Quality of life of patients with psoriasis.

OBJECTIVE: The two main aims of our study were to assess the quality of life (QOL) of patients with moderate or severe psoriasis treated by Goeckerman therapy and to compare QOL of our patients on the date of admission and 1 month after their discharge. METHODS: We performed a prospective study on 51 patients treated for chronic plaque psoriasis by Goeckerman regimen (GR). The psoriasis area involvement and severity was measured using the Psoriasis Area and Severity Index (PASI). Patients' health-related QOL was evaluated using Psoriasis Disability Index (PDI). RESULTS: In our study we demonstrated that the QOL of this sample of 51 patients with severe forms of psoriasis was relatively good; an average PDI value on the day of admission was 9.02, which represents a small effect on patient's QOL. We did not find any significant differences in QOL between younger and older respondents or between men and women. Despite good treatment efficiency, we did not find improvement in QOL 1 month after discharge. CONCLUSIONS: The QOL of our patients was relatively good. This could be explained by the fact that our patients have been suffering from psoriasis for many years and have probably adapted to their disease. QOL of our patients was not directly dependent on the extent and intensity of skin changes. Further studies on the connection between psoriasis therapy and patients' QOL are still highly needed.

Assessment of work-related stress by using salivary cortisol level examination among early morning shift workers.

OBJECTIVE: Early morning shifts have a negative effect on the hypothalamic-pituitary-adrenal axis. The aim of this study was to comprehensively assess the extent of occupational stress in early shift workers of the car industry by using salivary cortisol as an objective marker during a workday and on a day off. METHODS: For this cross-sectional epidemiological type of study, a survey included 55 suitable volunteers from the car industry. Five saliva samples were collected according to the following schedule: during one work day in the morning, during the morning shift from 6 a.m. - 2 p.m., then after the shift was completed, 3 hours after work and in the evening before going to sleep. Control samples were taken from the same participants on a day off. Radioimmunoanalysis was used as the main analytical method, and the effect of factors and between-factor interactions on the levels of salivary cortisol during the workday were assessed using an ANOVA model. RESULTS: The cortisol diurnal rhythm was as expected, with the highest values in the morning and declining to the lowest values in the evening hours. Concentrations of salivary cortisol showed higher values during the workday, especially higher concentrations of evening cortisol and attenuated cortisol slope. Based on the results, irregular shift work has a greater increase in cortisol excretion after waking in the morning and a slower progressive recovery of the organism during the workday. In addition, cortisol levels were significantly higher in older women than in older men but did not differ in younger subjects. CONCLUSIONS: Salivary cortisol levels are a suitable objective marker of stress and can be used as a good predictor of occupational stress by public health services for the purposes of primary prevention.

Trends in Parent-adolescent Communication in the Czech Republic between 2002 and 2014: Results of the HBSC Study.

OBJECTIVE: Good parent-child communication is associated with adolescent well-being. The aim of the present study was to report time trends in parent-adolescent communication in biological and stepfamilies in the Czech Republic between 2002 and 2014 and to assess gender and age differences. METHODS: The research sample consisted of 16,160 adolescents aged 11, 13, and 15 years (48.1% of boys) who participated in the 2002, 2006, 2010 and 2014 surveys within the Health Behaviour in School-aged Children (HBSC) study in the Czech Republic. The trends in family communication were evaluated using logistic regression. RESULTS: Compared with 2002, a significant increase in the ease of communication with biological parents was observed in 2014. On the other hand, the adolescents' perception of communication with stepparents did not change in this period. Compared with the girls, a higher rate of boys reported communication with their father or stepfather as being easy throughout the study period. The ease of talking to biological parents decreased with age. CONCLUSION: The growing positive trend demonstrated an improvement in communication in intact families at the beginning of the 21st century, while communication with stepparents remained unchanged from 2002 to 2014. The increase in rates of ease of communication with biological fathers was reported by both genders. However, the ease of talking to biological mothers grew mainly among boys.

Trends in Life Satisfaction and Self-rated Health in Czech School-aged Children: HBSC Study.

OBJECTIVE: The aim of the study is to examine cross-sectional time trends of life satisfaction and self-rated health in a representative sample of Czech children aged 11, 13 and 15 years using the Health Behaviour in School-aged Children (HBSC) study data from the Czech Republic. METHODS: Data from survey years 2002, 2006, 2010 and 2014 was used. The sample consisted of 16,357 participants (48.5% of boys). Life satisfaction (LS) was measured by Cantril's ladder; self-rated health was measured through the simple item "Would you say your health is: excellent, good, fair, poor". RESULTS: Most of the children were satisfied with their lives in all surveyed years (mean LS scores range from 7.21 to 7.51; maximum 10). LS was consistently significantly associated (p<0.001) with age and gender. Overall, children and adolescents in the Czech Republic also reported good health. In total, 87.6% of respondents from all samples reported their health as excellent or good. Gender was found to be significantly associated with self-rated health (p<0.05) in all surveyed years. CONCLUSIONS: No permanent trends in both followed indicators have been seen in the examined period.

Experience of Czech Children with Alcohol Consumption in Relation to Selected Family Indicators.

OBJECTIVE: The aim of this study is to monitor and analyze the influence of chosen family indicators related to alcohol consumption and experience of drunkenness in a representative sample of Czech children. METHODS: Data for our work were obtained from the Health Behaviour in School Aged Children (HBSC) study - a World Health Organization (WHO) cross national study. The sample consisted of 4,293 children aged 11, 13 and 15 years. Data collection was conducted in June 2010 in 88 randomly selected schools in the Czech Republic using standardized questionnaires. Statistical analysis was performed in the program NCSS 9, methods of descriptive statistics, χ2 test of independence in the contingency tables and logistic regression analysis were used. RESULTS: Regular alcohol consumption (at least weekly) was reported by 7.4% of children aged eleven, 19.3% of children aged thirteen and 38.4% of children aged fifteen years. Drunkenness at least twice in their life was admitted by 3% of children aged eleven, 15% of children aged thirteen and 43% of children aged fifteen years. Both alcohol consumption and drunkenness were significantly associated (p<0.001) with age and gender. Formal structure of family was found to have significant effect on the experience of drunkenness, but no effect on alcohol consumption was recorded. Based on our results, neither the amount of time spent together, nor the children communication with parents had a statistically significant influence on alcohol consumption or drunkenness experience within each family type. However, statistically significant differences were observed between different family types (p<0.001). CONCLUSIONS: These findings indicate a high degree of liberalism of Czech society towards alcohol. It appears that alcohol consumption will remain a serious problem in Czech society, therefore, more attention should be paid to this phenomenon in the future.

The attitude of Czech dental patients to the use of rubber dam.

BACKGROUND: The most frequent arguments against rubber dam are that patients generally do not like it and the prolonged time of treatment. However, according to several studies, the attitude of patients towards rubber dam is rather positive. OBJECTIVE: To find out the attitudes of patients to treatment with rubber dam; to determine influence of the circumstances of treatment or factors about patients; and to establish a mean time needed for rubber dam placement. DESIGN: A questionnaire survey. SETTING AND PARTICIPANTS: Patients of general dental practitioners, university clinical specialists and undergraduate dental students. RESULTS: A total of 179 questionnaires were distributed, from which 150 were returned. The mean time needed for rubber dam placement was 4 min for students and < 2 min for dentists. For 56% of patients, this had been their first experience with rubber dam. A total of 77% of patients indicated a higher level of comfort during treatment with rubber dam. A preference to the future rubber dam usage was indicated by 86% of patients. The preference to the further rubber dam usage was statistically significantly affected by the level of comfort during the treatment with rubber dam (P < 0.001) and by the sufficiency of explanation of reasons for rubber dam usage (P < 0.05). The other factors presented no statistically significant influence on patients' attitude to rubber dam usage. CONCLUSIONS: The attitude of patients to rubber dam was rather positive in our study. The time needed for rubber dam application was rather short.

Salivary cortisol in two professions: daily cortisol profiles in school teachers and firefighters.

BACKGROUND: It's indicated negative-perceived stress could induce worse health status and change of cortisol secretion. OBJECTIVES: To assess salivary cortisol levels in two occupations with a high psychosocial workload, but different features, teachers and firefighters. METHODS: The study population consisted of 142 school teachers and 136 firefighters. Four saliva samples were collected from pedagogical participants during their busiest workday. The cortisol measures used were: morning values, evening values, slope of decline, ratio (evening value divided by morning value), and area under the curve (AUC). RESULTS: The salivary cortisol measurements in both genders were almost equal regarding morning values, slope, and AUC increase. Evening values were lower and the relative reactivity was higher (lower ratio) for female teachers, compared to male teachers. There was a tendency of a lower total daytime output of cortisol (AUC ground) among female teachers. Firefighters had lower levels of cortisol, lower total daytime output, and higher relative reactivity (lower ratio), but lower absolute reactivity, regarding both slope and AUC increase. CONCLUSION: Overall, male teachers might be the group most affected by stress in this study, even if some of their cortisol values were almost equal to the female teachers' values. Male teachers also seemed to be more affected by stress, according to salivary cortisol, compared to male firefighters, even if there were some inconsistencies.

The prevalence of musculoskeletal disorders among dentists in the Czech Republic.

The aim of this study was to determine the prevalence of musculoskeletal problems among Czech dentists and to analyze the factors that affect these disorders. Information was gathered through questionnaire completed by 581 physicians. The questionnaire ascertained general information about physicians including their work habits and the characteristics of their work environment along with the occurrence of musculoskeletal problems as well as their intensity. In the past year the occurrence of at least mild difficulties associated with the locomotive system was reported by 96.9% of dentists surveyed (n = 557), with 66.3% of respondents (n = 381) reporting difficulties ofa moderate or major nature. Most respondents of both sexes indicated neck pain. A statistically significant correlation with the occurrence of musculoskeletal complaints of medium and major intensity was demonstrated for the following factors: sex, age, running a private practice, past injury or musculoskeletal diseases, and the perception of work as psychologically demanding. Musculoskeletal disorders in dentists in Czech Republic are relatively frequent and serious health problem. The causes of these diseases must be identified and appropriate preventive interventions undertaken that will contribute to a reduction in the incidence of these problems.

Validation of the Czech Version of the Voice Handicap Index.

OBJECTIVE(S): The present study aims to evaluate the reliability and construct validity of the Czech version of the Voice Handicap Index (VHI-CZ) and determine the cut-off value to distinguish dysphonic patients from nondysphonic individuals. STUDY DESIGN: Prospective study, Parallel group design. METHODS: The study investigated 100 adult patients with dysphonia, divided into three groups based on the etiology of the voice problem (neurogenic, functional, and structural). Out of these, 25 patients were used for test-retest analysis, and 45 patients to determine the responsiveness to change. The control group consisted of 51 healthy subjects. All 151 individuals completed the VHI-CZ and were examined with the videolaryngostroboscopy. The internal consistency (Cronbach's alpha), the test-retest reliability (Intra-class Correlation Coefficient, ICC), and the construct validity were analyzed and the normative cut-off value was determined. RESULTS: The internal consistency of the VHI-CZ was excellent (Cronbach α = 0.984), and test-retest reliability was also excellent (ICC = 0.95, P < 0.001). The correlation between the self-assessed severity of the voice disorder and the VHI-CZ score was strong (Spearman's ρ = 0.877, P < 0.001). The VHI scores differences between dysphonic and nondysphonic patients were statistically significant (Mann-Whitney U test, P < 0.001). The differences among the three etiological subgroups (neurogenic, functional, and structural) were also statistically significant (Kruskal-Wallis test, P < 0.001). Moreover, the differences in the VHI-CZ total scores between pretreatment and posttreatment were statistically significant (Wilcoxon test, P < 0.001). The cut-off score of 13 points was found, by the analysis of the Receiver Operating Characteristic (ROC, Youden Index), to be most suitable for preselecting dysphonic individuals. CONCLUSION: The existing VHI-CZ showed excellent reliability and construct validity. The Czech VHI is a useful and valid monitoring tool for clinicians.

The Prevalence and Development of Neck and Lower Back Pain and Associated Factors in Dentistry Students-A Long-Term Prospective Study.

Musculoskeletal disorders (MSDs) represent a significant occupational burden for dentists and dentistry students. This study aimed to assess the five-year development of most common musculoskeletal complaints among dentistry students during the whole length of their studies and to analyze the impact of some potentially associated risk factors. A longitudinal questionnaire survey regarding the occurrence of MSDs was conducted among a total of 73 dentistry students between 2014 and 2021. The same students enrolled in three consecutive years were monitored throughout their entire studies. Statistical analysis was performed using methods of descriptive statistics, Chi-square test, Fisher's exact test, McNemar test, and univariate and multivariate logistic regression analyses. The most frequent areas of complaints were neck (61.6%) and lower back (49.3%). The increase in self-reported complaints between the first and the fifth year was statistically significant for neck pain (increase by 15%, p = 0.043) but not for lower back pain (by 6.8%, p = 0.44). According to our data, age, performing top-level sport, and participating in regular sporting activities had a statistically significant influence on neck and/or back pain. The results of this longitudinal prospective study showed that neck, as well as lower back pain, are significant problems for dentistry students.

The Development of Musculoskeletal Disorders during Undergraduate Dentistry Studies-A Long-Term Prospective Study.

Musculoskeletal disorders (MSDs) frequently occur among dental practitioners and present a significant occupational burden with an early onset in the dentists' career. This study aimed to analyze the five-year development of self-reported overall MSDs among the dentistry students during the course of their studies and to assess the possible influence of the risk as well as protective factors. The questionnaire inquiry was performed among the first-year dentistry students, regarding the occurrence of MSDs and the presence of potential risk and protective factors. The same students were followed, and they filled in the same questionnaire in the middle and at the end of their studies. A total of 73 dentistry students and 28 general medicine students participated. The occurrence of the overall MSDs statistically significantly increased from 30.1% at the beginning of the first year to 45.2% at the end of the fifth year among the dentistry students. The top-level sport was statistically significantly associated with the higher occurrence of MSDs in the fifth year and with the development of new MSDs between the first and the fifth year. This longitudinal prospective evaluation showed a significant increase in the MSDs occurrence among the dentistry students during their studies.

Oral health-related quality of life in Czech population.

OBJECTIVE: The purpose of this study was to assess the oral health-related quality of life in Czech population. METHODS: Data were collected from 1,380 subjects aged 30 to 69 years attending the Department of Dentistry, Medical Faculty of Charles University in Hradec Králové or attending three private dental practitioners collaborating on the study. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP-14) questionnaire that was translated to Czech. The OHIP-14 scores were assessed in relation to chosen clinical and sociodemographic characteristics and oral health behaviour. Statistical analyses included descriptive analyses, the Mann-Whitney test, the Kolmogorov-Smirnov test and the Kruskal-Wallis test using the NCSS 2007 program. The chi2 test of independence in contingency tables or Fisher's exact test was used for qualitative data. RESULTS: Internal reliability for the 14 items overall was very high (Cronbach's ac = 0.924). The two most frequently scored items using the answer other than "never" during the last year were "painful aching" (62% of subjects) and "uncomfortable to eat" (44.4%), representing subdomain physical pain. The domain of social disability was reported least frequently. The OHIP-14 was significantly associated with dental status, dental behaviour, income and age. CONCLUSIONS: The findings of this study do suggest that the culturally adapted OHIP-14 version may be a good research instrument to be considered for use in measuring the impact of oral problems on the quality of life in Czech population.

Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists.

The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue.