The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision.ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

• MeSH
• delfská metoda MeSH
• gastrointestinální endoskopie normy   MeSH
• lidé MeSH
• společnosti lékařské MeSH
• ukazatele kvality zdravotní péče normy   MeSH
• zajištění kvality zdravotní péče metody   organizace a řízení   MeSH
• zlepšení kvality organizace a řízení   normy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• konsensus - konference MeSH
• práce podpořená grantem MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Evropa MeSH

This study aimed at examining the Resident Assessment Instrument- Home Care (RAI-HC) regarding its potential for a variety of researches as well as for improving quality of care. We searched Medline and PubMed database for peer-reviewed articles reporting primary data on the RAIHC in English. Study site, objectives of the studies, and findings were abstracted. The search identified 34 articles that met the author’s criteria. Nearly a half of the identified studies was conducted in Canada where the RAI-HC is officially used; therefore population based longitudinal survey is widely possible. Another nearly a half was based on a joint European study called ADHOC. There were broadly four types of studies. Firstly, the main focus was on a prevalence of particular conditions of home care clients across different care settings. Secondly, the focus was on predicting factors of either inappropriate events such as falls and nursing home admission or appropriate treatment regimen. Thirdly, the focus was on adverse consequences of clients’ conditions, such as care giver burden as a possible consequence of depressed clients. Lastly, the focus was on development of algorism or protocol to prioritize long-term care placement or rehabilitation planning. Substantial studies have been done using the RAI-HC and they have provided useful scientific insights in the area of home care. Official use of the RAI-HC in home care agencies throughout could contribute to help identify and respond to health promotion and disease prevention issues in this population.

• MeSH
• geriatrie MeSH
• lidé MeSH
• longitudinální studie MeSH
• průřezové studie MeSH
• senioři MeSH
• služby domácí péče * MeSH
• testování osobnosti MeSH
• ukazatele kvality zdravotní péče * MeSH
• ukazatele zdravotního stavu MeSH
• výzkum zdravotnických služeb MeSH
• výzkum MeSH
• zajištění kvality zdravotní péče * MeSH
• zdravotní služby pro seniory MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• práce podpořená grantem MeSH

BACKGROUND: Almost 100 novel cancer medicines have been approved in Europe over the last decade. Limited public health care resources in countries in Central and Eastern Europe (CEE) call for a prioritization of access to effective medicines. We investigated how both reimbursement status and waiting time to reimbursement correlate with the magnitude of clinical benefit provided by novel medicines in four selected countries (Czechia, Hungary, Poland, and Slovakia). MATERIALS AND METHODS: A total of 124 indications of 51 cancer medicines with marketing authorization by the European Medicines Agency in 2011-2020 were included and followed up until 2022. Data on reimbursement status and waiting time to reimbursement (i.e. time from marketing authorization to national reimbursement approval) were collected for each country. Data were analyzed in relation to clinical benefit status (i.e. substantial versus nonsubstantial clinical benefit) of indications according to the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). RESULTS: The degree of reimbursement differed between countries with 64% of indications with reimbursement in Czechia, 40% in Hungary, 51% in Poland, and 19% in Slovakia. In all countries, a significantly greater proportion of indications with a substantial clinical benefit was reimbursed (P < 0.05). The median waiting time to reimbursement ranged from 27 months in Poland to 37 months in Hungary. No significant differences in waiting time in relation to clinical benefit were observed in any country (P = 0.25-0.84). CONCLUSIONS: Cancer medicines with a substantial clinical benefit are more likely to be reimbursed in all four CEE countries. Waiting times to reimbursement are equally long for medicines with or without a substantial clinical benefit, indicating a lack of prioritization of fast access to medicines delivering a substantial benefit. Incorporation of the ESMO-MCBS in reimbursement assessments and decisions could aid in better utilization of limited resources to deliver more effective cancer care.

• MeSH
• lékařská onkologie MeSH
• lidé MeSH
• nádory * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH
• Polsko MeSH

BACKGROUND AND PURPOSE: Neurological disorders constitute a significant portion of the global disease burden, affecting >30% of the world's population. This prevalence poses a substantial threat to global health in the foreseeable future. A lack of awareness regarding this high burden of neurological diseases has led to their underrecognition, underappreciation, and insufficient funding. Establishing a strategic and comprehensive research agenda for brain-related studies is a crucial step towards aligning research objectives among all pertinent stakeholders and fostering greater societal awareness. METHODS: A scoping literature review was undertaken by a working group from the European Academy of Neurology (EAN) to identify any existing research agendas relevant to neurology. Additionally, a specialized survey was conducted among all EAN scientific panels, including neurologists and patients, inquiring about their perspectives on the current research priorities and gaps in neurology. RESULTS: The review revealed the absence of a unified, overarching brain research agenda. Existing research agendas predominantly focus on specialized topics within neurology, resulting in an imbalance in the number of agendas across subspecialties. The survey indicated a prioritization of neurological disorders and research gaps. CONCLUSIONS: Building upon the findings from the review and survey, key components for a strategic and comprehensive neurological research agenda in Europe were delineated. This research agenda serves as a valuable prioritization tool for neuroscientific researchers, as well as for clinicians, donors, and funding agencies in the field of neurology. It offers essential guidance for creating a roadmap for research and clinical advancement, ultimately leading to heightened awareness and reduced burden of neurological disorders.

