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.
OBJECTIVES: Decision-analytic models assessing the value of emerging Alzheimer's disease (AD) treatments are challenged by limited evidence on short-term trial outcomes and uncertainty in extrapolating long-term patient-relevant outcomes. To improve understanding and foster transparency and credibility in modeling methods, we cross-compared AD decision models in a hypothetical context of disease-modifying treatment for mild cognitive impairment (MCI) due to AD. METHODS: A benchmark scenario (US setting) was used with target population MCI due to AD and a set of synthetically generated hypothetical trial efficacy estimates. Treatment costs were excluded. Model predictions (10-year horizon) were assessed and discussed during a 2-day workshop. RESULTS: Nine modeling groups provided model predictions. Implementation of treatment effectiveness varied across models based on trial efficacy outcome selection (clinical dementia rating - sum of boxes, clinical dementia rating - global, mini-mental state examination, functional activities questionnaire) and analysis method (observed severity transitions, change from baseline, progression hazard ratio, or calibration to these). Predicted mean time in MCI ranged from 2.6 to 5.2 years for control strategy and from 0.1 to 1.0 years for difference between intervention and control strategies. Predicted quality-adjusted life-year gains ranged from 0.0 to 0.6 and incremental costs (excluding treatment costs) from -US$66 897 to US$11 896. CONCLUSIONS: Trial data can be implemented in different ways across health-economic models leading to large variation in model predictions. We recommend (1) addressing the choice of outcome measure and treatment effectiveness assumptions in sensitivity analysis, (2) a standardized reporting table for model predictions, and (3) exploring the use of registries for future AD treatments measuring long-term disease progression to reduce uncertainty of extrapolating short-term trial results by health-economic models.
- MeSH
- Alzheimer Disease * economics drug therapy MeSH
- Cost-Benefit Analysis * MeSH
- Models, Economic MeSH
- Cognitive Dysfunction * economics MeSH
- Quality-Adjusted Life Years MeSH
- Humans MeSH
- Decision Support Techniques MeSH
- Disease Progression MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
Úvod: Současný demografický vývoj zvyšuje potřebu hledání efektivních způsobů podpory starší populace, zejména v oblasti duševního zdraví, životní pohody a soběstačnosti. V ordinacích praktických lékařů se stále častěji objevují pacienti, jejichž potřeby přesahují rámec farmakologické léčby. Jedním z možných přístupů jak s touto tendencí pracovat je tzv. „social prescribing“ – doporučování nefarmakologických a komunitních intervencí jako součást komplexní zdravotní péče. Přehled konceptu: Social prescribing je inovativní mezioborový přístup, který propojuje zdravotní a sociální profesionální péči s neformální podporou a dostupnými komunitními zdroji. Jeho cílem je poskytovat individualizovanou podporu přizpůsobenou potřebám jednotlivce i charakteru komunity, ve které žije, a zároveň odlehčit systému profesionální zdravotní péče. Důraz je kladen na aktivní zapojení člověka do života v komunitě s ohledem na jeho zdravotní, sociální, emocionální i praktické potřeby ovlivňující jeho zdraví. Příklad z praxe: Článek dále představuje mezinárodní studii RECETAS, která zkoumá potenciál social prescribing aktivit v přírodním prostředí při snižování osamělosti a zlepšování kvality života u seniorů žijících ve městech. Studie se zaměřuje na možnosti propojení zdravotní péče s komunitními programy podporujícími duševní zdraví a jedním z míst, kde studie probíhá je Praha. Závěr: Social prescribing představuje perspektivní doplněk klasické profesionální péče, který může obohatit praxi i v českém prostředí. Podporuje aktivní stárnutí, duševní pohodu a propojení formální a neformální péče o seniory. Pro jeho širší využití je však klíčová další odborná diskuse, výzkumné ověření a institucionální ukotvení v systému zdravotní a sociální péče.
Novotná B, Bártová A, Šlemarová G, Macháčová K, Holmerová I. Beyond medications: Social prescribing for older persons Introduction: Current demographic trends are increasing the need to develop effective approaches to support the growing older population, particularly in areas such as mental health, well-being, and self-sufficiency. General practitioners are increasingly encountering patients whose needs extend beyond pharmacological treatment. One emerging approach is known as social prescribing – the recommendation of non-pharmacological and community-based interventions as part of comprehensive care. Conceptual Framework: Social prescribing is an innovative, interdisciplinary approach that integrates professional healthcare and social services with informal support and locally available community resources while also reducing the burden on the health care system. Its primary aim is to provide individualized care tailored to the needs of each person and their community context. The emphasis is on encouraging meaningful participation and active engagement in community life, considering the individual’s health, social, emotional, and practical needs. Research-Based example: The article also presents the international RECETAS study, which investigates the potential of nature-based social prescribing interventions to reduce loneliness and enhance the quality of life among older adults living in urban environments. The study explores how healthcare can be meaningfully linked to community programs that support mental health and social inclusion. Conclusion: Social prescribing offers a promising complement to traditional care and has the potential to enrich clinical practice in the Czech Republic. It promotes active aging, mental well-being, and the integration of formal and informal support systems for older people. However, broader implementation requires further expert discussion, empirical validation, and institutional integration into the health and social care systems.
- Keywords
- social prescribing,
- MeSH
- Quality of Life * MeSH
- Humans MeSH
- Loneliness MeSH
- Delivery of Health Care MeSH
- Aged MeSH
- Social Welfare MeSH
- Aging * MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Conflict deeply affects human experiences, frequently testing individual resilience to its breaking point and leaving enduring psychological and societal wounds. The current conflict in Ukraine, initiated by Russia's invasion in 2022, illustrates this phenomenon by altering regional relationships and triggering a major humanitarian crisis marked by extensive displacement, loss of life, and emotional turmoil. This study explores the factors influencing hope and distress in Ukraine alongside six nearby European countries during the ongoing conflict. A cross-sectional survey collected data primarily via internet panel samples from the Czech Republic, Georgia, Lithuania, Poland, Romania, Slovakia, and Ukraine in the second year since the war's initiation. The current study utilised validated instruments, collecting data on levels of hope, distress, individual resilience, community resilience, societal resilience, morale, sense of danger, perceived security threats, and demographic characteristics. Hope and distress levels differ across countries, with Ukraine exhibiting the highest levels of both (3.74 ± 1.02 and 2.89 ± 0.87, respectively). Overall, average scores of hope were higher than average distress levels. Across the regression models for the seven countries, hope showed strong associations with individual (between β = 0.089 and β = 0.327) and societal resilience (between β = 0.206 and β = 0.514), while morale (between β = -0.104 and β = -0.479) and individual resilience (between β = -0.077 and β = -0.335) displayed a protective relationship against distress (all β values were significant, p < 0.01). Monitoring hope and distress is crucial during the Russian-Ukrainian war and other adversities, as these factors give insight into the current and future psychological states of affected populations. The results offer valuable information that can guide the development of tailored strategies to enhance hope and buffer distress in war-impacted countries, as well as those experiencing its broader effects. Fostering individual and societal resilience, alongside enhancing morale, may strengthen hope and mitigate distress amid adversity. Developing targeted interventions that address each population's unique needs, as well as their sociocultural and geopolitical contexts can enhance efficacy.
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Hope * MeSH
- Armed Conflicts * psychology MeSH
- Cross-Sectional Studies MeSH
- Resilience, Psychological * MeSH
- Psychological Distress * MeSH
- Stress, Psychological * psychology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Russia MeSH
- Ukraine MeSH
BACKGROUND: The role of primary healthcare (PHC) during a pandemic varies across European countries. The coronavirus disease 2019 (COVID-19) pandemic has altered the working practices of family medicine doctors and impacted the resilience of healthcare systems. OBJECTIVES: This study aimed to examine European healthcare system responses to the pandemic, focusing on rural and urban differences. MATERIAL AND METHODS: This cross-sectional, mixed-methods study used a semi-structured online questionnaire with 68 questions, including 21 free-text comments. Data were collected from May 2020 to January 2021. Key informants from 16 European Rural and Isolated Practitioners Association (EURIPA) member countries distributed questionnaires to 406 PHC doctors. Data were analyzed using descriptive statistics and nonparametric tests (χ2, Kruskal-Wallis, Mann-Whitney U) with a significance threshold of 0.05. RESULTS: A statistically significant difference was found between rural (36.4%, 55/151), semirural (19.4%, 24/124) and urban populations (29.8%, 39/131) regarding medicine shortages (χ2 = 9.91, degrees of freedom (df) = 4, p = 0.042). The semirural setting showed a statistically significant difference from the other settings (p = 0.004 in post hoc χ2 test). Significant differences were found between countries in resilience features including, effectiveness of triage, adapting to the rapidly changing requirements, government help, existence of a community resilience group, improved interprofessional collaboration, medicine shortage, and general practitioners (GPs) involvement in palliative care. CONCLUSIONS: Medicine shortage was more prevalent in rural and urban areas compared to semirural areas. Differences were observed between countries in their responses to the pandemic, particularly in adapting to the rapidly changing requirements, effectiveness of triage, government help, and the existence of a community resilience group. These differences were confirmed with qualitative analysis. The results emphasize the need for tailored approaches considering diverse contexts in shaping effective healthcare system resilience.
- MeSH
- COVID-19 * epidemiology MeSH
- Humans MeSH
- Pandemics MeSH
- Primary Health Care * organization & administration MeSH
- Cross-Sectional Studies MeSH
- Surveys and Questionnaires MeSH
- SARS-CoV-2 MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
V špecifických klinických situáciách sa jasne preukázala dôležitosť včasného rozpoznania deficitov mikronutrientov a účinnosť ich liečby. Približne tretina populácie vo svete má dokázateľný deficit niektorého z druhov mikronutientov. Na druhej strane sa predpokladá, že asi 20 mikronutrientov má dôležitý vplyv na metabolóm, proteóm a genóm u človeka. V súčasnosti už máme dostatok vedomostí z veľkých randomizovaných kontrolovaných štúdií, ktoré dokázali dôležitosť nedostatočného statusu mikronutrientov, ako aj účinok a účinnosť intervencií zameraných na efektívnu liečbu ich deficitných stavov. V kontexte deficitu vitamínu D sa v súčasnosti preukázala výhoda zavedenia novej suplementačnej farmakologickej liečby.
In specific clinical situations clearly have been seen an importance of the early identification of micronutrient deficiencies and an effectivity of their therapies. About one third of all population in the world suffers from an certain micronutrient deficiency. On the other site it is supposed, that about 20 micronutrients have an important effects on metabolome, proteome and genome of the humans. At present we have growing number of large, randomized, controlled trials concerning the evidences of the micronutrient deficiency, as well as of the effects and effectivity of interventions in the therapy of deficient states. In context of vitamin D deficiency quite new therapeutic possibility in the supplementation pharmacotherapy is present.
- MeSH
- Calcifediol pharmacology therapeutic use MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Micronutrients deficiency therapeutic use MeSH
- Vitamin D Deficiency * drug therapy MeSH
- Vitamin D * therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Cosmetic/aesthetic surgery has increased in popularity, reflecting the increased consumer demand. Modern women feel compelled to meet near-impossible standards of beauty. Most of those who undergo cosmetic/aesthetic surgery are (middle-aged) women. Women are often under pressure to meet near-impossible standards of beauty. This study examined cosmetic/aesthetic surgery attitudes and perceptions among 516 Czech middle-aged women. It assessed the perception and attitudes towards cosmetic/aesthetic procedures of middle-aged Czech women and determined the possible factors influencing their level of acceptance through a quantitative survey. The research findings are based on an online questionnaire survey. Based on our analyses, we revealed that acceptance and attitudes towards cosmetic/aesthetic surgery among women can be influenced by the variables such as marital status, place of living, fear of ageing, the importance of physical appearance, occupational status, and partner’s influence. This study provided a first general look at the situation around cosmetic/aesthetic surgery in the context of the Czech Republic. However, to gain a more comprehensive understanding of the acceptance and attitudes towards cosmetic/aesthetic surgery in the Czech Republic, further research should be conducted across the country to assess the attitudes of the wider population (for example, different age groups).
- Keywords
- anti-aging medicína,
- MeSH
- Esthetics * psychology MeSH
- Physical Appearance, Body MeSH
- Cosmetic Techniques * psychology statistics & numerical data MeSH
- Beauty MeSH
- Middle Aged MeSH
- Humans MeSH
- Attitude MeSH
- Surveys and Questionnaires MeSH
- Socioeconomic Factors MeSH
- Plastic Surgery Procedures methods psychology statistics & numerical data MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
Cílem studie bylo zjistit, zda je střídavý nácvik v prostředí běžné školy realizovatelný a zda u našeho výzkumného souboru, tvořeného školní třídou, povede ke vyšší míře retence dovedností ve srovnání s blokovým nácvikem. Studie vycházela z dosavadních výzkumů zaměřených na vliv kontextuální in- terference, avšak nově na tuto problematiku nahlížela z didaktického hlediska v kontextu standardního prostředí české školy. Výzkumného šetření se zúčastnilo 38 žáků šesté třídy základní školy. V rámci hodin tělesné výchovy byla zkoumána efektivita blokového a střídavého nácviku při osvojování tří specifických pohybových dovedností. Vybrané dovednosti byly pro účastníky nové, atraktivní a odpo- vídaly jejich úrovni obtížnosti. Nácvik probíhal ve dvou skupinách (dívky a chlapci) za rovnocenných podmínek, přičemž jedna dovednost byla nacvičována blokově a zbývající dvě střídavě. Každé doved- nosti bylo věnováno celkem 30 minut nácviku rozdělených do tří týdnů. Výsledky učení byly hodnoceny bezprostředně po skončení nácviku a následně po čtyřtýdenní pauze pomocí retenčního testu. Srovnání blokového a střídavého režimu nácviku pomocí Mann-Whitneyho U testu ukázalo, že střídavý nácvik byl u našeho souboru efektivnější metodou učení. Z řízených rozhovorů a pozorování vyplynulo, že střídavý nácvik kladl vyšší nároky na organizaci výuky, motivaci žáků a didaktické kompetence učitele. Celkově lze konstatovat, že střídavý nácvik je v podmínkách školní tělesné výchovy realizovatelný a z hlediska retence dovedností může být efektivnější než tradiční blokový přístup.
The aim of the study was to determine whether variable practice is feasible in a mainstream school setting and whether our research population, consisting of a school classroom, would lead to a higher rate of skill retention compared to block practice. The study was based on previous research focusing on the influence of contextual interference, but it took a new didactical perspective on this issue in the context of a standard Czech school environment. Thirty-eight sixth grade elementary school pupils participated in the research investigation. The effectiveness of block and variable drills in the acquisition of three specific movement skills was investigated in physical education classes. The selected skills were new and attractive to the participants and matched their level of difficulty. Training was conducted in two groups (girls and boys) under equivalent conditions, with one skill practiced in block and the remaining two skills practiced variably. Each skill received a total of 30 minutes of practice divided into three weeks. Learning outcomes were assessed immediately after the end of practice and then after a four-week break using a retention test. Comparison of block and variable practice mode using Mann-Whitney U test showed that variable practice was the more effective learning method for our sample. The guided interviews and observations showed that the variable training placed higher demands on the organisation of teaching, the motivation of the pupils and the didactic competence of the teacher. Overall, it can be concluded that variable practice is feasible in school physical education conditions and may be more effective than the traditional block approach in terms of skill retention.
- MeSH
- Child MeSH
- Humans MeSH
- Motor Skills * MeSH
- Motor Activity physiology MeSH
- Psychomotor Performance physiology MeSH
- Retention, Psychology MeSH
- Physical Education and Training * methods MeSH
- Learning MeSH
- Educational Technology methods education MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
BACKGROUND: Effective diabetes management requires a multimodal approach involving lifestyle changes, pharmacological treatment, and continuous patient education. Self-management demands can be overwhelming for patients, leading to lowered motivation, poor adherence, and compromised therapeutic outcomes. In this context, digital health apps are emerging as vital tools to provide personalized support and enhance diabetes management and clinical outcomes. OBJECTIVE: This study evaluated the impact of the digital health application Vitadio on glycemic control in patients with type 2 diabetes mellitus (T2DM). Secondary objectives included evaluating its effects on cardiometabolic parameters (weight, BMI, waist circumference, blood pressure, and heart rate) and self-reported measures of diabetes distress and self-management. METHODS: In this 6-month, 2-arm, multicenter, unblinded randomized controlled trial, patients aged 18 years or older diagnosed with T2DM were randomly assigned (1:1) to an intervention group (IG) receiving standard diabetes care reinforced by the digital health app Vitadio or to a control group (CG) provided solely with standard diabetes care. Vitadio provided a mobile-based self-management support tool featuring educational modules, motivational messages, peer support, personalized goal setting, and health monitoring. The personal consultant was available in the app to provide technical support for app-related issues. The primary outcome, assessed in the intention-to-treat population, was a change in glycated hemoglobin (HbA1c) levels at 6 months. Secondary outcomes included changes in cardiometabolic measures and self-reported outcomes. Data were collected in 2 study centers: diabetologist practice in Dessau-Roßlau and the University of Dresden. RESULTS: Between November 2022 and June 2023, a total of 276 patients were screened for eligibility, with 149 randomized to in intervention group (IG; n=73) and a control group (CG; n=76). The majority of participants were male (91/149, 61%). The dropout rate at month 6 was 19% (121/149). While both groups achieved significant HbA1c reduction at 6 months (IG: mean -0.8, SD 0.9%, P<.001; CG: mean -0.3, SD 0.7%, P=.001), the primary confirmatory analysis revealed statistically significant advantage of the IG (adjusted mean difference: -0.53%, SD 0.15, 95% CI -0.24 to -0.82; P<.001; effect size [Cohen d]=0.67, 95% CI 0.33-1). Significant between-group differences in favor of the IG were also observed for weight loss (P=.002), BMI (P=.001) and systolic blood pressure (P<.03). In addition, Vitadio users experienced greater reduction in diabetes-related distress (P<.03) and obtained more pronounced improvements in self-care practices in the areas of general diet (P<.001), specific diet (P<.03), and exercise (P<.03). CONCLUSIONS: This trial provides evidence for the superior efficacy of Vitadio in lowering the HbA1c levels in T2DM patients compared to standard care. In addition, Vitadio contributed to improvements in cardiometabolic health, reduced diabetes-related distress, and enhanced self-management, highlighting its potential as an accessible digital tool for comprehensive diabetes management. TRIAL REGISTRATION: German Clinical Trials Registry DRKS00027405; https://drks.de/search/de/trial/DRKS00027405.
- MeSH
- Diabetes Mellitus, Type 2 * blood therapy MeSH
- Adult MeSH
- Glycated Hemoglobin analysis MeSH
- Middle Aged MeSH
- Humans MeSH
- Mobile Applications * MeSH
- Self Care MeSH
- Self-Management MeSH
- Aged MeSH
- Telemedicine MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
The world is presently undergoing a recovery phase following the unexpected challenges posed by the coronavirus disease 2019 (COVID-19) pandemic. The loss of lives and the economic setbacks experienced by the global population will require considerable time to address. It is clear that future outbreaks, epidemics, or even pandemic caused by unknown bacterial, fungal, or viral pathogens are inevitable. In this context, public health front-liners will be essential in minimizing the impact of such incidents. This mini-review briefly discusses sociocultural issues, diagnostic capacities, surveillance, and screening strategies for potential future viral pandemic - referred to as Pandemic X. Additionally, it addresses treatment responses, vaccine development efforts, scientific advancements, policy considerations, and prospects for science communication related to forthcoming viral pandemics. While this review does not encompass all scientific approaches available on these topics, it aims to serve as a guideline for informing public health sectors about appropriate measures that should be undertaken.
- MeSH
- COVID-19 * epidemiology prevention & control diagnosis MeSH
- Humans MeSH
- Pandemics * prevention & control MeSH
- SARS-CoV-2 MeSH
- Public Health MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
