BACKGROUND: We aimed to identify therapeutic approaches for managing schizophrenia in different phases and clinical situations - the prodromal phase, first-episode psychosis, cognitive and negative symptoms, pregnancy, treatment resistance, and antipsychotic-induced metabolic side effects - while assessing clinicians' adherence to guidelines. METHODS: A cross-sectional online survey was conducted in 2023 as part of the Ambassador project among psychiatrists and trainees from 35 European countries, based on a questionnaire that included six clinical vignettes (cases A-F). Additionally, a review of multiple guidelines/guidance papers was performed. RESULTS: The final analysis included 454 participants. Our findings revealed a moderate to high level of agreement among European psychiatrists regarding pharmacological treatment preferences for first-episode psychosis and cognitive and negative symptoms, prodromal symptoms and pregnancy, with moderate adherence to clinical guidelines. There was substantial similarity in treatment preferences for antipsychotic-induced metabolic side effects and treatment resistance; however, adherence to guidelines in these areas was only partial. Despite guideline recommendations, non-pharmacological treatments, including psychotherapy and recovery-oriented care, were generally underutilized, except for psychoeducation and lifestyle recommendations, and cognitive behavioural therapy for treatment of the prodromal phase. Contrary to guidelines, cognitive remediation and physical exercise for cognitive symptoms were significantly neglected. CONCLUSIONS: These discrepancies highlight the need for effective implementation strategies to bridge the gap between research evidence, clinical guidelines/guidance papers, and real-world clinical practice. Clinicians' unique combination of knowledge and experience positions them to shape future guidelines, especially where real-world practice diverges from recommendations, reinforcing the need to integrate both research evidence and clinical consensus.

• Klíčová slova
• Europe, guidelines, psychopharmacology, psychotherapy, schizophrenia,
• MeSH
• antipsychotika * terapeutické užití   škodlivé účinky   MeSH
• dodržování směrnic * statistika a číselné údaje   MeSH
• dospělí MeSH
• lékařská praxe - způsoby provádění * statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• postoj zdravotnického personálu * MeSH
• průřezové studie MeSH
• psychiatři MeSH
• psychiatrie * statistika a číselné údaje   MeSH
• schizofrenie * terapie   farmakoterapie   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• antipsychotika * MeSH

BACKGROUND: The development of child's lifestyle occurs within regular 24-hour movement patterns under the guidance of parents. Accelerometer-based monitoring allows for the capture of these 24-hour movement patterns of behaviour. Therefore, the aim of this study was to reveal whether active participation in organised physical activity (OPA) contributed to the achievement of the World Health Organization's (WHO) 24-hour movement behaviour guidelines (24-hMBGS) among 3-10-year-old children, considering the influence of parents' movement behaviour and families' material background. METHODS: The 24-hour movement behaviour (24-hMB) of 348 child-parent pairs (with at least one parent) was continuously monitored for 7 days via ActiGraph accelerometers placed on the non-dominant wrist. Children's adherence to the WHO's 24-hMBGS was analysed using logistic regression analysis. The socioeconomic status (SES) of families was measured using the Family Affluence Scale. Body mass level was determined according to body mass index gender- and age-specific WHO reference data. Univariate analysis of variance/Pearson's chi-square test was used to test differences in sedentary behaviour duration/excess body weight between active participants and non-participants in OPA. RESULTS: Active 3-10-year-old participants in OPA, compared to non-participants, were significantly more likely to meet at least two of the 24-hMBGS (77.7% vs. 66.4%, p = 0.008), had significantly shorter daily sedentary time (by 30 min per day, p = 0.001), and a significantly lower prevalence of excessive body weight (10.26% vs. 24.87% p < 0.001). Engaging in OPA significantly (p < 0.01) helped 3-10-year-old children achieve at least two of the 24-hMBGS, regardless of their gender, age, excess body weight, or family SES. In addition, a mother's non-excessive body weight and achievement of at least two of the WHO's 24-hMBGS significantly (p < 0.05) contributed to children attaining at least two of the WHO's 24-hMBGS. CONCLUSIONS: Even in young children, active participation in OPA tend to contribute to a healthier lifestyle profile, characterised by shorter sedentary behaviour and lower excess body weight, with a significant influence from the mother's movement behaviour.

• Klíčová slova
• 24-hour movement behaviour, Accelerometer, Father, Mother, Organised physical activity,
• MeSH
• akcelerometrie MeSH
• cvičení * MeSH
• dítě MeSH
• lidé MeSH
• předškolní dítě MeSH
• rodiče MeSH
• sedavý životní styl * MeSH
• směrnice jako téma * MeSH
• spánek MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The antioxidant and antimicrobial activities of lignin are often emphasized; however, not every type exhibits these properties. In this work, water-soluble fractions of alkali lignin (AL), poly-(caffeyl alcohol) lignin (PCFA), pyrolytic lignin (PL) and grape seed lignin (GSL) were prepared. The original and water-soluble lignin fractions were comprehensively characterized using high-resolution 2D NMR spectroscopy. Notably, water-soluble fractions of PCFA, PL and GSL lignins exhibited 3.6 to 3.9 higher antioxidant activities than the original lignins despite having a phenolic content of approximately 12 % to 55 % lower. Additionally, these fractions demonstrated antimicrobial activities against Micrococcus luteus, Serratia marcescens and Escherichia coli. The potential of water-soluble lignin fractions as active modifiers for physically crosslinked hydrogels was also investigated. Specifically, PL/F lignin served as an antioxidant and antimicrobial agent for modifying carrageenan without disrupting its viscoelastic and swelling behaviour. Carrageenan hydrogels with 6 % PL/F lignin showed an antioxidant activity of 219.6 mg TE g-1 hydrogel and reduction rates of 43.9 % against M. luteus, 31.6 % against S. marcescens and 20.6 % against E. coli.

• Klíčová slova
• Antibacterial properties, Antioxidant properties, Hydrogel, Lignin, NMR,
• MeSH
• antibakteriální látky * farmakologie   chemie   izolace a purifikace   MeSH
• antiinfekční látky * farmakologie   chemie   izolace a purifikace   MeSH
• antioxidancia chemie   farmakologie   izolace a purifikace   MeSH
• Escherichia coli účinky léků   MeSH
• hydrogely * chemie   farmakologie   MeSH
• karagenan chemie   MeSH
• lignin * chemie   farmakologie   izolace a purifikace   MeSH
• Micrococcus luteus účinky léků   MeSH
• mikrobiální testy citlivosti MeSH
• Serratia marcescens účinky léků   MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky * MeSH
• antiinfekční látky * MeSH
• antioxidancia MeSH
• hydrogely * MeSH
• karagenan MeSH
• lignin * MeSH

OBJECTIVES: Regular physical activity (PA) and reduced sedentary behaviour (SB) have been associated with positive health outcomes, but many older adults do not comply with the current recommendations. Sensor-triggered ecological momentary assessment (EMA) studies allow capturing real-time data during or immediately after PA or SB, which can yield important insights into these behaviours. Despite the promising potential of sensor-triggered EMA, this methodology is still in its infancy. Addressing methodological challenges in sensor-triggered EMA studies is essential for improving protocol adherence and enhancing validity. Therefore, this study aimed to examine (1) the patterns in sensor-triggered EMA protocol adherence (eg, compliance rates), (2) the impact of specific settings (eg, event duration) on the number of prompted surveys, and (3) participants' experiences with engaging in a sensor-triggered EMA study. DESIGN: Two longitudinal, sensor-triggered EMA studies-one focused on PA and the other on SB-were conducted using similar methodologies from February to October 2022. Participants' steps were monitored for seven days using a Fitbit activity tracker, which automatically prompted an EMA survey through the HealthReact smartphone application when specified (in)activity thresholds were reached. After the monitoring period, qualitative interviews were conducted. Data from both studies were merged. SETTING: The studies were conducted among community-dwelling Belgian older adults. PARTICIPANTS: The participants had a median age of 72 years, with 54.17% being females. The PA study included 88 participants (four dropped out), while the SB study included 76 participants (seven dropped out). PRIMARY AND SECONDARY OUTCOME MEASURES: Descriptive methods and generalised logistic mixed models were employed to analyse EMA adherence patterns. Simulations were conducted to assess the impact of particular settings on the number of prompted EMA surveys. Additionally, qualitative interview data were transcribed verbatim and thematically analysed using NVivo. RESULTS: Participants responded to 81.22% and 79.10% of the EMA surveys in the PA and SB study, respectively. The confirmation rate, defined as the percentage of EMA surveys in which participants confirmed the detected behaviour, was 94.16% for PA and 72.40% for SB. Logistic mixed models revealed that with each additional day in the study, the odds of responding to the EMA survey increased significantly by 1.59 times (OR=1.59, 95% CI: 1.36 to 1.86, p<0.01) in the SB study. This effect was not observed in the PA study. Furthermore, time in the study did not significantly impact the odds of participants confirming to be sedentary (OR=0.97, 95% CI: 0.92 to 1.02, p=0.28). However, it significantly influenced the odds of confirming PA (OR: 0.81, 95% CI: 0.68 to 0.97, p=0.02), with the likelihood of confirming decreasing by 19% with each additional day in the study. Furthermore, a one-minute increase in latency (ie, time between last syncing and starting the EMA survey) in the PA study decreased the odds of the participant confirming to be physically active by 20% (OR: 0.80, 95% CI: 0.72 to 0.89, p<0.01). Simulations of the specific EMA settings revealed that reducing the event duration and shorter minimum time intervals between prompts increased the number of EMA surveys. Overall, most participants found smartphone usage to be feasible and rated the HealthReact app as user-friendly. However, some reported issues, such as not hearing the notification, receiving prompts at an inappropriate time and encountering technical issues. While the majority reported that their behaviour remained unchanged due to study participation, some noted an increased awareness of their habits and felt more motivated to engage in PA. CONCLUSIONS: This study demonstrates the potential of sensor-triggered EMA to capture real-time data on PA and SB among older adults, showing strong adherence potential with compliance rates of approximately 80%. The SB study had lower confirmation rates than the PA study, due to technical issues and discrepancies between self-perception and device-based measurements. Practical recommendations were provided for future studies, including improvements in survey timing, technical reliability and strategies to reduce latency.

• Klíčová slova
• Aging, Behavior, Feasibility Studies, Observational Study, PUBLIC HEALTH, eHealth,
• MeSH
• cvičení * MeSH
• fitness náramky MeSH
• lidé MeSH
• longitudinální studie MeSH
• okamžité posouzení v přirozeném prostředí * MeSH
• samostatný způsob života * MeSH
• sedavý životní styl * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Belgie MeSH

Optimal adherence to CML therapy is of key importance to maximize treatment effectiveness. Two clinical studies (ADAGIO and Hammersmith) have proven a clear correlation between adherence and achieving optimal treatment response and have revealed that non-adherence is common in CML patients (Marin et al. in J Clin Oncol 28(24):2381-2388, 2010, Noens et al. in Haematologica 99(33):437-447, 2014). The aim of this study is to assess the extent of suboptimal adherence and to investigate motivations and behavioural patterns of adherence in a worldwide patient sample. Questionnaires were provided by the CML Advocates Network and were filled in by patients online and offline. Patient characteristics, treatment and motivations were collected. Adherence was assessed by the 8-item Morisky Medication Adherence scale. Logistic regression models were fitted to investigate the influence of different factors on adherence. Overall, 2 546 questionnaires from 63 countries and 79 CML patient organisations were evaluable. 32.7% of participants were highly adherent, 46.5% were in the medium and 20.7% in the low adherence group. Factors increasing the probability of being in the high adherence group are older age, male sex, management of side effects, only one tablet per day and feeling well informed about CML by the doctor. More than 2 years since diagnosis were significantly lowering the chance as was the use of reminding tools. Living arrangements, multiple medication and personal payment obligations increased the probability to be at least in the medium adherent group. This is the most comprehensive study conducted to date to gain knowledge about factors causing non-adherence in CML. Better information on the disease, medication and management of side effects, supported by haematologists, is key to improve adherence.

• Klíčová slova
• Adherence patient motivations, Behavioural patterns of adherence, CML treatment adherence, Chronic myeloid leukaemia, Driving factors of nonadherence, Factors causing nonadherence, Haematology, Molecular response, Morisky Medication Adherence scale, Optimal adherence, Patient advocacy, Patient-driven survey, Tyrosine kinase inhibitors,
• MeSH
• chronická myeloidní leukemie farmakoterapie   MeSH
• dospělí MeSH
• hodnocení adherence k farmakoterapii * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• protinádorové látky terapeutické užití   MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• věkové faktory 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
• multicentrická studie MeSH
• Názvy látek
• protinádorové látky MeSH

Geriatric pharmacotherapy represents one of the biggest achievements of modern medical interventions. However, geriatric pharmacotherapy is a complex process that encompasses not only drug prescribing but also age-appropriate drug development and manufacturing, appropriate drug testing in clinical trials, rational and safe prescribing, reliable administration and assessment of drug effects, including adherence measurement and age-appropriate outcomes monitoring. During this complex process, errors can occur at any stage, and intervention strategies to improve geriatric pharmacotherapy are targeted at improving the regulatory processes of drug testing, reducing inappropriate prescribing, preventing beneficial drug underuse and use of potentially harmful drugs, and preventing adverse drug interactions. The aim of this review is to provide an update on selected recent developments in geriatric pharmacotherapy, including age discrimination in drug trials, a new healthcare professional qualification and shared competence in geriatric drug therapy, the usefulness of information and communication technologies, and pharmacogenetics. We also review optimizing strategies aimed at medication adherence focusing on complex elderly patients. Among the current information technologies, there is sufficient evidence that computerized decision-making support systems are modestly but significantly effective in reducing inappropriate prescribing and adverse drug events across healthcare settings. The majority of interventions target physicians, for whom the scientific concept of appropriate prescribing and the acceptability of the alert system used play crucial roles in the intervention's success. For prescribing optimization, results of educational intervention strategies were inconsistent. The more promising strategies involved pharmacists or multidisciplinary teams including geriatric medicine services. However, methodological weaknesses including population and intervention heterogeneity do not allow for comprehensive meta-analyses to determine the clinical value of individual approaches. In relation to drug adherence, a recent meta-analysis of 33 randomized clinical trials in older patients found behavioural interventions had significant effects, and these interventions were more effective than educational interventions. For patients with multiple conditions and polypharmacy, successful interventions included structured medication review, medication regimen simplification, administration aids and medication reminders, but no firm conclusion in favour of any particular intervention could be made. Interventions to optimize geriatric pharmacotherapy focused most commonly on pharmacological outcomes (drug appropriateness, adverse drug events, adherence), providing only limited information about clinical outcomes in terms of health status, morbidity, functionality and overall healthcare costs. Little attention was given to psychosocial and behavioural aspects of pharmacotherapy. There is sufficient potential for improvements in geriatric pharmacotherapy in terms of drug safety and effectiveness. However, just as we require evidence-based, age-specific, pharmacological information for efficient clinical decision making, we need solid evidence for strategies that consistently improve the quality of pharmacological treatments at the health system level to shape 'age-attuned' health and drug policy.

• MeSH
• farmakoterapie metody   normy   statistika a číselné údaje   MeSH
• geriatrie metody   normy   statistika a číselné údaje   MeSH
• hodnocení adherence k farmakoterapii MeSH
• lékové předpisy statistika a číselné údaje   MeSH
• lidé MeSH
• medicína založená na důkazech metody   normy   MeSH
• nežádoucí účinky léčiv MeSH
• samoléčba statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH