BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) still has a relatively high complication rate, underscoring the importance of high-quality training. Despite existing guidelines, real-world data on training conditions remain limited. This pan-European survey aims to systematically explore the perceptions surrounding ERCP training. METHODS: A survey was distributed through the friends of United European Gastroenterology (UEG) Young Talent Group network to physicians working in a UEG member or associated states who regularly performed ERCPs. RESULTS: Of 1035 respondents from 35 countries, 649 were eligible for analysis: 228 trainees, 225 trainers, and 196 individuals who regularly performed ERCP but were neither trainees nor trainers. The mean age was 43 years, with 72.1% identifying as male, 27.6% as female, and 0.3% as non-binary. The majority (80.1%) agreed that a structured training regimen is desirable. However, only 13.7% of trainees and 28.4% of trainers reported having such a structured program in their institutions. Most respondents (79.7%) supported the concept of concentrating training in centers meeting specific quality metrics, with 64.1% suggesting a threshold of 200 annual ERCPs as a prerequisite. This threshold revealed that 36.4% of trainees pursued training in lower-volume centers performing <200 ERCPs annually. As many as 70.1% of trainees performed <50 annual ERCPs, whereas only 5.0% of trainers performed <50 ERCPs annually. A low individual trainee caseload (<50 ERCPs annually) was more common in lower-volume centers than in higher-volume centers (82.9% vs. 63.4%). CONCLUSIONS: The first pan-European survey investigating ERCP training conditions reveals strong support for structured training and the concentration of training efforts within centers meeting specific quality metrics. Furthermore, this survey exposes the low availability of structured training programs with many trainees practicing at lower-volume centers and 71% of all trainees having little hands-on exposure. These data should motivate to standardize ERCP training conditions further and ultimately improve patient care throughout Europe.

• MeSH
• Cholangiopancreatography, Endoscopic Retrograde * standards   adverse effects   MeSH
• Adult MeSH
• Gastroenterology * education   MeSH
• Clinical Competence standards   MeSH
• Middle Aged MeSH
• Humans MeSH
• Surveys and Questionnaires statistics & numerical data   MeSH
• Education, Medical, Graduate * standards   methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH

BACKGROUND: Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain. METHODS: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients with myocardial infarction who had undergone percutaneous coronary intervention to receive either spironolactone or placebo and either colchicine or placebo. The results of the spironolactone trial are reported here. The two primary outcomes were a composite of death from cardiovascular causes or new or worsening heart failure, evaluated as the total number of events; and a composite of the first occurrence of myocardial infarction, stroke, new or worsening heart failure, or death from cardiovascular causes. Safety was also assessed. RESULTS: We enrolled 7062 patients at 104 centers in 14 countries; 3537 patients were assigned to receive spironolactone and 3525 to receive placebo. At the time of our analyses, the vital status was unknown for 45 patients (0.6%). For the first primary outcome, there were 183 events (1.7 per 100 patient-years) in the spironolactone group as compared with 220 events (2.1 per 100 patient-years) in the placebo group over a median follow-up period of 3 years (hazard ratio adjusted for competing risk of death from noncardiovascular causes, 0.91; 95% confidence interval [CI], 0.69 to 1.21; P = 0.51). With respect to the second primary outcome, an event occurred in 280 of 3537 patients (7.9%) in the spironolactone group and 294 of 3525 patients (8.3%) in the placebo group (hazard ratio adjusted for competing risk, 0.96; 95% CI, 0.81 to 1.13; P = 0.60). Serious adverse events were reported in 255 patients (7.2%) in the spironolactone group and 241 (6.8%) in the placebo group. CONCLUSIONS: Among patients with myocardial infarction, spironolactone did not reduce the incidence of death from cardiovascular causes or new or worsening heart failure or the incidence of a composite of death from cardiovascular causes, myocardial infarction, stroke, or new or worsening heart failure. (Funded by the Canadian Institutes of Health Research and others; CLEAR ClinicalTrials.gov number, NCT03048825.).

• MeSH
• Mineralocorticoid Receptor Antagonists * therapeutic use   adverse effects   MeSH
• Stroke mortality   MeSH
• Double-Blind Method MeSH
• Myocardial Infarction * mortality   drug therapy   MeSH
• Kaplan-Meier Estimate MeSH
• Cardiovascular Diseases mortality   prevention & control   MeSH
• Percutaneous Coronary Intervention MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Spironolactone * therapeutic use   adverse effects   MeSH
• Heart Failure * drug therapy   mortality   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH

OBJECTIVES: Pseudomonas aeruginosa (PA) is a common causative pathogen of pneumonia acquired in the intensive care unit (ICU). The aim of this study was to determine the incidence of PA ICU pneumonia (PAIP) and to quantify its independent association with PA colonization at different body sites. METHODS: Adult patients on mechanical ventilation at ICU admission were prospectively enrolled across 30 European ICUs. PA colonization in the perianal area and in the lower respiratory tract was assessed within 72 hours after ICU admission and twice weekly until ICU discharge. PAIP development was evaluated daily. Competing risk models with colonization as a time-varying exposure and ICU death and discharge as competing events were fitted and adjusted for confounders to investigate the association between PA carriage and PAIP. RESULTS: A total of 1971 subjects were enrolled. The colonization prevalence with PA in the first 72 hours of ICU admission was 10.4% (179 perianal and 51 respiratory), whereas the acquisition incidence during the ICU stay was 7.0% (158 perianal and 47 respiratory). Of the 43 (1.8%) patients who developed PAIP, 11 (25.6%) were PA colonized on admission and 9 (20.9%) acquired colonization before PAIP onset. Both perianal (adjusted subdistribution hazard ratio, 4.4; 95% CI, 1.7-11.6) and respiratory colonization (adjusted subdistribution hazard ratio: 4.6, 95% CI, 1.9-11.1) were independently associated with PAIP development. DISCUSSION: PAIP incidence was higher in PA colonized vs. non-colonized patients. Colonization of both the rectum and of the respiratory tract was associated with development of PAIP. The increased risk of PA colonization for subsequent infection provides an opportunity for targeted preventive interventions.

• MeSH
• Adult MeSH
• Incidence MeSH
• Cross Infection epidemiology   microbiology   MeSH
• Intensive Care Units * statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Carrier State epidemiology   microbiology   MeSH
• Prevalence MeSH
• Prospective Studies MeSH
• Pseudomonas Infections * epidemiology   microbiology   MeSH
• Pseudomonas aeruginosa * isolation & purification   MeSH
• Aged MeSH
• Pneumonia, Ventilator-Associated epidemiology   microbiology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Geographicals
• Europe MeSH

Human migration is an increasingly common phenomenon and migrants are at risk of disadvantageous treatment. We reasoned that migrants may receive differential treatment by locals based on the closeness of their facial features to the host average. Residents of Türkiye, the country with the largest number of refugees currently, served as participants. Because many of these refugees are of Arabic origin, we created target facial stimuli varying along the axis connecting Turkish and Arabic morphological prototypes (excluding skin colour) computed using geometric morphometrics and available databases. Participants made judgements of two universal dimensions of social perception-warmth and competence-on these faces. We predicted that participants judging faces manipulated towards the Turkish average would provide higher warmth and competence ratings compared to judging the same faces manipulated towards the Arabic average. Bayesian statistical tools were employed to estimate parameter values in multilevel models with intercorrelated varying effects. The findings did not support the prediction and revealed raters (as well as target faces) to be an important source of variation in social judgements. In the absence of simple cues (e.g. skin colour, group labels), the effect of facial morphology on social judgements may be much more complex than previously assumed.