• MeSH
• globální zátěž nemocemi MeSH
• lidé MeSH
• nemoci nervového systému * epidemiologie   terapie   MeSH
• neurologie * MeSH
• výzkum MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Cieľom autorov bolo oboznámiť odbornú verejnosť s povahou a metodikou spracovávania jedného z piatich kľúčových indikátorov Európskeho monitorovacieho centra pre drogy a drogovú závislosť – s indikátorom problematického užívania drog na konkrétnom priklade použitia jeho lokálneho odhadu pre Bratislavu. Vzhľadom na dynamické zmeny, rôznorodosť situácie v populácii užívateľov v mieste a čase, autori očakávali, že pri viacerých prieskumoch a rôznych formách spracovania materiálu bude v tej istej lokalite zistený výrazný rozptyl výsledkov odhadu. Miestami zberu údajov boli nízkoprahové programy pre užívateľov drog v Bratislave v období roku 2005. Po triangulácii všetkých výstupov sa javí za odborne a aj z perspektívy minimalizácie rizika zjednodušujúcich politických interpretácií ako najspoľahlivejší dolný a horný limit odhadu počtu problematických užívateľov drog medzi 1,9 – 24,9 na 1000 obyvateľov, čo by bolo v prepočte od 900 do 12 200 problematických užívateľov. Z jednotlivých odhadov by autori uprednostnili odhad podľa údajov z materiálu z kontaktného centra pre počítaný na počet obyvateľov Bratislavy podľa pobytu nahláseného z jej mestských častí. Ten sa pohyboval v rozmedzí 7,4 – 24,9 / 1000 (od 3 600 do 12 300 osôb), s centrálnou hodnotou okolo 5 600. Výsledky ukazujú, že charakter skúmaných údajov neumožňuje presne utvoriť obraz o realite na základe jednotlivého odhadu. Preto je vhodnejšie jeho výsledok hodnotiť a interpretovať opatrne a k informácii o skutočnom stave problémového užívania sa dopracúvať postupne, aproximáciou z viacerých odhadov využívajúcich rôzne zdroje a metódy. Uvádzanie širšieho rozpätia a jeho uprednostnenie pred centrálnou hodnotou zvyšuje spolahlivosť odhadu a výpovednú hodnotu pre prax.

The aim of the authors was to inform the professionals about the principles and methods of elaboration of one of the European Monitoring Centre for Drugs and Drug Addiction key indicators – the indicator of Problematic Drug Use on its concrete example of the local estimates for Bratislava. The authors expected that there will be remarkable difference among the results of different estimations derived from several surveys with the usage of different procedure s in the same city. Data collection was realized in the low threshold programs for drug users in Bratislava in the year 2005. The most reliable seems to be the estimates of lower and upper limits between 1.9 – 24.9 / 1000 inhabitants, that would be from 900 to 12 300 of problematic drug users, which was derived from the triangulation of all the results. It is also preferable with the respect to minimize the risk of politically simplified interpretations. The single estimation preferred by the authors would be one where the data were gathered from the contact centre and calculated with the number of all inhabitants living in the city as they were reported by different Bratislava districts. It was 7.4 – 24.9 / 1000 (from 3 600 to 12 300) persons with the central value of 5 600. The results indicate, that the character of the research data does not enable us to form an exact picture of the reality on the basis of a single estimation. Therefore, it is more proper to evaluate and to interpret the results of PDU carefully and to come to the real situation gradually using the approximation of more estimates from different source s and with different methods. Presentation of a wider interval and its prioritization to central value increases the reliability of the estimation and its practical predictive value.

• Klíčová slova
• Bratislava (Slovensko),
• MeSH
• dospělí MeSH
• epidemiologické monitorování MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• poruchy spojené s užíváním psychoaktivních látek * epidemiologie   MeSH
• prevalence MeSH
• průzkumy a dotazníky MeSH
• sociální problémy MeSH
• uživatelé drog psychologie   MeSH
• velkoměsta MeSH
• zpráva o sobě MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• Geografické názvy
• Slovenská republika MeSH
• velkoměsta MeSH

About 15% of colorectal cancer (CRC) patients have first-degree relatives affected by the same malignancy. However, for most families the cause of familial aggregation of CRC is unknown. To identify novel high-to-moderate-penetrance germline variants underlying CRC susceptibility, we performed whole exome sequencing (WES) on four CRC cases and two unaffected members of a Polish family without any mutation in known CRC predisposition genes. After WES, we used our in-house developed Familial Cancer Variant Prioritization Pipeline and identified two novel variants in the solute carrier family 15 member 4 (SLC15A4) gene. The heterozygous missense variant, p. Y444C, was predicted to affect the phylogenetically conserved PTR2/POT domain and to have a deleterious effect on the function of the encoded peptide/histidine transporter. The other variant was located in the upstream region of the same gene (GRCh37.p13, 12_129308531_C_T; 43 bp upstream of transcription start site, ENST00000266771.5) and it was annotated to affect the promoter region of SLC15A4 as well as binding sites of 17 different transcription factors. Our findings of two distinct variants in the same gene may indicate a synergistic up-regulation of SLC15A4 as the underlying genetic cause and implicate this gene for the first time in genetic inheritance of familial CRC.

• MeSH
• genetická predispozice k nemoci MeSH
• kolorektální nádory * genetika   patologie   MeSH
• lidé MeSH
• membránové transportní proteiny genetika   MeSH
• proteiny nervové tkáně genetika   MeSH
• rodokmen MeSH
• sekvenování exomu MeSH
• zárodečné buňky patologie   MeSH
• zárodečné mutace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Mycotoxins are secondary metabolites produced by various molds that contaminate many staple foods and cause a broad range of detrimental health effects in animals and humans through chronic exposure or acute toxicity. As such, the worldwide contamination of food and feed with mycotoxins is a significant problem, especially in sub-Saharan Africa. In this study, mycotoxin occurrence in staple foods consumed in Somalia was determined. A total of 140 samples (42 maize, 40 sorghum, and 58 wheat) were collected from a number of markets in Mogadishu, Somalia, and analyzed by a UPLC-MS/MS multimycotoxin method that could detect 77 toxins. All of the maize samples tested contained eight or more mycotoxins, with aflatoxin B1 (AFB1) and fumonisin B1 (FB1) levels reaching up to 908 and 17 322 μg/kg, respectively, greatly exceeding the European Union limits and guidance values. The average probable daily intake of fumonisins (FB1 and FB2) was 16.70 μg per kilogram of body weight (kg bw) per day, representing 835% of the recommended provisional maximum tolerable daily intake value of 2 μg/(kg bw)/day. A risk characterization revealed a mean national margin of exposure of 0.62 for AFB1 with an associated risk of developing primary liver cancer estimated at 75 cancers per year per 100 000 people for white-maize consumption alone. The results clearly indicate that aflatoxin and fumonisin exposure is a major public-health concern and that risk-management actions require prioritization in Somalia.

• MeSH
• aflatoxin B1 analýza   MeSH
• fumonisiny aplikace a dávkování   analýza   MeSH
• kontaminace potravin analýza   MeSH
• kukuřice setá chemie   MeSH
• lidé MeSH
• maximální přípustná koncentrace MeSH
• mykotoxiny analýza   toxicita   MeSH
• nádory jater chemicky indukované   MeSH
• pšenice chemie   MeSH
• rizikové faktory MeSH
• Sorghum chemie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Somálsko MeSH

Barriers represent one of the largest anthropogenic impacts on the ecological status of rivers, and they also potentially restrict fishes' ability to respond to future environmental changes. Thus, river management aims to restore the longitudinal connectivity of rivers to allow continuous migration and movement of water, sediments and biota. However, it is often unclear whether the targeted barriers are also those most relevant for fish species, particularly to track future habitat shifts caused by environmental change. In this study, we applied species distribution models and the GIS-based fish dispersal model FIDIMO to evaluate the impacts of barriers (e.g. weirs and dams) on the dispersal of 17 native fish species in the European River Elbe with a particular focus on climate- and land use-induced habitat shifts. Specifically, we compared three scenarios of longitudinal connectivity: (i) current longitudinal connectivity, (ii) connectivity improvements as planned by river managers for 2021 and (iii) a reference with full longitudinal connectivity. The models indicated that barriers restricted the movement of two modeled fish species on average, thus impeding fishes' abilities to track future habitat shifts. Moreover, the number of species affected by barriers increased downstream. For the River Elbe, our results suggest that river management has most likely identified the most relevant barriers in respect to the modeled species and future environmental change. We emphasize that river management and barrier prioritization must thoroughly consider species-specific movement and dispersal abilities, as well as the specific spatial arrangement of barriers in the river system in relation to the spatial distribution of species' populations and suitable habitats.

• MeSH
• druhová specificita MeSH
• ekosystém * MeSH
• řeky MeSH
• ryby * MeSH
• společenstvo MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

• MeSH
• behaviorální vědy * metody   trendy   MeSH
• COVID-19 * epidemiologie   etnologie   prevence a kontrola   MeSH
• komunikace MeSH
• kultura MeSH
• lékařská praxe založená na důkazech * metody   MeSH
• lidé MeSH
• pandemie * prevence a kontrola   MeSH
• sociální normy MeSH
• veřejné zdravotnictví metody   trendy   MeSH
• vůdcovství MeSH
• vytváření politiky * MeSH
• zdravotní politika * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH