The sacroiliac joint (SIJ) exhibits significant variation in auricular surface morphology. This variation influences the mechanics of the SIJ, a central node for transmitting mechanical energy from upper body to lower limbs and vice versa. The impact of the auricular surface morphology on stress and deformation in the SIJ remains poorly understood to date. Computed tomography scans obtained from 281 individuals were included to extract the geometry of the pelvic ring. Then, the auricular surface area, SIJ cartilage thickness, and total SIJ cartilage volume were identified. Based on these reconstructions, 281 finite element models were created to simulate SIJ mechanical loading. It was found that SIJ cartilage thickness only weakly depended on age or laterality, while being strongly sex sensitive. Auricular surface area and SIJ cartilage volume depended weakly and non-linearly on age, peaking around menopause in females, but without significant laterality effect. Larger SIJs, characterized by greater auricular area and cartilage volume, exhibited reduced stress and deformation under loading. These findings highlight the significant role of SIJ morphology in its biomechanical response, suggesting a potential link between morphological variations and the risk of SIJ dysfunction. Understanding this relationship could improve diagnosis and targeted treatment strategies for SIJ-related conditions.

• MeSH
• analýza metodou konečných prvků MeSH
• biomechanika fyziologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mechanický stres MeSH
• mladiství MeSH
• mladý dospělý MeSH
• počítačová rentgenová tomografie * MeSH
• sakroiliakální kloub * anatomie a histologie   fyziologie   diagnostické zobrazování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články 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

Moderní medicína disponuje silnými nástroji k záchraně a udržení života. Přesto je každý lidský život konečný, a ne vždy je udržování života za každou cenu přijatelné ve smyslu zajištění jeho přijatelné kvality. Obecně uznávaným pravidlem ve společnosti je, že by žádný zdravotník neměl rozhodovat o životě a smrti pacienta. Navzdory tomu jsou ale zdravotníci často ve svém rozhodování postaveni do situací, kdy jejich postoj o životě rozhoduje, byť je to v kategorii zachránit, či nechat zemřít, nebo v aplikaci léků na tlumení bolesti či neklidu vysoko převyšující dávkovací limity uvedené v SPC, nebo dokonce při vysazování život udržující orgánové podpory. Jde o závažná rozhodnutí, pro něž zdravotníci potřebují pravidla a návody, které obecně zpracovává etika a v praxi jsou determinovány právními předpisy a morálními principy konkrétní společnosti. Jedním z pomáhajících etických pravidel je úcta k životu, jejímž praktickým vyjádřením v naší společnosti jsou i pravidla pro nezahajování kardiopulmonální resuscitace, omezování zdravotní péče v situaci nepomáhající léčby, přijetí paliativní péče, postoj k eutanazii a respektování dříve vyslovených přání pacienta. Z pohledu úcty k životu zaujímá článek přístup k těmto medicínským postupům s cílem povzbudit vzdělání a diskusi k etickým tématům, která mají stejný význam pro úroveň kvality zdravotnictví jako odborná úroveň aplikace nových vědeckých poznatků. Orientace v etických principech zdravotnictví se týká všech občanů společnosti, tedy nejen zdravotníků. Řada stížností v situacích zdravotní péče vyplývá z nedostatků v aplikaci morálních principů, a to na straně zdravotníků, pacientů a často též pacientovi blízkých osob. Stejně tak různé patologické psychické stavy u zdravotníků ve škále od přecitlivělého úzkostného jednání až po bezcitnost a cynismus mají původ v nezvládnutí etických principů. Odpovědnost za život je vztahována ke konkrétní osobě a společnosti, v náboženském prostředí též k nadpřirozené autoritě. Individuální život je vnímán v celistvosti vlastní i v začlenění do konkrétní společenské skupiny. Eutanazie, dystanazie a marná léčba jsou hodnoceny jako negativní jevy v chápání úcty k životu.

Modern medicine has powerful tools to save and sustain life. Nevertheless, every human life is finite, and maintaining life at any cost is not always acceptable in the sense of ensuring its acceptable quality. It is a generally accepted rule in society that no health care professional should decide the life and death of a patient. Despite this, however, in their decision-making, medical professionals are often put in situations where their attitude decides about life, even if it is in the category of saving or letting die, or in the application of drugs to reduce pain or restlessness that greatly exceed the dosage limits specified in the Summary of Product Characteristics, or even when withdrawing life-sustaining organ support. These are serious decisions for which health professionals need rules and instructions, which are generally processed by ethics and in practice are determined by legal regulations and moral principles of a particular society. One of the helping ethical rules is respect for life, the practical expression of which in our society are also the rules for not starting cardiopulmonary resuscitation, limiting health care in a situation of non-helpful treatment, accepting palliative care, the attitude towards euthanasia and respecting the previously expressed wishes of the patient. From the point of view of respect for life, the article takes an approach to these medical procedures with the aim of encouraging education and discussion on ethical topics that are as important to the level of quality of health care as the professional level of the application of new scientific knowledge. Orientation in the ethical principles of health care concerns all citizens of society, i.e. not only health professionals. Anumber of complaints in health care situations result from shortcomings in the application of moral principles, on the part of health professionals, patients and often also patients ́ relatives. In the same way, various psychological pathological conditions in health professionals ranging from oversensitive, anxious actions to callousness and cynicism have their origin in failure to master ethical principles. Responsibility for life is related to a specific person and society, in a religious environment also to a supernatural authority. Individual life is perceived both in its own integrity and in its integration into a specific social group. Euthanasia, distanasia and futile treatment are evaluated as negative phenomena in the understanding of respect for life.

V súvislosti s obezitou hovoríme o epidémii a Slovensko nie je výnimkou. Obezita je komplexné chronické ochorenie charakterizované dysfunkčným alebo nadmerným množstvom telesného tuku, ktoré zhoršuje zdravie alebo pohodu (z anglického wellbeing) a predstavuje bohatý multidimenzionálny konštrukt (silný genetický aspekt v kombinácii s obezitogénnym prostredím nevynímajúc). Na obezitu je nevyhnutne potrebné prestať nazerať ako na estetický problém, problém slabej vôle, lenivosti, osobnej zodpovednosti alebo voľby životného štýlu. Hmotnosť a obezita sú citlivé a veľmi osobné témy sprevádzané pocitmi zlyhania, hanby, obáv a strachu z odmietnutia a kritiky. Uznanie jej komplexnosti je dôležitou podmienkou pre zmysluplnú diskusiu a liečbu. Empatický a prijímajúci prístup zo strany nás odborníkov preukázateľne zlepšuje adherenciu pacienta a prognózu ochorenia. Vzťah medzi lekárom a pacientom je istým druhom partnerstva a efektívna komunikácia s vhodne zvoleným jazykom zohráva kľúčovú úlohu pri budovaní dôvery a porozumenia. Obezita je liečiteľné ochorenie.

In relation to obesity, we speak of an epidemic, and Slovakia is no exception. Obesity is a complex chronic disease characterized by dysfunctional or excessive body fat that impairs health and/or well-being, representing a rich multidimensional construct (with a strong genetic aspect combined with an obesogenic environment). It is essential to stop viewing obesity merely as an aesthetic issue, a problem of willpower, laziness, personal responsibility, or lifestyle choice. Weight and obesity are sensitive and very personal topics accompanied by feelings of failure, shame, anxiety, and fear of rejection and criticism. Recognizing its complexity is an important condition for meaningful discussion and treatment. An empathetic and accepting approach from us professionals demonstrably improves patient adherence and disease prognosis. The relationship between doctor and patient is a kind of partnership, and effective communication with appropriately chosen language plays a crucial role in building trust and understanding. Obesity is a treatable disease.

