Using low-cost portable air quality (AQ) monitoring devices is a growing trend in personal exposure studies, enabling a higher spatio-temporal resolution and identifying acute exposure to high concentrations. Comprehension of the results by participants is not guaranteed in exposure studies. However, information on personal exposure is multiplex, which calls for participant involvement in information design to maximise communication output and comprehension. This study describes and proposes a model of a user-centred design (UCD) approach for preparing a final report for participants involved in a multi-sensor personal exposure monitoring study performed in seven cities within the EU Horizon 2020 ICARUS project. Using a combination of human-centred design (HCD), human-information interaction (HII) and design thinking approaches, we iteratively included participants in the framing and design of the final report. User needs were mapped using a survey (n = 82), and feedback on the draft report was obtained from a focus group (n = 5). User requirements were assessed and validated using a post-campaign survey (n = 31). The UCD research was conducted amongst participants in Ljubljana, Slovenia, and the results report was distributed among the participating cities across Europe. The feedback made it clear that the final report was well-received and helped participants better understand the influence of individual behaviours on personal exposure to air pollution.

• Keywords
• air pollution exposure campaign, communication, design thinking, focus group, report to participants, user-centred design,
• MeSH
• Air Pollutants * analysis   MeSH
• Humans MeSH
• Environmental Monitoring MeSH
• Cities MeSH
• Environmental Exposure analysis   MeSH
• Air Pollution * analysis   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH
• Cities MeSH
• Names of Substances
• Air Pollutants * MeSH

Monitoring injecting drug users' (IDUs) health is challenging because IDUs form a difficult to reach population. We examined the impact of recruitment setting on hepatitis C prevalence. Individual datasets from 12 studies were merged. Predictors of HCV positivity were sought through a multilevel analysis using a mixed-effects logistic model, with study identifier as random intercept. HCV prevalence ranged from 21% to 86% across the studies. Overall, HCV prevalence was higher in IDUs recruited in drug treatment centres compared to those recruited in low-threshold settings (74% and 42%, respectively, P < 0·001). Recruitment setting remained significantly associated with HCV prevalence after adjustment for duration of injecting and recent injection (adjusted odds ratio 0·7, 95% confidence interval 0·6-0·8, P = 0·05). Recruitment setting may have an impact on HCV prevalence estimates of IDUs in Europe. Assessing the impact of mixed recruitment strategies, including respondent-driven sampling, on HCV prevalence estimates, would be valuable.

• MeSH
• Substance Abuse Treatment Centers * MeSH
• Adult MeSH
• Hepatitis C epidemiology   MeSH
• Substance Abuse, Intravenous epidemiology   MeSH
• Humans MeSH
• Prevalence MeSH
• Needle-Exchange Programs * MeSH
• Seroepidemiologic Studies MeSH
• Patient Selection * MeSH
• Selection Bias MeSH
• Research Design MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe epidemiology   MeSH

Large-scale biodiversity data, for example, on species distribution and richness information, are being mobilized and becoming available at an increasing rate. Interactive web applications like atlases have been developed to visualize available datasets and make them accessible to a wider audience. Web mapping tools are changing rapidly, and different underlying concepts have been developed to visualize datasets at a high cartographic standard.Here, we introduce the Combined Atlas Framework for the development of interactive web atlases for ecological data visualization. We combine two existing approaches: the five stages of the user-centred design approach for web mapping applications and the three U approach for interface success.Subsequently, we illustrate the use of this framework by developing the Atlas of Plant Invasions based on the Global Naturalized Alien Flora (GloNAF) database. This case study illustrates how the newly developed Combined Atlas Framework with a user-centred design philosophy can generate measurable success through communication with the target user group, iterative prototyping and competitive analysis of other existing web mapping approaches.The framework is useful in creating an atlas that employs user feedback to determine usability and utility features within an interactive atlas system. Finally, this framework will enable a better-informed development process of future visualization and dissemination of biodiversity data through web mapping applications and interactive atlases.

• Keywords
• D3, GloNAF, JavaScript, atlas, cartography, framework development, invasive alien species, web mapping, workflow,
• Publication type
• Journal Article MeSH

BACKGROUND: Injecting drug users (IDUs) represent a major subpopulation of hepatitis C virus (HCV)-infected people in developed countries. Yet their uptake to treatment is generally low despite well-documented effectiveness of HCV treatment among former and active IDUs. The present study represents the first attempt to describe the HCV treatment coverage among IDUs and identify factors that affect treatment uptake in the Czech Republic. METHODS: From January to March 2011, a questionnaire survey was conducted among viral hepatitis treatment centres in the Czech Republic. RESULTS: From a total of 76 identified hepatitis treatment centres existing in the country, 39 provided HCV treatment to (mainly former or abstaining) IDUs in 2010. Most clinicians reported being cautious in initiating HCV treatment in IDUs. Abstinence, a screening phase before treatment initiation, opioid substitution treatment and an external evaluation by a specialist were often prerequisites for skrting treatment. However, HCV treatment centres rarely provided drug-use specific services. Financial constraints were also reported, further limiting the inclusion of IDUs into treatment, as non-users are widely preferred to active drug users. Clinicians reported no difference in treatment uptake and adherence between drug users and non-users, nor between opioid and methamphetamine users. CONCLUSION: A number of system- and provider-related factors limit HCV treatment in IDUs in the Czech Republic, despite permissive national clinical guidelines. Targeting these factors is crucial to reduce HCV prevalence at population level.

• MeSH
• Patient Compliance * MeSH
• Antiviral Agents therapeutic use   MeSH
• Hepatitis C drug therapy   epidemiology   etiology   psychology   MeSH
• Substance Abuse, Intravenous complications   MeSH
• Humans MeSH
• Patients psychology   MeSH
• Prevalence MeSH
• Surveys and Questionnaires MeSH
• Drug Users statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Antiviral Agents MeSH

BACKGROUND: The electronic patient record (EPR) has been introduced into nursing homes in order to facilitate documentation practices such as assessment and care planning, which play an integral role in the provision of dementia care. However, little is known about how the EPR facilitates or hinders these practices from the end-user's perspective. Therefore, the objective of this qualitative study was to explore the usability issues associated with the EPR for assessment and care planning for people with dementia in nursing homes from a staff perspective. METHODS: An exploratory, qualitative research design with a multiple case study approach was used. Contextual Inquiry was carried out with a variety of staff members (n = 21) who used the EPR in three nursing homes situated in Belgium, Czech Republic and Spain. Thematic analysis was used to code interview data, with codes then sorted into a priori components of the Health Information Technology Evaluation Framework: device, software functionality, organisational support. Two additional themes, structure and content, were also added. RESULTS: Staff provided numerous examples of the ways in which EPR systems are facilitating and hindering assessment and care planning under each component, particularly for people with dementia, who may have more complex needs in comparison to other residents. The way in which EPR systems were not customisable was a common theme across all three homes. A comparison of organisational policies and practices revealed the importance of training, system support, and access, which may be linked with the successful adoption of the EPR system in nursing homes. CONCLUSIONS: EPR systems introduced into the nursing home environment should be customisable and reflect best practice guidelines for dementia care, which may lead to improved outcomes and quality of life for people with dementia living in nursing homes. All levels of nursing home staff should be consulted during the development, implementation and evaluation of EPR systems as part of an iterative, user-centred design process.

• Keywords
• Assessment, Care plan, Dementia, Electronic health records, Electronic patient records, Nursing home,
• MeSH
• Dementia * MeSH
• Electronic Health Records * MeSH
• Quality of Life MeSH
• Humans MeSH
• Nursing Homes MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Background: Adverse drug reactions (ADRs), particularly in the context of polypharmacy, remain a persistent, unresolved problem for patients and healthcare professionals. The ADRe Profile identifies medicine-related harms, and supports their resolution, thereby improving care quality and preventing future problems. Objective: The objective of this study was to assess the validity and reliability of the ADRe Profile (https://www.swansea.ac.uk/adre/) in U.K. primary care general practices, building on assessments in other settings. Methods: The ADRe Profile's validity and reliability were investigated using complementary mixed methods: content validity index, contrast group construct validity, cognitive interviewing, and inter-rater reliability. Results: Cognitive interviews (n = 5) confirmed that the ADRe Profile needed only minor adjustments. The scale-level content validity index was 0.67 (n = 14), items ranging from 0.08 to 1. Significant differences in signs and symptoms associated with ADRs between service users taking different numbers of regular prescribed medicines confirmed construct validity (n = 68, U = 870.50, p < 0.001). Inter-rater reliability testing showed substantial agreement between service users and research nurse: 10 items had 100% agreement. Overall kappa mean was 0.71 (range: 0.31-1), (n = 42). Conclusions and Relevance: The ADRe Profile is suitable for use with older service users in primary care who live at home. Users understood the questions and provided meaningful answers. ADRe Profile responses were sufficiently reliable to be used as a basis for further investigations, prescriber referral and clinical actions. However, clinician judgement of content validity may depend on knowledge and experience, highlighting the importance of training. Clinicians acknowledged that the ADRe Profile was comprehensive but identified practical difficulties. Instruments to reduce ADRs should be validated before testing in feasibility studies and randomised controlled trials. Implications for Nursing Management: Managers need to optimise patient safety by introducing patient-centred symptom monitoring, with decision support. Before instruments are adopted, managers should check the reliability and validity data. Trial Registration: ClinicalTrials.gov identifier: NCT04663360.

• Keywords
• drug-related side effects and adverse reactions, pharmacovigilance, primary health care, validation study,
• MeSH
• Middle Aged MeSH
• Humans MeSH
• Drug-Related Side Effects and Adverse Reactions * prevention & control   MeSH
• Polypharmacy MeSH
• Surveys and Questionnaires MeSH
• Psychometrics * instrumentation   methods   standards   MeSH
• Reproducibility of Results MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH
• Validation Study MeSH
• Geographicals
• United Kingdom MeSH

UNLABELLED: General practitioners (GPs) in their surgeries and substitution treatment centres are the major providers of opioid maintenance treatment in a number of European countries. Although in the Czech Republic any GP has been allowed to prescribe buprenorphine (Subutex) since 2001, the opioid substitution treatment provided by primary care professionals has not been the subject of research to date. OBJECTIVE: To collect and analyze data on GPs' experience gained with opioid maintenance treatment in the Czech Reupblic, their attitudes and needs. METHOD: A structured questionnaire was distributed via the Bulletin of the Association of General Practitioners and district Association representatives. The validity of study results may be affected by a low respondence rate (10%) with 398 questionnaires only returned by mail. RESULTS: Twenty-eight (7%) GPs reported to have gained experience with buprenorphine which was most frequently prescribed in the regions with the highest prevalence of heroin users, i.e. in Prague and the Ustí nad Labem region (27% and 12%, respectively). Other regions, including wes- tern and southern Bohemia with relatively high prevalence of heroin users, showed lower buprenorphine prescription rates (0-6%). Most buprenorphine prescribers (78%) rated their experience as positive or highly positive. Availability and effectiveness were seen as the main pros of the substitution treatment. One third of the GPs who have not prescribed opioid maintenance treatment yet are considering doing so in the future. Greater awareness of drug abuse issues and availability of methodical guidance and consulting in opioid substitution treatment are going to become the most relevant factors in the future. Possible reportability of data on opioid maintenance treatment to a central registry does not seem to be a major obstacle to implementing the substitution treatment in the GPs' surgeries. Decision makers should take advantage of the GPs' potential to promote the opioid maintenance treatment in the Czech Republic.

• MeSH
• Buprenorphine therapeutic use   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Narcotic Antagonists therapeutic use   MeSH
• Attitude of Health Personnel * MeSH
• Surveys and Questionnaires MeSH
• Family Practice MeSH
• Aged MeSH
• Drug Utilization MeSH
• Heroin Dependence rehabilitation   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Buprenorphine MeSH
• Narcotic Antagonists MeSH

BACKGROUND: Genetic testing rapidly penetrates into all medical specialties and medical students must acquire skills in this area. However, many of them consider it difficult. Furthermore, many find these topics less appealing and not connected to their future specialization in different fields of clinical medicine. Student-centred strategies such as problem-based learning, gamification and the use of real data can increase the appeal of a difficult topic such as genetic testing, a field at the crossroads of genetics, molecular biology and bioinformatics. METHODS: We designed an electronic teaching application which students registered in the undergraduate Medical Biology course can access online. A study was carried out to assess the influence of implementation of the new method. We performed pretest/posttest evaluation and analyzed the results using the sign test with median values. We also collected students' personal comments. RESULTS: The newly developed interactive application simulates the process of molecular genetic diagnostics of a hereditary disorder in a family. Thirteen tasks guide students through clinical and laboratory steps needed to reach the final diagnosis. Genetics and genomics are fields strongly dependent on electronic databases and computer-based data analysis tools. The tasks employ publicly available internet bioinformatic resources used routinely in medical genetics departments worldwide. Authenticity is assured by the use of modified and de-identified clinical and laboratory data from real families analyzed in our previous research projects. Each task contains links to databases and data processing tools needed to solve the task, and an answer box. If the entered answer is correct, the system allows the user to proceed to the next task. The solving of consecutive tasks arranged into a single narrative resembles a computer game, making the concept appealing. There was a statistically significant improvement of knowledge and skills after the practical class, and most comments on the application were positive. A demo version is available at https://medbio.lf2.cuni.cz/demo_m/ . Full version is available on request from the authors. CONCLUSIONS: Our concept proved to be appealing to the students and effective in teaching medical molecular genetics. It can be modified for training in the use of electronic information resources in other medical specialties.

• Keywords
• Bioinformatics, E-learning, Gamification, Genomics, Interactive teaching application, Medical databases, Medical genetics, Problem-based learning,
• MeSH
• Genetic Diseases, Inborn diagnosis   MeSH
• Genetic Testing * MeSH
• Genetics, Medical education   MeSH
• Humans MeSH
• Molecular Medicine education   MeSH
• Computer-Assisted Instruction * MeSH
• Problem-Based Learning MeSH
• Education, Medical, Undergraduate methods   MeSH
• User-Computer Interface MeSH
• Video Games MeSH
• Computational Biology education   MeSH
• Teaching MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH

OBJECTIVE: Mapping of the socioeconomic background of opioid-addicted pregnant women and women included in substitution therapy. Determination of the effect of substitution on the course of pregnancy and delivery in drug-addicted pregnant women. DESIGN OF THE STUDY: A three-year prospective study. SETTING: The Department of Gynecology and Obstetrics of the Teaching Hospital and the 2nd Medical Faculty of the Charles University Prague. METHODS: During the 3 years we followed-up 47 heroin-addicted women and 60 women under substitution therapy for prenatal screening. Of this number, 36 pregnant women were methadone-substituted and 24 buprenorphine-substituted. All women were screened for socioeconomic indicators, for duration of pregnancy, weight gain during pregnancy, number of visits in the prenatal centre, complications associated with intravenous application of drugs and the way of delivery. Individual groups were compared using the Kruskal-Wallis ANOVA test. Correlation of dichotomic variables was evaluated by means of longlinear models. Calculations were done by means of NCSS 2002 statistical software. RESULTS: Statistically, the age of heroin-dependent women is significantly lower as compared to women receiving substitution therapy. Unemployment was statistically significantly higher in the group using heroin as compared to both groups of women receiving substitution therapy (p < 0.001). Attending the prenatal centre were all buprenorphine-substituted women, 14 of 44 heroin-addicted women and 32 of 36 methadone-ubstituted women. Statistically no significant difference was found when comparing duration of pregnancy of heroin-addicted women and the buprenorphine- or methadone substituted women. Weight gain during pregnancy was statistically significantly higher in the buprenorphine users as compared to the heroin users (p < 0.01) as well as with the methadone users (p < 0.05). CONCLUSION: Clients in substitution programme stabilized in the long run often start to work, complete their education and are able to be involved in normal social activities. In these women, pregnancy is significantly more often wanted and planned, as well. As a result they have a responsible approach to the prenatal care.

• MeSH
• Adult MeSH
• Pregnancy Complications rehabilitation   MeSH
• Humans MeSH
• Narcotic Antagonists therapeutic use   MeSH
• Prenatal Care * MeSH
• Socioeconomic Factors MeSH
• Pregnancy MeSH
• Delivery, Obstetric * MeSH
• Pregnancy Outcome * MeSH
• Heroin Dependence rehabilitation   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Names of Substances
• Narcotic Antagonists MeSH

One of the important research tasks of the European Centre for Medical Informatics, Statistics and Epidemiology - Cardio (EuroMISE Centre - Cardio) is the applied research in the field of electronic health record design including electronic medical guidelines and intelligent systems for data mining and decision support. The research in the field of data storage and data acquisition was inspired by several European projects and standards, mostly by the I4C and TripleC projects. Based on experience gathered during cooperation in the TripleC project we have proposed a description of a flexible information storage model. The motivation for this effort was the large variability of the set of collected features in different departments - including temporal variability. Therefore, a dynamically extensible and modifiable structure of items is needed. In our model we use two basic structures called the knowledge base and data files. The main function of the knowledge base is to express the hierarchy of collectable features - medical concepts, their characteristics and relations among them. The data files structure is used to store the patient's data itself. These two structures can be described using graph theory expressions. Based on this model, a three-layer system architecture named "Multimedia Distributed Record" (MUDR) has been proposed and implemented. During the implementation, modern technologies such as Web Services, SOAP and XML were used. For the practical usage of EHR MUDR, an intelligent application called MUDRc (MUDR Client) was created. It enables physicians to use EHR MUDR in a flexible way. During the development process, maximum emphasis was placed on user-friendliness and comfortable usage of this application. Several methods of data entry can be used: pre-defined forms, direct entry into the tree data structure of the EHR MUDR, or automatic unstructured free-text report parsing and data retrieval. The system enables fast and simple importing and exporting of data as well. The system integrates modern multimedia formats (X-ray photos, sonography and other pictures, video-sequences, audio records) as well as progressive methods of decision support systems realized by medical guidelines and other modules.

• MeSH
• Medical Records Systems, Computerized * MeSH
• Humans MeSH
• Multimedia MeSH
• Computer Systems MeSH
• Decision Support Systems, Clinical * MeSH
• Information Storage and Retrieval * MeSH
• Artificial Intelligence * MeSH
• User-Computer Interface MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH