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ObjectivesThe aim of this qualitative study was to identify the main factors that help and hinder adolescents’ wellbeing at school using their perspectives and experiences.MethodsWe used data from 45 adolescents in the first year of high school in Slovakia (mean age = 14.98; 22.2% boys). We obtained the data using 11 semi-structured group interviews conducted in 2020/2021. Participants were selected from three types of high school with regard to graduation system. Data was analysed using consensual qualitative research and thematic analysis.ResultsWe identified three main themes of factors contributing to their wellbeing at school: 1. School (atmosphere and organisation of life at school, physical environment, threats and the ability of school to deal with issues); 2. Relationships (with peers and teachers, and teachers’ behaviour towards them); 3. Myself (own perceived obstacles and resilience resources).ConclusionThe organisation of life at school, surroundings, threats and dealing with issues importantly affect adolescents’ wellbeing. Therefore, adjustment of physical environment and interpersonal competences of teachers, supporting of resilience resources of adolescents should be targets for interventions and prevention programmes at schools.

Purpose Clinical guidelines call for the inclusion of exercise interventions in every patient’s dialysis session, but these recommendations are rarely adopted. Healthcare providers play a key role in this. Therefore, the aim of this study was to explore how healthcare providers perceive the benefits, risks and barriers of intradialytic exercise (IDE). Methods We conducted 21 individual, semi-structured interviews with 11 nurses, 5 nephrologists, 3 training assistants and 2 managers from two dialysis centres in Slovakia. Verbatim transcripts of digitally recorded interviews were thematically analysed using MAXQDA®. Results Participants reported the benefits of IDE as improvements in patients’ physical and psychosocial functioning, independence and self-efficacy, clinical profile and quality of therapy. As risks of IDE, they most frequently reported exercise-related damage to vascular access, insufficient individualization of training and musculoskeletal injuries. The presence of psychological problems among patients was reported as a major barrier for initiating and maintaining patients’ exercise. Other reported barriers included limitations in financial and personnel resources of haemodialysis care. Conclusions Safe and sustainable implementation of IDE, which might improve a patient’s well-being, need to be prescribed in alignment with the patient’s clinical profile, be delivered individually according to the patient’s characteristics and requires adjustments in the available resources.

BackgroundHealth care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs’ well-being and ultimately improve the quality of care and patient safety. ObjectiveThis study aims to describe and evaluate a multimodal training organized by the European Researchers’ Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs. MethodsWe implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities. ResultsOut of 42 accepted candidates, 38 (90%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants’ satisfaction increased, particularly when adjusting the allocated time for the case studies’ discussion (P

PurposeExcessive daytime sleepiness (EDS) can have a significant impact on health and quality of life but may remain undiagnosed due to low awareness and underestimation of the clinical impact of the symptoms. An online screening tool supported by media campaigns might increase awareness and help detect undiagnosed cases of EDS and narcolepsy. The aim of this study was to develop an online screening method, along with a media campaign focusing on EDS, and evaluate its feasibility.MethodsOnline screening supported by a media campaign targeting young and middle-aged adults (18–45 years old) were developed and implemented over a period of 1 year starting from November 2022. The Epworth Sleepiness Scale was used to identify EDS, and the Swiss Narcolepsy Scale was used to identify narcolepsy. In addition, the data on sociodemographic characteristics, selected sleep and health indicators and lifestyle behaviors were collected to indicate the etiology of the EDS. Feasibility, e.g., implementation and practicality, was assessed by the response rate, response to the promotion strategy, time spent on the tool, sample characteristics, and the prevalence of identified EDS and narcolepsy cases.ResultsA total of 2,390 people opened the screening link; 568 of them completed the online screening (23.8%), and most of them (n = 437, 76.9%) left their contact data to receive feedback. We identified 171 (30.1%) respondents at risk of EDS and 61 (10.7%) at risk of narcolepsy. The mean time of the screening was 15 min.ConclusionAn online screening tool supported with a campaign seems to be a feasible way to increase awareness about EDS and prevent delayed detection of EDS cases.

Objectives: Patient safety incidents (PSIs) are common in healthcare. Open communication facilitated by psychological safety in healthcare could contribute to the prevention of PSIs and enhance patient safety. The aim of the study was to explore medical professionals’ responses to a PSI in relation to psychological safety in Slovak healthcare.Methods: Sixteen individual semi-structured interviews with Slovak medical professionals were performed. Obtained qualitative data were transcribed verbatim and analysed using the conventional content analysis method and the consensual qualitative research method.Results: We identified eight responses to a PSI from medical professionals themselves as well as their colleagues, many of which were active and with regard to ensuring patient safety (e.g., notification), but some of them were passive and ultimately threatening patients’ safety (e.g., silence). Five superiors’ responses to the PSI were identified, both positive (e.g., supportive) and negative (e.g., exaggerated, sharp).Conclusion: Medical professionals’ responses to a PSI are diverse, indicating a potential for enhancing psychological safety in healthcare.

IntroductionResearch on adolescents’ academic performance has mostly focused on the contribution of objective factors, such as socioeconomic situation of the family or individual cognitive skills and school results. Evidence with a focus on adolescents’ subjective experiences is scarce. The aim of this qualitative study was to explore factors related to adolescents’ academic performance from their perspectives.MethodsWe used data from 11 group semi-structured interviews conducted in 2020/2021 with 45 adolescents in the first year of high school in Slovakia (mean age = 14.98; 22.2% boys). Participants were selected from three types of high school with regards to the graduation system. We analysed the data using consensual qualitative research and thematic analysis.ResultsBased on the statements of the adolescents, we identified five main themes of factors that affect their academic performance. Adolescents reported that the following contribute to their academic performance: the contents and methods of teaching; how teachers behave and do their jobs; the way in which adolescents study and what motivates them; support within and outside the school, and the environment and appearance of the school. Adolescents reported that improving the curricula and using teaching methods that balance theoretical information with practical skills training would help their academic performance immensely.ConclusionWe identified several factors related to adolescents’ academic performance using their own perspectives and experiences. Strengthening the capacities of teachers may largely benefit adolescents’ educational process and further academic performance.