• MeSH
• duševní zdraví MeSH
• komunikace MeSH
• kvalita života MeSH
• lidé MeSH
• obezita * psychologie   MeSH
• vztahy mezi lékařem a pacientem MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

This article summarizes information contained in the book, Improving Speech Intelligibility in Adults: Clinical Application of Evidence-Based Strategies, authored by Connie Porcaro (Plural Publishing, Inc., 2023). For specific details on assessment and management of intelligibility as well as useful checklists and references, please refer to this book. Speech-language pathologists can have a significant impact on improving intelligibility in clients by teaching them strategies to provide useful information for communication partners. Speech-language pathologists should facilitate shared communication responsibilities by encouraging use of listener's strategies and for all involved in communication, to optimize the environment for optimum message sharing.

• MeSH
• dysartrie terapie   MeSH
• jazykové poruchy terapie   MeSH
• komunikace MeSH
• komunikační poruchy terapie   MeSH
• lidé MeSH
• naslouchací úsilí MeSH
• percepce řeči MeSH
• pochopení MeSH
• řečová terapie metody   MeSH
• srozumitelnost řeči * MeSH
• Check Tag
• lidé MeSH

BACKGROUND: The etiopathogenesis of atopic dermatitis is complicated, and it includes aspects such as dysfunction of the skin barrier, changes in immune responses, IgE-mediated hypersensitivity, and many characteristics of the environment. Regarding skin barrier dysfunction, a number of genetic changes have been described. This genetic predisposition could be related to the phenotypes of atopic dermatitis. AIM: In this study, several polymorphisms in five proinflammatory genes were associated with certain phenotypes of AD patients (genotype-phenotype study). METHODS: In total, 89 unrelated AD Czech (Caucasian) patients were genotyped regarding five proinflammatory gene polymorphisms (angiotensinogen AGT M235T, AGT-6 G/A, TNF-α-238 G/A, TNF-β Fok1, IL-6-174 C/G and IL-6-596 G/A). Genotyping was performed using PCR and restriction analysis. For phenotypes, patients' sex, age and personal and family history of atopy, aero- and food allergies and other complex diseases were evaluated. RESULTS: A significant association with transepidermal water loss (TEWL) measured on the forearm was found with the AGT M235T polymorphism (p = 0.02). For the AG genotype of TNF-α-238 G/A, a six-times higher risk for a family history of diabetes mellitus compared to other examined aspects of family history was found (p = 0.02). A family history of thyreopathy was associated with the IL-6-174 G/C polymorphism when compared to a family history of other complex diseases. The GG genotype had a ten-times higher risk for a family history of thyreopathy compared to the other genotypes (p = 0.004). This result was highly specific (0.914). The GG genotype of IL-6-596 G/A was associated with a family history of thyreopathy, with the same result (p = 0.004). Moreover, the G allele of IL-6-174 G/C was associated with a family history of thyreopathy compared to AD patients without a positive family history of complex diseases (p = 0.03). In AD men, the MM genotype of the AGT M235T gene was found to be associated with food allergies (p = 0.004). This result was highly sensitive (0.833). A family history of cardiovascular disease in AD men was associated with AGT-6 G/A variability. The A allele was found to be six times more frequent in patients with a positive family history of cardiovascular disease (p = 0.02, with high sensitivity and specificity (0.700 and 0.735, respectively)). A family history of diabetes mellitus was associated with the TNF-β Fok1 polymorphism, where the B1 allele was almost six times more frequent in AD men with a positive family history of diabetes mellitus (p = 0.02), with high sensitivity (0.85). A significant association between TEWL measured on the forearm and the AGT M235T polymorphism was found when AD women were carriers of the MM genotype, with a median of 25 and range 4-61; those patients with the MT genotype had a median of 10 and range of 0.3-39; and patients with the TT genotype had a median of 5 and range of 3-40, p = 0.003. The polymorphism AGT-6 G/A was associated with different ages of eczema onset. The AG genotype was almost nine times more risky for the youngest group (0-7 years) compared to the oldest group (more than 18 years) (p = 0.02), with high specificity for this result. CONCLUSIONS: Our results in the field of cytokine signaling in the immune system in patients with atopic dermatitis are in agreement with those of GWASs. We suggest that cost-effective and simple PCR tests may be the best approach for the rapid and optimal collection of valid genetic information in clinical practice.

• MeSH
• atopická dermatitida * genetika   patologie   MeSH
• dospělí MeSH
• fenotyp MeSH
• genetická predispozice k nemoci MeSH
• genotyp MeSH
• interleukin-6 genetika   MeSH
• jednonukleotidový polymorfismus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• TNF-alfa genetika   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
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: Sexually transmitted infections (STIs) are an everlasting health issue globally. The military environment is recognised as a high-risk setting. Human papillomavirus (HPV), Chlamydia trachomatis and Neisseria gonorrhoeae are the most frequent STIs worldwide. This prospective cross-sectional pilot study focuses on the prevalence of selected STIs in the female population of the Czech Republic's Armed Forces. METHODS: C. trachomatis, N. gonorrhoeae and HPV detection and genotyping were performed between August 2020 and December 2022 in 141 women. Participants were divided into three groups according to their military status-recruits (n=72), active soldiers (n=25) and control civilian group (n=44). Cervical smear tests were performed, and data on STI risk factors were obtained through a questionnaire. RESULTS: A significant difference in the HPV prevalence between recruits (64.5 %) and both active soldiers (46.4 %) and civilians (47.3 %) was found when adjusted for age (p=0.007 and p=0.01, respectively). Lower age of coitarche (median 16; p=0.005) and smaller agglomeration origin (p=0.013) were reported for military recruits. No difference was proven in other researched risk factors. Associations between HPV detection and the higher number of sexual partners (p=0.013), early coitarche (p=0.016) and single marital status (p=0.002) across the groups were observed. Not a single case of N. gonorrhoeae was detected in any of the 141 participants. The prevalence of C. trachomatis did not differ significantly between the three evaluated groups-recruits, control civilian group, and active soldiers (5.6%, 2.3%, 0%, respectively; p=0.567). CONCLUSIONS: This pilot study showed a significantly higher HPV prevalence in female military recruits compared with both active military and civilian women. Recruits reported earlier coitarche which is a strong STI risk factor. Further study is needed to expand on the findings of this pilot study and generate data to support adjustment of STI preventive measures within the Czech Republic Armed Forces.

• MeSH
• dospělí MeSH
• lidé MeSH
• ozbrojené síly * statistika a číselné údaje   MeSH
• pilotní projekty MeSH
• prevalence MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• sexuálně přenosné nemoci * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: This study aimed to evaluate the beliefs about third-hand tobacco smoke (THS) among administrative and academic staff at a university. THS is a residual pollutant from tobacco smoke that lingers on surfaces and poses health risks, particularly to children. The study also aimed to understand these beliefs in relation to socio-demographic factors. METHODS: A cross-sectional survey was conducted with 332 university employees aged 18 and over. Data were collected between September and December 2023 through face-to-face and online questionnaires. The survey included the Beliefs About Third-hand Smoke (BATHS-T) Scale and questions on socio-demographic characteristics, second-hand smoke exposure, and attitudes towards a smoke-free campus. Beliefs About Third-hand Smoke Scale total and sub-dimension scores increase, it is understood that the participant's belief in the negative effects of third-hand tobacco exposure on persistence and health increases. RESULTS: The average age of participants was 36.1 years, with 38.3% being administrative personnel and 61.7% academic personnel. About 40.5% of the participants used tobacco products. The mean total BATHS-T score was 35.6, with health and persistence subscale scores averaging 19.9 and 15.7, respectively. Non-smokers had significantly higher BATHS-T scores than smokers. The participants with children scored higher on the health sub-dimension. Additionally, 78.9% supported a smoke-free campus, and those supporting it had higher BATHS-T scores. Awareness of the harms of second-hand smoke correlated with higher BATHS-T scores. CONCLUSION: The study highlights that non-smokers and those with children are more aware of THS risks. There is strong support for a smoke-free campus among university staff. The findings suggest a need for increased education on THS, especially targeted at smokers and those without children. Universities can play a crucial role in promoting smoke-free environments and raising awareness about the health risks associated with THS.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• univerzity MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• znečištění tabákovým kouřem * škodlivé účinky   statistika a číselné údaje   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

Cílem studie bylo zjistit kvalitu života adolescentů (13-18 let) s cévním přístupem Broviac, používaným pro parenterální výživu při syndromu krátkého střeva. Výzkum probíhal během pandemie covidu-19, formou on-line polostrukturovaných rozhovorů se 7 účastníky. Data byla analyzována interpretativní fenomenologickou analýzou a rozdělena do pěti kategorií: fyzická oblast, psychická oblast, interpersonální vztahy, každodenní život a prostředí. Výsledky ukázaly negativní dopad cévního přístupu a parenterální výživy na kvalitu života, zejména v oblastech pohybu, vzdělávání, společenského života a sebepojetí. Přesto účastníci vykazovali adekvátní sociální a emocio­nální oporu. Klíčovou roli vnímání kvality života hraje osobní přístup k onemocnění. Studie zdůrazňuje potřebu individuální podpory pro tyto adolescenty.

The aim of the study was to evaluate the quality of life of adolescents (aged 13-18) with a Broviac catheter, used for parenteral nutrition in the context of short bowel syndrome. The research was conducted during the COVID-19 pandemic through online semi-structured interviews with seven participants. Data were analyzed using interpretative phenomenological analysis and categorized into five domains: physical area, psychological area, interpersonal relationships, daily life, and environment. The results revealed a negative impact of the Broviac catheter and parenteral nutrition on quality of life, particularly in the areas of mobility, education, social life, and self-concept. However, participants reported adequate social and emotional support. Personal attitudes towards the condition play a crucial role in perceived quality of life. The study emphasizes the need for individualized support for these adolescents.

• Klíčová slova
• Broviac catheter,
• MeSH
• analýza dat MeSH
• cévní přístupy MeSH
• kvalita života * psychologie   MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• mladiství MeSH
• parenterální výživa metody   přístrojové vybavení   MeSH
• průzkumy a dotazníky MeSH
• syndrom krátkého střeva * diagnóza   psychologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

BACKGROUND: The social space of birth-the birth environment, its occupants, and the human activities taking place-is interconnected with birth experiences. AIM: To investigate how the reality of the social space of birth affects women's positive birth experiences. METHODS: We combined open-text responses to the Babies Born Better survey from 3633 postpartum women in Austria, Belgium, the Czech Republic, Germany, Spain, the Netherlands, and the United Kingdom and 39 interview transcripts from Czech and Dutch postpartum women. We conducted a textual and thematic analysis. FINDINGS: Three themes and 11 categories were generated: (1) Exercising fundamental human agency in the birth space consists of the categories: 'exercising rights', 'the protection of human vulnerability', and 'the freedom to be authentic', which women regard as prerequisite components of the birth space. (2) Regulatory frameworks & care philosophies in maternity services, including the categories '(financial) regulations', 'values of the care provider and the institution', and 'model of care', are regarded as attributes of the birth space. Theme (3) Building a nest for comfort and connection comprises the categories 'relational and affective atmosphere during labour & birth', 'performative atmosphere during labour & birth', 'shelter', 'implicit and explicit tacit doing & being' and 'symbol of deeper meaning'. DISCUSSION/CONCLUSION: The reality of the birth space of women with positive birth experiences consists of human rights and birth rights, the quality of interactions with care providers during labour and birth in a relationship-centred and relation-continuity model of care, and a place to retreat from the world.

• MeSH
• dospělí MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• matky * psychologie   MeSH
• poporodní období psychologie   MeSH
• porod * psychologie   MeSH
• průzkumy a dotazníky MeSH
• sociální prostředí * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH