Opportunities to strengthen resilience of health care workers regarding patient safety.

BACKGROUND: The COVID-19 pandemic endangered the quality of health care and the safety of patients and health care workers (HCWs). This provided challenges for HCWs' resilience and for hospital management and probably increased risks for patient safety incidents (PSI). HCWs may also have experienced psychological consequences as second victims of PSI, but evidence on this is lacking. Therefore, we mapped HCWs' experiences with PSI during the second wave of COVID-19, the associations of these experiences with the hospital management of patient safety culture and HCWs' interests in receiving further training. METHODS: We obtained data from 193 HCWs working at the COVID-related departments of one large hospital in eastern Slovakia via a questionnaire developed in direct collaboration with them. We measured PSI experiences as various HCWs' experiences with near miss and adverse events and the hospital management of patient safety culture using indicators such as risk of recurrence, open disclosure and second victim experiences. For analysis, we used logistic regression models adjusted for age and gender of the HCWs. RESULTS: One-third of the hospital HCWs had experienced PSI; these were more likely to expect adverse events to recur (odds ratio, OR = 2.7-3.5). Regarding the hospital management of patient safety culture, the HCWs' experiencing openly disclosed PSI was associated with one negative outcome, i.e. conflicts among colleagues (OR = 2.8), and one positive outcome, i.e. patients' acceptance of their explanation and apologies (OR = 2.3). We found no associations for any other essential domains after disclosure. PSI experiences were strongly associated with psychological indicators of second victimhood, such as sadness, irritability, anxiety and depression (OR = 2.2-4.3), while providing support was not. The majority of the HCWs would like to participate in the suggested trainings (83.4%). CONCLUSION: HCWs with PSI experiences reported poor hospital management of the patient safety culture, which might reflect they missed the opportunities to strengthen their resilience, especially during the COVID-19 pandemic.

Associations of childhood trauma with long-term diseases and alcohol and nicotine use disorders in Czech and Slovak representative samples.

OBJECTIVE: The abuse and neglect of a child is a major public health problem with serious psychosocial, health and economic consequences. The aim of this study was to assess the relationship between various types of childhood trauma, selected long-term diseases and alcohol and nicotine use disorder in Czech and Slovak representative samples. METHODS: Data on retrospective reporting about selected long-term diseases, alcohol and nicotine use disorder (CAGE Questionnaire) and childhood maltreatment (Childhood Trauma Questionnaire; CTQ) in two representative samples (Czech sample: n = 1800, 48.7% men, mean age 46.61 ± 17.4; Slovak sample: n = 1018, 48.7% men, mean age: 46.2 ± 16.6) was collected. Multinomial logistic regression models were used to assess the relationships between childhood maltreatment and long-term diseases. RESULTS: There is a higher occurrence of some long-term diseases (such as diabetes, obesity, allergy, asthma) and alcohol and nicotine use disorder in the Czech sample; however, in the Slovak sample the associations between child maltreatment and long-term diseases are stronger overall. Emotional abuse predicts the occurrence of all the studied long-term diseases, and the concurrent occurrence of emotional abuse and neglect significantly predicts the reporting of most diseases. All types of childhood trauma were strong predictors of reporting the occurrence of three or more long-term diseases. CONCLUSION: The extent of reporting childhood trauma and associations with long-term diseases in the Czech and Slovak population is a challenge for the strengthening of preventive and therapeutic programmes in psychosocial and psychiatric care for children and adolescents to prevent later negative consequences on health.

Associations of multidimensional health literacy with reported oral health promoting behaviour among Slovak adults: a cross-sectional study.

BACKGROUND: Modification of health literacy (HL) is an important factor for improving and maintaining oral health. The aim of the study is to examine the association of HL with oral health-promoting behaviour (OHPB) and assess possible mediating effects of HL on the impact of socioeconomic status on OHPB. METHODS: A cross-sectional questionnaire survey on the Slovak general adult population (N = 360, mean age 39) was conducted in 2014 and 2015. The association of HL (9 domains of the Health Literacy Questionnaire) and OHPB was analysed using logistic regression models adjusted for gender, age and educational level. Testing the mediating effect of HL domains between education attainment and OHPB was performed using the Sobel test. RESULTS: Women and respondents with higher education reported better OHPB. Regular tooth-brushing is associated with better HL in five domains: Feeling understood and supported by healthcare provider, Having sufficient information to manage my health, Activelymanaging my health, Social support for health, Appraisal of health information (Odds ratios (ORs) from 1.64 to 2.33, p < 0.05). Using interdental tools is in association with better HL in two domains: Feeling understood and supported by a healthcare provider and Having sufficient information to manage my health (ORs 1.71 to 1.80, p < 0.05). Respondents who visited a dentist for prevention score higher in Social support for health (OR 1.79, p < 0.05). Using a tongue scraper and single brush and reporting gums bleeding is notstatistically significantly associated with HL. Mediation was confirmed between the effect of respondents' education on using fluoride toothpaste - mediated respondent's ability to find good health information. Frequency of tooth-brushing and using interdental hygiene aids were both mediated by patient's sufficient information to manage health. CONCLUSIONS: Our results indicate HL to be an important factor related to good oral health, and HL should be considered when planning oral health interventions.

Do Adolescents with T1DM Differ from Their Peers in Health, Eating Habits and Social Support?

OBJECTIVE: The aim of this study was to analyse differences in health, eating habits and social support in adolescents with type 1 diabetes mellitus (T1DM) in comparison to peers with another long-term illness or without any medical condition. METHODS: We used self-reported data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents as well as data from adolescents with T1DM collected in outpatient settings (11 to 15 years old, N=8,910, 50.3% of boys). Logistic regression models and general linear models were used to analyse differences between adolescents with T1DM and their peers with and without long-term illness in self-rated health, life satisfaction, health complaints, regular breakfast, sweets and soft drink consumption, and perceived support from family, teachers and classmates. RESULTS: Adolescents with T1DM reported worse self-rated health and suffer from more health complaints, but they have lower chance of having breakfast irregularly in comparison to their peers with another long-term illness or without any medical condition. Moreover, compared with their peers, adolescents with T1DM perceived stronger support from teachers and classmates, but weaker support from their family. We did not confirm any differences in life satisfaction, sweets and soft drink consumption between adolescents with T1DM and their peers. CONCLUSIONS: Adolescents with T1DM reported more regular eating habits, no difference in life satisfaction and more social support outside the family in comparison to their peers. However, their worse self-rated health, more health complaints and weaker support from family should be considered in interventions targeting psychosocial adjustment of adolescents with T1DM.

The Spiritual Well-Being Scale: Psychometric Evaluation of the Shortened Version in Czech Adolescents.

The aim of this study was to psychometrically evaluate the shortened version of the Spiritual Well-Being Scale (SWBS) in Czech adolescents. A nationally representative sample of 4217 adolescents participated in the 2014 Health Behaviour in School-aged Children survey. The internal consistency of the SWBS was assessed using Cronbach's alpha (α) and Mean Inter-Item Correlation (MIIC) values. The factor structure was evaluated using principal component analyses. After adjustment, our new seven-item version of the scale supports a two-factorial model of the SWBS with satisfactory internal consistency (α = 0.814, MIIC = 0.379). This version of the SWBS is suitable for measuring spiritual well-being in a secularising environment.

Time trends: a ten-year comparison (2005-2015) of pedometer-determined physical activity and obesity in Czech preschool children.

BACKGROUND: To explore the time trends (2005-2015) of pedometer-determined weekday and weekend physical activity (PA) and obesity prevalence in 4-7-year-old Czech preschool children and changes in proportion of kindergarten vs. leisure-time PA. METHODS: The study compared data of two cross-sectional cohorts of preschool children (2005: 92 boys and 84 girls; 2015: 105 boys and 87 girls) in the Czech Republic, using the same measurements and procedures in both cases. PA was monitored by the Yamax Digiwalker SW-200 pedometer for at least eight continuous hours a day over seven consecutive days. Body weight and height were measured using calibrated Tanita scales and anthropometry. The analysis of variance was conducted to examine the gender and cohort effect on step counts. The t-test was used to examine the difference in step counts in kindergarten (or leisure-time) between non-obese and obese children, and the chi-square test compared the prevalence of obesity between 2005 and 2015. RESULTS: The steps/day (mean ± standard deviation) of preschoolers was significantly higher (p < 0.05) in 2015 (11,739 ± 4,229 steps/day) than in 2005 (10,922 ± 3,181 steps/day); and (p < 0.001) in boys (11,939 ± 3,855 steps/day) than in girls (10,668 ± 3,587 steps/day). In 2015, girls, but not boys, had a significantly (p < 0.01) greater step count on weekdays than in 2005, but not at weekends. A decline of leisure-time step counts on weekdays between 2005 and 2015 in girls (6,8652005 vs. 6,0592015, p < 0.01) and boys (7,8612005 vs. 6,4362015, p < 0.001) is compensated for by the increase of step counts in kindergarten (girls: 3,0582005 vs. 5,3302015, and boys: 4,0032005 vs. 5,9992015, p < 0.001). The prevalence of obesity was not significantly different either in 2005 or 2015 among preschool girls (7.14 % 2005 vs. 9.20 % 2015) or boys (6.52 % 2005 vs. 9.52 % 2015). CONCLUSION: The steps/day of preschoolers was higher in 2015 than in 2005; this higher level of PA was the result of increased PA in kindergartens over the last ten years, particularly among girls. Thus, the current PA program in kindergartens effectively compensates for the decline in PA in leisure-time of weekdays of non-obese and obese preschoolers compared to 2005 and 2015. Prevalence of obesity among Czech preschool children remains relatively stable between 2005 and 2015.

Screen-based behaviour in school-aged children with long-term illness.

BACKGROUND: Evidence is lacking on the screen-based behaviour of adolescents with a chronic condition. The aim of our study was to analyse differences in screen-based behaviour of adolescents by long-term illness, asthma and learning disabilities. METHODS: We used data from the cross-sectional Health Behaviour of School-aged Children study collected in 2014 among Slovak adolescents (age 13 to 15 years old, N = 2682, 49.7 % boys). We analysed the associations between screen-based behaviour and long-term illness, asthma and learning disabilities using logistic regression models adjusted for gender. RESULTS: We found no associations between screen-based behaviour and long-term illness, except that children with asthma had a 1.60-times higher odds of excessively playing computer games than healthy children (95 % confidence interval of odds ratio (CI): 1.11-2.30). Children with learning disabilities had 1.71-times higher odds of risky use of the Internet (95 % CI: 1.19-2.45). CONCLUSION: Adolescents with a long-term illness or with a chronic condition or a learning disability do not differ from their peers in screen-based activities. Exceptions are children with asthma and children with learning disabilities, who reported more risky screen-based behaviour.

The mediating effect of discrimination, social support and hopelessness on self-rated health of Roma adolescents in Slovakia.

BACKGROUND: According to the EU-MIDIS report on discrimination, Roma are the most discriminated against group in Europe. Research suggests that experiencing discrimination may itself be detrimental to health. The aim of this paper is to investigate whether discrimination, hopelessness and social support mediate differences in self-rated health (SRH) between Roma and non-Roma adolescents. METHODS: We conducted a cross-sectional study among Roma from separated and segregated settlements in the eastern part of Slovakia (N = 330; mean age = 14.50; interview) and non-Roma adolescents (N = 722; mean age = 14.86; questionnaire); only non-missing data were used for analyses (n = 759). The effect of perceived discrimination, mother and father social support, and hopelessness on SRH was analysed as crude and adjusted for ethnicity, age, gender, parental education and social desirability. Mediating effects were separately assessed using the Sobel test and structural equation modelling. RESULTS: Roma adolescents reported poorer SRH and more discrimination, mother and father social support, hopelessness and social desirability. Roma ethnicity (Odds ratio/95 %-Confidence interval 3.27/2.40-4.47), discrimination (2.66/1.82-3.88), hopelessness (1.35/1.20-1.51) and mother (0.92/0.88-0.97) and father social support (0.96/0.93 - 0.997) were statistically significant predictors of poor SRH. Perceived discrimination, social support and hopelessness mediated the ethnicity-health association, with adjustment for social support increasing its strength and the other two variables decreasing it. CONCLUSIONS: Perceived discrimination, social support and hopelessness mediate a part of the association between Roma ethnicity and poor SRH, with discrimination and hopelessness being risk factors and social support a protective factor.

When children play, they feel better: organized activity participation and health in adolescents.

BACKGROUND: Participation in organized leisure-time activities (OLTA) has been linked to healthy youth development. This study aimed to assess whether participation in OLTA is associated with both physical and mental health in adolescents, and whether this association differs by pattern of activity participation, age and gender. METHODS: The present study was based on data from the 2013/2014 Health Behaviour in School-aged Children study in the Czech Republic. This data concerned 10,503 adolescents (49.2 % boys) aged 11, 13 and 15. A cluster analysis was carried out to obtain patterns of activity participation and yielded five groups (all-rounders, artists, individual sports, team sports and inactive). The association between participation in types of OLTA and physical and mental health was analysed using logistic regression models adjusted for age and gender. We also assessed interactions between types of OLTA and gender and age. RESULTS: Participation in OLTA was associated with better self-rated health and higher life satisfaction regardless of gender or age. Participation in team or individual sports was associated with better general health and less frequent health complaints in boys, while participation in art activities was associated with lower occurrence of health complaints in girls and 11-year-olds. CONCLUSION: Participation in OLTA is associated with better physical and mental health in adolescents. The association varies by pattern of activity participation and is partly gender- and age-specific.

Age and Gender Differences in Prevalence of Screen Based Behaviour, Physical Activity and Health Complaints among Slovak School-aged Children.

AIM: The aim of this study was to assess age and gender differences in prevalence of screen based behaviour, physical activity and health complaints among Slovak school-aged children. METHODS: Data from the cross-sectional Health Behaviour of School-aged Children study collected in 2010 among Slovak children (age 11-15 years, N=8,042) was used. Logistic regression models adjusted to age and gender were used to analyse the associations between watching TV, working with a computer or playing computer games and physical activity and headache, backache, sleep difficulties, feeling low, irritability, and feeling nervous. RESULTS: Around one-quarter of adolescents is spending more than three hours a day with screen-based activities. While the age was significantly associated with watching TV and computer use, gender was significantly associated only with excessive computer use. As for physical activity only 25% of adolescents reported being physically active every day as recommended, and this number decreases with increasing age. Boys used to be more often active in comparison with girls. A sizeable number of adolescents suffer with selected health complaints every week. Moreover, the prevalence of health complaints increases with age and is significantly higher among girls. CONCLUSIONS: The prevalence of screen-based activities as well as insufficient physical activity and health complaints among adolescents is relatively high and it increases with age. Gender differences are also significant, except for watching TV.

Physical Activity and Screen-based Activity in Healthy Development of School-aged Children.

AIM: Physical and screen-based activity in adolescents plays a crucial role in future health outcomes. Therefore, the aim of the study was to examine the associations of physical activity and screen-based activity with behavioural and psychosocial characteristics of school-aged children. METHODS: Data on 11, 13 and 15 years old elementary school pupils (N=9,014; mean age=13.59) who participated in the cross-sectional Health Behaviour in School-aged Children 2009/2010 study in the Czech Republic and the Slovak Republic were analyzed. The associations of vigorous physical activity and screen-based activity with substance use, violent behaviour, eating habits and school-related outcomes adjusted for age were explored using logistic regression. RESULTS: Vigorous physical activity was positively associated with some of the health-related behaviours (smoking, breakfast consumption, vegetable and fruit consumption) and school related outcomes (perceived school achievement and school pressure), with gender and country based differences. Screen-based activity was significantly associated with all examined health-related behaviours and school related outcomes with only some country and gender based differences. CONCLUSIONS: Vigorous physical activity is positively associated with healthy development of adolescents. Screen-based behaviour shows an inverse relationship with adolescents' healthy development, especially in the group of 11 and 13 years old children. Supporting physical activity conducive environments might lead to a reduction in screen-based behaviour in adolescents and should be highlighted in health-promoting strategies.

Motives for Physical Activity among Adolescents in the Czech and Slovak Republics.

OBJECTIVES: Physical activity significantly contributes to overall health and the level of activity during adolescence has been associated with physical activity in adulthood. The aim of this paper was to analyse motives for young people undertaking leisure time physical activity in the Czech and Slovak Republics. METHODS: Eleven to fifteen year old schoolchildren (N=9,014; mean age=13.59) participating in the Health Behaviour in School-aged Children 2009/2010 study in the Czech and Slovak Republics completed 12 items measuring physical activity motivations. To analyse the factor structure of motives for physical activity, Confirmatory Factor Analysis (CFA) was conducted using Principal Component Analysis (PCA) with varimax rotation. RESULTS: Contrary to previous research that reported three main motives for physical activity (health, social, achievement), our study suggests four motives. The additional motive is a combination of internal and external motivations and was called the "Good Child Motive". CONCLUSIONS: Better understanding of motives behind physical activity or inactivity of young people could significantly contribute to evidence based planning and development of national strategies for public health and active living.

Adolescents' drinking and drunkenness more likely in one-parent families and due to poor communication with mother.

OBJECTIVES: Alcohol use is a relatively common behaviour, particularly among adolescents, and has become a major public health concern. This study explores the associations between family composition, the quality of adolescents' communication with parents and adolescents' recent frequent alcohol drinking and lifetime drunkenness. METHODS: Data were obtained from the Slovak part of the 2005-2006 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3,882 students (46.3% males; mean age 13.3; ± 1.6). Data on drinking alcohol in the past week, lifetime drunkenness, communication and family composition were collected via anonymous questionnaires stratified for ages 11, 13 and 15 years and following the methodology of the HBSC study. RESULTS: The results showed that living in an incomplete family increased the risk of frequent drinking and drunkenness among adolescents as well as a low quality of communication between mothers and their children. Risks were higher for drunkenness than for frequent alcohol use and strongly increased by age, with the communication with parents worsening at increasing age. CONCLUSIONS: Our findings show the importance of the quality of communication between parents and adolescents in preventing the hazardous alcohol use among adolescents. Preventive interventions to reduce adolescents' use of alcohol should therefore also target the quality of communication in the family.

ActiTrainer-determined segmented moderate-to-vigorous physical activity patterns among normal-weight and overweight-to-obese Czech schoolchildren.

UNLABELLED: This study uncovered the patterns of moderate-to-vigorous physical activity (MVPA) in normal-weight and overweight/obese children before, during, and after school lessons. ActiTrainer-based MVPA was assessed over 2 school days (with and without a physical education lesson [PEL] in a sample of three hundred thirty-eight 9- to 11-year-old children (50.3 % female; 29.6 % overweight/obese), in the Czech Republic, during spring 2012. MVPA was quantified based on the step count (number), MVPA duration, and MVPA heart-rate response (minutes). No differences in the MVPA based on the time during the school day were confirmed in normal-weight versus overweight/obese girls, whereas normal-weight boys significantly exceed their overweight/obese peers in step count and after-school and daylong MVPA. Active participation in PEL contributes to a significantly higher step count, exercise duration, and MVPA heart-rate response in normal-weight and overweight/obese boys (p < 0.001) and normal-weight (p < 0.001) and overweight/obese (p < 0.04) girls during school time. Moreover, active participation in PEL significantly (p < 0.04) increases the overall daily step count, duration, and MVPA heart-rate response in normal-weight boys and overweight/obese girls. Active exercise during PEL accounted for 16.7 % of the total number of steps, 25.1 % of overall MVPA duration, and 24.1 % of the MVPA heart-rate response in 9- to 11-year-old children. During days with a PEL, a significantly (p < 0.02) higher number of overweight/obese girls and a higher number of normal-weight boys achieved the duration of 60 min/day of MVPA compared with days without a PEL. CONCLUSION: Adding one PEL or an equivalent amount of MVPA to the daily school routine appears to be a promising strategy to effectively increase daily MVPA, particularly among overweight/obese girls.

How parents can affect excessive spending of time on screen-based activities.

BACKGROUND: The aim of this study is to explore the association between family-related factors and excessive time spent on screen-based activities among school-aged children. METHODS: A cross-sectional survey using the methodology of the Health Behaviour in School-aged Children study was performed in 2013, with data collected from Slovak (n = 258) and Czech (n = 406) 11- and 15-year-old children. The effects of age, gender, availability of a TV or computer in the bedroom, parental rules on time spent watching TV or working on a computer, parental rules on the content of TV programmes and computer work and watching TV together with parents on excessive time spent with screen-based activities were explored using logistic regression models. RESULTS: Two-thirds of respondents watch TV or play computer games at least two hours a day. Older children have a 1.80-times higher chance of excessive TV watching (CI: 1.30-2.51) and a 3.91-times higher chance of excessive computer use (CI: 2.82-5.43) in comparison with younger children. More than half of children have a TV (53%) and a computer (73%) available in their bedroom, which increases the chance of excessive TV watching by 1.59 times (CI: 1.17-2.16) and of computer use by 2.25 times (CI: 1.59-3.20). More than half of parents rarely or never apply rules on the length of TV watching (64%) or time spent on computer work (56%), and their children have a 1.76-times higher chance of excessive TV watching (CI: 1.26-2.46) and a 1.50-times greater chance of excessive computer use (CI: 1.07-2.08). A quarter of children reported that they are used to watching TV together with their parents every day, and these have a 1.84-times higher chance of excessive TV watching (1.25-2.70). CONCLUSIONS: Reducing time spent watching TV by applying parental rules or a parental role model might help prevent excessive time spent on screen-based activities.

Do eating habits of the population living in Roma settlements differ from those of the majority population in Slovakia?

Living in Roma settlements is associated with worse health in comparison with the majority population; this might be partially explained by socioeconomic disadvantages as well as cultural differences, including lifestyle. Eating habits represent an important part of lifestyle closely related to primary causes of morbidity and mortality, such as cardiovascular diseases, metabolic diseases or cancers. The eating habits of the population living in Roma settlements in comparison with those of the majority population were explored using the cross-sectional epidemiological HepaMeta study conducted in 2011. A representative sample of Roma (n = 452, mean age = 34.7; 35.2% men) and non-Roma (n = 403, mean age = 33.5; 45.9% men) aged 18-55 years living in the Kosice region were asked about breakfasting and recent consumption of fruits, vegetables, dairy products, meat products, meat, farinaceous dishes, and soft drinks. A logistic regression model was used separately for male and female participants. The population living in Roma settlements reported the recent consumption of fruit, vegetables and dairy products significantly less frequently in comparison with the majority population. Moreover, Roma females, in comparison with non-Roma females, reported significantly more frequently the consumption of meat and soft drinks. No differences were found between Roma and non-Roma in the consumption of meat products and farinaceous dishes. The population living in Roma settlements reported more frequently unhealthy eating habits in comparison with the majority population; this might contribute to worse health status of this population. The differences might be attributed to cultural differences between ethnic as well as socioeconomic groups, reduced availability of certain food items due to segregation or poverty and lower health literacy.

Hepameta-- prevalence of hepatitis B/C and metabolic syndrome in population living in separated and segregated Roma settlements: a methodology for a cross-sectional population-based study using community-based approach.

BACKGROUND: Roma represent one of the largest and oldest minorities in Europe. Health of many of them, particularly those living in settlements, is heavily compromised by poor dwelling, low educational level, unemployment, and poverty rooted in generational poverty, segregation and discrimination. The cross-sectional population-based study using community based approach aimed to map the prevalence of viral hepatitis B/C and metabolic syndrome in the population living in separated and segregated Roma settlements and to compare it with the occurrence of the same health indicators in the majority population, considering selected risk and protective factors of these health indicators. METHODS: The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Data were collected in 2011 via questionnaire, anthropometric measures and analysed blood and urine samples. A methodology used in the study as well as in the following scientific papers is described in the Methods section (i.e. study design, procedures, samples, methods including questionnaire, anthropometric measurements, physical measurements, blood and urine measurements). CONCLUSIONS: There are regions of declining prosperity due to high unemployment, long-term problems with poverty and depleted resources. Populations living in these areas, i.e. in Central and Eastern Europe in Roma settlements, are at risk of poverty, social exclusion and other factors affecting health. Therefore, we should look for successful long-term strategies and tools (e.g. Roma mediators, terrain work) in order to improve the future prospects of these minorities.

Higher prevalence of nephropathy in young Roma females compared with non-Roma females.

OBJECTIVES: Ethnic differences in the prevalence of various chronic diseases, including end-stage renal disease, have been previously reported. Surprisingly, data focusing on the lower grade of chronic kidney disease (CKD) are scarce. Thus, the aim of this study was to explore differences in the prevalence of nephropathy between the Roma and non-Roma populations. METHODS: Data from the cross-sectional population based HepaMeta study conducted in Slovakia were used. Nephropathy was defined as: a known history of any kidney disease; or the presence of proteinuria/hematuria; or glomerular filtration rate (GFR) < 60 ml/min. The odds ratio for the prevalence of nephropathy was calculated using binary logistic regression. RESULTS: In an age-adjusted model, Roma females had OR of 1.56 for having nephropathy over non-Roma females (OR 1.56; 95% CI 1.01-2.42; p < 0.05). In addition, Roma females had a significantly lower GFR (mean difference 3.4 ml/min, t = -3.58, p < 0.001); all female patients with proteinuria were Roma. CONCLUSIONS: This cross-sectional study on the young general population found that Roma females have half-higher odds for nephropathy than non-Roma females. Therefore, to prevent risks we should focus on searching for ethnic, social and medical determinants of CKD. Interventions to decrease the incidence of CKD in the target population should also address ethnic inequalities as well as female gender.

Does the population living in Roma settlements differ in physical activity, smoking and alcohol consumption from the majority population in Slovakia?

BACKGROUND: Several studies have revealed a high prevalence of risk factors associated with unhealthy lifestyle among individuals with lower socioeconomic status. In Slovakia, one of the most socially and health-disadvantaged groups is the Roma minority. The aim of this study is to explore differences in physical activity, smoking and alcohol consumption between the population living in Roma settlements and the majority population in Slovakia. METHODS: Data from the cross-sectional epidemiological HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. The differences in health-related behaviour between the population living in Roma settlements and the majority population were analysed using logistic models separately for males and females. RESULTS: These data show a clear difference between the population living in Roma settlements and the majority population with regard to leisure-time physical activity (only in women) and smoking, although not alcohol consumption. The prevalence of leisure-time physical activities such as walking or some other type of sport was significantly lower among Roma women than among non-Roma women. Men and women living in Roma settlements are more likely to smoke on a daily basis and they are heavier smokers in comparison with the majority population. HepaMeta study did not find differences in alcohol consumption between the Roma and non-Roma men. However, Roma women reported less frequent recent drinking and binge-drinking of 6 or more doses of alcohol on a single occasion. CONCLUSION: The higher prevalence of unhealthy lifestyle activities among Roma seem to contribute to these inequalities in cardiovascular diseases morbidity and mortality in comparison with the majority population.

Biomarkers associated with obesity and overweight in the Roma population residing in eastern Slovakia.

BACKGROUND: Obesity and overweight are major contributors to the global burden of chronic diseases and disability in both majority and minority populations. METHODS: Data from the cross-sectional population-based HepaMeta study conducted in Slovakia in 2011 were used. The sample comprised a total of 452 Roma. Measurements of special bioactive mediators were taken in final groups consisting of 63 male Roma respondents (mean age = 32.59; SD = 8.63) and 117 female Roma respondents (mean age = 34.55; SD = 8.35). Respondents were divided into three groups: those with normal weight, those with overweight and obese. Values for anthropometric parameters, lipids parameters, C-reactive protein, TNF-alpha, IL-6, leptin, and adiponectin were determined. RESULTS: 27.6% of examined Roma females and 26.9% of males were overweight. Obesity (BMI > 30.0 kg/m2) appeared in a higher proportion of males (28.8%) compared with female (26.5%). Mean levels of total cholesterol, triacylglycerol and LDL-cholesterol were significantly elevated in the overweight and obese subjects compared to normal-weight Roma respondents. The relation was reversed for HDL-C level, with significantly decreased levels in both male and female obese Roma (p < 0.001). The concentration of adiponectin was significantly lower in obese subjects of both genders versus non-obese (Roma male p < 0.001, Roma female p < 0.05). Plasma levels of leptin, IL-6, hs-CRP as well as TNF-alpha increased in Roma significantly with increasing BMI. CONCLUSION: The study is the first one to provide data about selected biomarkers. Results may be useful in predicting obesity and its related diseases in the Roma population from the eastern part of Slovakia.