Objective: Stroke treatment is often hampered by delayed Emergency Medical Services activation. Public campaigns to improve the response to stroke symptoms are either costly or not working. We evaluate the effectiveness of a school-based HOBIT program in improving Emergency Medical Services activation. Methods: This cluster randomized trial was conducted from May to June 2023 at 13 schools in the South Moravian region of Czechia. Schools were randomized to the HOBIT intervention or control group with a 3:1 ratio. Both groups had knowledge assessments at baseline and follow-up. The primary outcome was the percentage change from the pretest to the follow-up test in the intervention group compared to the control group in 4 domains: 1) knowledge, 2) self-efficacy, 3) outcome expectations, 4) behavioral intentions. Results: The baseline knowledge was greater than 50 % in most metrics except for knowledge of the FAST test, which was only 16 %. The intervention effect was 16 % (95 % CI 12-21) for knowledge, 10 % (95 % CI 4-15) for self-efficacy,10 % (95 % CI 5-15) for outcome expectations, 8 % (95 % CI 2-11) for behavioral intentions. Conclusions: In school children, even those with high baseline, "HOBIT" intervention can improve determinants and behavioral intentions of Emergency Medical Services activation for suspected stroke.

• Klíčová slova
• Children, Cluster randomized trial, Health education, Intervention, School, Stroke awareness,
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: This study aimed to examine the occurrence of adverse childhood experiences (ACE) in the adult Slovak population and to examine the relationships between mental and physical health, ACE, attachment anxiety and avoidance, and loneliness. SAMPLE AND SETTINGS: A cross-sectional study with a representative Slovak sample (n = 1018, mean age 46.24 years, 48.7 % men) collected in April 2019 data on ACE (Adverse Childhood Experiences International Questionnaire; ACE-IQ), attachment (Experiences in Close Relationships Revised; ECR-R-14), mental and physical health (SF-8 Health Survey; questions on long-term health difficulties) and loneliness single-item question. Nested linear regression models were employed to analyzed the associations. RESULTS: Over 75 % of respondents reported at least one ACE, and nearly a third reported four or more. Community violence (43.6 %), violent treating of a household member (38.1 %), emotional abuse (34.4 %) and emotional neglect (30.9 %) were the most common ACE. The average number of ACE was 2.7 (± 2.6). Multiple ACE were associated with attachment insecurity and loneliness. ACE were found to be significantly associated with both physical and mental health. Attachment anxiety and avoidance were linked to mental health, but only attachment anxiety remained significant when loneliness was included. Loneliness was associated with mental and physical health difficulties. CONCLUSION: ACE and loneliness are associated with physical health difficulties. ACE, attachment anxiety and loneliness are linked to mental health difficulties. Preventing child maltreatment and addressing loneliness are key to mitigating the long-term health effects of ACE.

• Klíčová slova
• ACE-IQ, Attachment, Loneliness, Mental health difficulties, Physical health difficulties, Representative sample, Slovakia,
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: A wide range in prevalence rates of burnout among general practitioners (GPs) has been reported in various regions, with an increasing trend. This nationwide cross-sectional study aimed to estimate the prevalence and associated determinants of burnout in Czech GPs. METHODS: 1000 randomly selected physicians from the Czech Society of General Practitioners (through a pseudorandom number generator) were emailed an online survey based on the Maslach Burnout Inventory - Human Services Survey. Data collection was performed between January and February 2023. RESULTS: 331 questionnaires were obtained (227 females and 104 males, mean age - 49.9 years, the mean number of registered patients - 1951). 21.8 % of GPs scored a high level of burnout in all three of its dimensions and 23.9 % in no dimension at all. The most prevalent dimension was reduced personal accomplishment (PA, 56.2 %) followed by emotional exhaustion (EE, 50.2 %) and depersonalization (DP, 40.5 %). Reaching burnout in all three dimensions was significantly more frequent in males and in GPs registering a number of patients above the median. Increasing age and years of practice were protective factors for DP but risk factors for reduced PA. Employed GPs had lower EE scores than GP practice owners. The respondents' basic characteristics reflected their presence among Czech GPs, which testifies against selection bias. CONCLUSIONS: The high rate of burnout (∼22 %) should be addressed by promoting personal resources along with the perception of the importance of GPs in society. A sufficiently dense network of GPs should allow them to register a lower number of patients.

• Klíčová slova
• Burnout, Depersonalization, Emotional exhaustion, General practitioner, Job demands-resources model, Personal accomplishment, Prevalence,
• Publikační typ
• časopisecké články MeSH

Schools around the world were closed during the spring 2020 lockdown to reduce the spread of COVID-19. As such, these rapid changes to adolescent daily routines may have had immediate as well as long-term effects on their physical, social, and mental health. Therefore, the aim of this study was to examine the experiences, health behaviors and perceived change in health behaviors among adolescents in Czechia during the spring 2020 lockdown. Adolescents (n = 3,440, 54% girls; Mage = 13.5 years, SD = 1.6) from all regions of Czechia were recruited to complete a self-report survey based on the Health Behaviour in School-aged Children study, with additional items on household disruptions and socialization during lockdown, as well as items on perceived changes in health behaviors during lockdown. First, we described the self-reported impacts of the spring lockdown by gender and grade. Second, log-linear analyses were used to examine the perceived behavioral changes based on standardized cut-off values reporting for health behaviors and gender. Less than a third, 19% and 32% of the respondents reported economic and psychosocial disruptions to their family life, 79% indicated they had positive opportunities for family interactions or learning new things. Girls and older adolescents reported the worst levels of social and mental well-being. Changes in respondents' perceived health behaviors varied by reported behavior frequencies and gender. These results may be useful to compare with future secular trends, and may serve as input in developing strategies to counter the impact of the spring 2020 or future similar lockdowns on the adolescents' well-being..

• Klíčová slova
• Coronavirus, Food, Health behaviors, Physical activity, SARS-CoV-2, School closure, Screentime, Sleep, Well-being,
• Publikační typ
• časopisecké články MeSH

Cardio-metabolic diseases (CMD; cardiovascular disease, type 2 diabetes, chronic kidney disease) represent a global public health problem. Worldwide, nearly half a billion people are currently diagnosed with diabetes, and cardiovascular disease is the leading cause of death. Most of these diseases can be assuaged/prevented through behavior change. However, the best way to implement preventive interventions is unclear. We aim to fill this knowledge gap by creating an evidence-based and adaptable "toolbox" for the design and implementation of selective prevention initiatives (SPI) targeting CMD. We built our toolbox based on evidence from a pan-European research project on primary-care SPIs targeting CMD. The evidence includes (1) two systematic reviews and two surveys of patient and general practitioner barriers and facilitators of engaging with SPIs, (2) a consensus meeting with leading experts to establish optimal SPI design, and (3) a feasibility study of a generic, evidence-based primary-care SPI protocol in five European countries. Our results related primarily to the five different national health-care contexts from which we derived our data. On this basis, we generated 12 general recommendations for how best to design and implement CMD-SPIs in primary care. We supplement our recommendations with practical, evidence-based suggestions for how each recommendation might best be heeded. The toolbox is generic and adaptable to various national and systemic settings by clinicians and policy makers alike. However, our product needs to be kept up-to-date to be effective and we implore future research to add relevant tools as they are developed.

• Klíčová slova
• Behavior change, Cardiovascular disease, Lifestyle-related disease, Prevention, Preventive health care, Primary care, Self-efficacy,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH