virových původců gastroenteritidy v oběhovém vodním hospodářství s cílem omezit riziko ohrožení veřejného zdraví v důsledku virové kontaminace. Enterické viry se do odpadních vod dostávají stolicí infikovaných jedinců. Při konvenčním mechanicko‐biologickém čištění odpadních vod jsou odstraňovány jen částečně a společně s viry v odlehčených odpadních vodách mohou pronikat až do zdrojů surové vody pro úpravny vod. Během procesů úpravy vody dochází ke snižování jejich množství, zejména díky pokročilým oxidačním procesům a dezinfekci. Zatímco v rozvojových zemích je přítomnost těchto virů v distribučních sítích běžná a dlouhodobá, v České republice je jejich výskyt zaznamenáván pouze výjimečně, a to při haváriích, například v Praze v roce 2015 nebo v Libereckém kraji v roce 2022. Z důvodu snížení potenciálních rizik při úpravě vody je vhodné sledovat míru znečištění viry v celém antropogenním vodním cyklu a zamezit únikům nevyčištěné odpadní vody do prostředí.
Contamination of drinking water by viral agents of gastroenteritis (e.g., norovirus, rotavirus, adenovirus) poses a challenge for water management, especially in protecting the freshwater resources and water disinfection. Mapping the occurrence of these viral pathogens within the anthropogenic water cycle can help reduce the risk to public health resulting from viral contamination. Enteric viruses are excreted in the feces of infected individuals and enter the wastewater. During conventional mechanical‐biological wastewater treatment, the excreted viruses are removed only partially and, together with viruses in overflow discharges, may reach raw water sources for drinking water production. During water treatment processes, their concentrations are reduced, especially by advanced oxidation processes and disinfection. The presence of these viruses in distribution systems has been documented even in the Czech Republic during incidents (e.g., Prague 2015, Liberec region 2022) and is a persistent issue in developing countries. Therefore, it is essential to monitor viral contamination throughout the entire anthropogenic water cycle and to prevent the release of untreated wastewater into the environment.
