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Objectives: The paper analyses real-world data on cost of treatment in patients after stroke hospitalized in early rehabilitation units within comprehensive stroke centres in the Czech Republic. This is the first study of the kind in the Czech Republic, while such information is extremely rare worldwide. Stroke treatment witnessed a dramatic development in the last years, when the main progress was due to establishment of specialized (comprehensive) stroke units incorporating also early rehabilitation. There is a general agreement among clinicians that early rehabilitation is beneficial for patients after stroke.Methods: Costs of early rehabilitation after stroke were calculated by the micro-costing method alongside a pragmatic study in three Czech hospitals. Patients were transferred to specialized early rehabilitation units usually on 7th to 14th day after stroke onset and received four hours of interprofessional rehabilitation per day.Results: The analysis of data collected during the prospective observational research of 87 patients proved significant differences between patients. The average costs of hospitalization were determined to be CZK 5,104 (EUR 194) per one day of intensive rehabilitation in seriously affected patients early after stroke. These costs differed significantly between hospitals (p-value < 0.001); the structure of direct costs was quite stable, though. About 60% of these costs were due to nursing and overhead, while no more than 15% were consumed by therapists.Conclusions: The treatment of patients after stroke in specialized stroke units proved to be beneficial for the patients increasing the number of those re-integrated in family and community life. [ABSTRACT FROM AUTHOR]

Objectives: Smoking at the workplace has a negative impact both on employers' economic interests and employees' health. The aim of this study is to describe the current situation, mainly barriers in implementation and resources in the Czech Republic as an example of a Central European country.Methods: We synthesised relevant review papers with our knowledge of the local situation based upon professional experience of both authors.Results: Despite smoke-free laws, some EU workers are still exposed to passive smoking during working hours. The main barriers towards smoke-free workplace implementation are the lack of resources, perception of smoking as a norm, and exceptions for leading personalities and their smoking. Social support increases smoking cessation effectiveness. Low availability of local smoking cessation services is an overall problem in Central Europe.Conclusions: The working environment influences smoking habits. Smoking cessation support is cost-effective not only for the smoking employee but for employers as well. Smoking cessation resources should be available during the working day. No exceptions should be made as they serve as barriers to a smoke-free working environment. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes and comments on contemporary legislation concerning prevention of epidemics caused by contaminated drinking water from public water supplies in the Czech Republic.Methods: Suggestions are made for removing existing legislative shortcomings, clarifying diction of existing laws and expanding sanctions and penalties for health injury caused by providers and operators of public drinking water.Results: The author reflects on improving legislation concerning the compensation of victims of contaminated water with reference to the aftermath of a local epidemic in the Dejvice District of Prague.Conclusion: The issues raised should be addressed since better legislation can significantly contribute to the limitation of water-borne epidemics and their consequences. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to provide information about the concentrations of airborne bioaerosols (airborne bacteria, fungi and endotoxins) in outdoor suburban environments in Ostrava, Moravian-Silesian region, Czech Republic.Methods: The methods were based on systematic bioaerosol monitoring during one calendar year, subsequent analysis of the samples and statistical processing. The regression, correlation analysis and analysis of variance for one factor and pairwise comparisons were performed on bioaerosol data to determine their dependence on season, daytime, temperature, humidity and dew point.Results: The results show higher fungi concentrations especially in summer (corrected mean 365 colony forming units - CFU per m3) compared to other seasons (75-209 CFU/m3) and higher concentrations of bacteria in the evening (380 CFU/m3) compared to other parts of the day and seasons (in summer 206-252 CFU/m3 and in winter 81-87 CFU/m3). Concentrations of endotoxins were relatively low throughout the year, on average 0,056 endotoxin units (EU) per m3.Conclusions: The concentration of bioaerosol (bacteria, fungi and endotoxins) were found in ambient air at substantially lower levels than in an indoor environment. Although the concentrations of this bioaerosol greatly fluctuate with temperature, dew point, season and daytime, they do not represent increased health risks. [ABSTRACT FROM AUTHOR]

Background and Aim: According to the World Health Organization (WHO) more than 2 million premature deaths and 7 million of total deaths each year can be attributed to the effects of air pollution. The contribution of air pollution to the health status of population is estimated to be about 20%. Health is largely determined by factors outside the reach of healthcare sector, including low income, unemployment, poor environment, poor education, and substandard housing. The aim of the paper was to review a current knowledge of relationships among air pollution, socioeconomic health inequalities, socio-spatial differentiation, and environmental inequity. The relationships were demonstrated on an example of the Ostrava region. Also basic approaches to health valuation were reviewed.Results: Social differences are reasons both for health inequalities and spatial patterns of unprivileged area housing. In urban environments with poor air quality there is also a large concentration of low income residents. Less affluent population groups are more often affected by inadequate housing conditions including second-hand smoking and higher environmental burden in their residential neighbourhoods. Environmental injustice is highly correlated with other factors that link poverty with poor health, including inadequate access to medical and preventive care, lack of availability of healthful food, lack of safe play spaces for children, absence of good jobs, crime, and violence.Conclusions: The theoretical background and also results of the studies brought evidence that population health is affected by both socioeconomic and environmental inequalities. Air pollution is unevenly distributed in Ostrava and is related to distribution of socially disadvantaged environment and social exclusion as well. [ABSTRACT FROM AUTHOR]

Aim: The problem of family care for people dependent on another person has only recently become a focus of research. As demand for health and social services has not been adequately met by public service providers, growing attention has been given to informal care and the integration of families within systems of health and social care at the community level. This paper presents the results of a survey on informal carers' views and opinions under the current conditions of social support in the Czech Republic. The survey was based on theoretical concepts of caring societies, deinstitutionalization, refamilization, and integrated community care, and aimed to shed light on caring families' experiences and needs in the Czech Republic.Methods: Family lay carers completed an original self-administered questionnaire. A convenient sample of 200 family carers was selected.Results: The survey collected information about the most influential factors in determining whether the families continue to provide care for their relatives in the household. More than 50% of the caregivers provide care from moral and emotional reasons. Financial problems, risk of losing their jobs, and further deterioration of health of the person they care for emerged as key risk factors, but overall, determination among carers to continue providing care "at any cost" was high (53%).Conclusions: Involving local communities and services, e.g. general practitioners (GPs) to a greater extent in the coordination of various social and health services, and in support mechanisms at the juncture between informal and formal care would make it easier for family carers to continue providing long-term care. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]