• MeSH
• Bayes Theorem MeSH
• Adult MeSH
• Humans MeSH
• Judgment * MeSH
• Adolescent MeSH
• Young Adult MeSH
• Face anatomy & histology   MeSH
• Facial Recognition physiology   MeSH
• Social Perception * MeSH
• Stereotyping * MeSH
• Refugees psychology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Turkey MeSH

BACKGROUND: Ice hockey is a dynamic game. We can observe collisions between the players that bring a risk of injury. There are many hockey clubs in the Czech Republic. These clubs raise great hockey players and many competing players in various levels of national leagues. The aim of this study was to map injuries in Czech hockey players and outline the situation of injury prevention and body care in ice hockey players. METHODS: We used a questionnaire survey method to obtain data. We received answers from 100 male active Czech ice hockey players, playing in the top three highest men's competitions (Extraleague - 2nd league). Individual injuries were analyzed according to specific body parts, injury type, playing position, level of competition using basic statistical characteristics and relative frequency analyses, including the recovery time, injury reason and the injury statistics per 1000 sporting performances in ice hockey. RESULTS: We found that 81% of participants suffered injuries with the overall incidence of injuries was 17.1 per 1000 sports performances and mainly happened during the match compared to training. The most common injuries were in the head and neck area (25%), often caused by a collision with another player, a stick or puck hit, or a collision with a board. Other frequently injured parts were the knees (21%), where internal ligament injuries predominate, and the shoulders (20%), where we recorded mainly ligament injuries. CONCLUSIONS: There is a high risk of various injury types of ice hockey players, that are developed accidentally in all body parts mostly in the match (mostly upper part of the body and knee) or by overloading (hip/groin area). We recommend strategies to avoid or minimize the injury risk of players. The hockey clubs, coaches, and players should extensively and regularly cooperate with physiotherapists, starting from the younger age of hockey groups, to prevent injuries and use regular strengthening of crucial muscle parts, regeneration, and compensatory exercises. We endorse adequately evaluating dangerous foul actions for referees and disciplinary officials also in minor competitions.

• MeSH
• Adult MeSH
• Hockey * injuries   MeSH
• Incidence MeSH
• Humans MeSH
• Young Adult MeSH
• Surveys and Questionnaires MeSH
• Athletic Injuries * epidemiology   prevention & control   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Mezinárodní vzdělávací program Erasmus+ nabízí studentům jedinečnou příležitost prohloubit své odborné dovednosti a zároveň poznat odlišné kultury. Tento článek reflektuje zkušenosti studentek Střední zdravotnické školy Hradec Králové, které se v únoru 2025 zúčastnily dvoutýdenní stáže ve vesnici Delpitiya na Srí Lance. Text se zaměřuje na kulturní, náboženské, gastronomické a vzdělávací aspekty tohoto pobytu, přičemž analyzuje specifika místního prostředí a jeho vliv na osobní a profesní rozvoj účastnic. Článek zkoumá náboženskou rozmanitost Srí Lanky, upozorňuje na charakteristiku místní kuchyně, zkoumá postupy předškolního vzdělávání a popisuje volnočasové aktivity, které obohatily interkulturní kompetence studentů. Prostřednictvím přímé interakce s místní komunitou si studenti zvýšili svou adaptabilitu, empatii a rozšířili své perspektivy, což dokazuje hodnotu programů mezinárodní mobility pro budoucí zdravotnické pracovníky.

The international Erasmus+ educational program offers students a unique opportunity to deepen their professional skills while experiencing different cultures. This article reflects the experiences of students from the Secondary Medical School of Hradec Králové, who participated in a two-week internship in the village of Delpitiya, Sri Lanka, in February 2025. It focuses on cultural, religious, gastronomic, and educational aspects of their stay, analyzing the specifics of the local environment and its impact on their personal and professional growth. The article explores the religious diversity of Sri Lanka, highlights the characteristics of local cuisine, examines preschool education practices, and describes leisure activities that enriched the students’ intercultural competencies. Through direct interaction with the local community, students enhanced their adaptability, empathy, and broadened their perspectives, demonstrating the value of international mobility programs for future healthcare professionals.

• MeSH
• Clinical Competence MeSH
• Professional Competence MeSH
• Psychotherapy classification   organization & administration   education   MeSH
• Terminology as Topic MeSH
• Publication type
• News MeSH

Tento článek se zaměřuje na zkušenosti získané ze zahraniční stáže během ošetřovatelské praxe. Popisuje nejen přípravu a průběh stáže, ale také nabízí pohled na finský systém zdravotní péče, který podporuje digitalizaci a modernizaci. Dalšími tématy jsou pracovní podmínky sester a konkrétní návrhy na zlepšení českého zdravotnictví inspirované finským přístupem.

This article focuses on the experience gained during a nursing internship abroad. It describes not only the preparation and the course of the internship, but also offers insights into the Finnish healthcare system that supports digitalization and modernization. Other topics include the working conditions of nurses and concrete suggestions for improving the Czech healthcare system, inspired by the Finnish approach.

• MeSH
• Digital Technology MeSH
• Clinical Competence MeSH
• Monitoring, Physiologic MeSH
• Salaries and Fringe Benefits MeSH
• Professional Practice MeSH
• Nursing Care MeSH
• Food Service, Hospital MeSH
• Education, Nursing MeSH
• Health Care Quality, Access, and Evaluation MeSH
• Nurses MeSH
• Geographicals
• Finland MeSH

Syndrom vyhoření je v oblasti zdravotnictví významným problémem, který ovlivňuje nejen duševní, ale fyzickou pohodu zdravotníků, dokonce i kvalitu poskytované péče. Zvláště ohroženou skupinou profesionálů jsou všeobecné sestry pracující na jednotkách intenzivní péče, které jsou vystaveny denně vysokým pracovním nárokům, stresu a emočně náročným situacím. Jeden z faktorů, který prokazatelně přispívá k rozvoji syndromu vyhoření, je omezení profesní autonomie, tedy míra, do jaké mají všeobecné sestry možnost rozhodovat o své práci a vykonávat ji v rozsahu stanovených kompetencí dle vlastního úsudku. Cílem provedeného literárního review bylo analyzovat existující publikace vydané v letech 2020–2025 týkající se přímo všeobecných sester pracujících v intenzivní péči. Analýza již sama ukázala, že tato problematika je není doposud dostatečně prozkoumána a zaslouží si pozornost dalších výzkumníků. Porozumění těchto souvislostem může přispět k hledání strategií pro prevenci vyhoření a zlepšení pracovních podmínek a postavení všeobecných sester v intenzivní péči.

Jirkovská V, Dolák F. The impact of misunderstanding and limited professional autonomy of general nurses working in intensive care on the development of burnout syndrome Burnout is a significant problem in healthcare, affecting not only the mental but also the physical well-being of healthcare professionals and the quality of care provided. A particularly vulnerable group of professionals are general nurses working in intensive care units, who are exposed to high daily work demands, stress and emotionally demanding situations. One of the factors that has been shown to contribute to the development of burnout syndrome is the limitation of professional autonomy, i.e. the extent to which general nurses are able to make decisions about their work and exercise their own judgement within their defined competencies. The aim of the literature review was to analyse existing publications published between 2020 and 2025 that relate specifically to general nurses working in critical care. The analysis itself has already shown that this topic has not been sufficiently explored and deserves the attention of further researchers. Understanding these contexts can contribute to the search for strategies to prevent burnout and improve the working conditions and status of general nurses in critical care.

• MeSH
• Qualitative Research MeSH
• Professional Competence standards   MeSH
• Operating Room Nursing methods   standards   organization & administration   MeSH
• Perioperative Care nursing   MeSH
• Nurse Specialists standards   organization & administration   education   MeSH

• Conspectus
• Ortopedie. Chirurgie. Oftalmologie
• NML Publication type
• závěrečné práce