Abstract 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.

BackgroundInterventions to improve physical activity (PA) among adolescents continue to be a public health priority. To promote PA more effectively, we need to identify the main factors contributing to (not) engagement in PA in the perspective of adolescents themselves. Thus, we explored the barriers and enablers for sufficient moderate-to-vigorous physical activity (MVPA) in adolescents from their point of view.MethodsWe used qualitative data collected as part of the international Health Behaviour in School-Aged Children study. We obtained data from 14-17 years old adolescents from the first year of Slovak high school. We conducted 11 online, semi-structured individual and group interviews with 24 participants in total (7 boys; mean age = 15.17, SD = 0.87) in Slovakia. We analysed the data using consensual qualitative research and thematic analysis.ResultsIn the statements of adolescents, four main themes were identified regarding factors contributing to (not) engagement in PA among adolescents. 'Myself as a source' represents the importance of adolescents' own efforts, knowledge, physical predispositions and PA experience. 'How PA can be done' represents school as an opportunity for PA, and PA teachers and sports coaches as specialists who can create an enabling environment for sports. 'Others as a source' represents the social circle that can set a positive sports example and can encourage adolescent's efforts in PA. 'Factors outside' represents other factors that can inspire adolescents, e.g. by giving them a comfortable space and time to exercise, or can be a barrier to PA.ConclusionThe potential factors that include adolescents' perspectives can be more leveraged in designing supportive, inclusive, enjoyable, and skills-appropriate PA programmes.

Abstract Background Our study aims to follow this effort and to explore the association between health, socioeconomic background, school-related factors, social support and adolescents' sense of coherence and educational aspirations among adolescents from different educational tracks and to contribute to the existing body of knowledge on the role of educational aspirations in the social reproduction of health inequalities. We expect that socioeconomic background will contribute to the development of educational aspirations, but this association will be modified by available social and individual resources, which may be particularly favourable for the group of adolescents who are on lower educational tracks, since for them such resources may lead to gaining a higher educational level. Methods We collected data on the socioeconomic background (mother's and father's education and employment status, doubts about affordability of future study), school-related factors (school atmosphere, school conditions, attitudes towards school), perceived social support, sense of coherence (manageability, comprehensibility, meaningfulness) and the self-rated health of a national sample of Slovak adolescents (n = 1992, 53.5% females, mean age 16.9 years). We assessed the association of these factors with educational aspirations, overall and by educational tracks (grammar schools, specialised secondary schools, vocational schools). Results We found statistically significant associations with educational aspirations for the factors parental educational level, father's unemployment, doubts about the affordability of future study, school atmosphere, attitude towards school, social support from the father and a sense of coherence. Social support from the mother and friends was not associated with educational aspiration, nor was self-rated health. Besides affinity towards school, the determinants of educational aspirations differed among adolescents on different educational tracks. Educational aspirations of grammar school students were associated with father's education, while the aspirations of their peers on lower educational tracks had a stronger association with mother's education and perceived social support from father and friends. Moreover, a sense of coherence contributes to the reporting of educational aspiration by students on different educational tracks. Conclusions Characteristics of the school environment, the family and the individual adolescent are all associated with the level of educational aspiration, but in a different way for different educational tracks. Interventions aimed at reducing socioeconomic inequalities in health via the educational system should, therefore, take this variation and the rather pivotal role of the father into account.

Abstract Background Recent research shows the possibility that the link between parental employment status and children's health can be affected by different cultural or societal settings. The aim of this study was to explore whether the effect of father's and mother's employment status on several aspects of adolescents' health differs between Slovakia and the Netherlands. Methods Two data sets were used: 2616 Slovak adolescents (mean age 14.9) and 2054 Dutch adolescents (mean age 16.3). Self-rated health, GHQ-12, long-term well-being and Rosenberg self-esteem scale were used to assess the health of adolescents. Parental employment status was classified into the following categories: employed, unemployed, disabled, housewife (among mothers only). Logistic regression analyses were done separately for males and females. Results Results indicate that having an unemployed father negatively influences self-rated health and long-term well-being of Slovak male adolescents, but has no effect on the health of Dutch adolescents. Secondly, having a disabled father has a negative effect on the psychological well-being of Dutch males and the self-rated health of females, but does not influence the health of Slovak adolescents. Thirdly, having a mother who is disabled, unemployed or a housewife has a negative effect on the self-esteem of Slovak adolescents. Fourthly, Dutch males whose mother was a housewife had worse long-term well-being than those with an unemployed mother, whereas Dutch females whose mother was a housewife reported better psychological well-being than those with an employed mother. Conclusion To conclude briefly our results, father's unemployment seems to be a better predictor of health for Slovak adolescents, father's disablement of health for Dutch ones. Mother's employment status seemed to be important for the self-esteem of Slovak adolescents and mother as a housewife for the health of Dutch ones. This suggests that the link between parental employment status and the health of their children may vary between countries, and therefore further studies involving various cultures are needed.

BackgroundThe fast development of digital technology and of its use at even younger ages is significantly shaping the current generation of adolescents. This is leading to an almost unlimited accessibility that provides a large number of opportunities, but also to many challenges that adolescents have to face. The aim of our study was to explore the perceptions adolescents have of the risks of digital technology.MethodsWe conducted online semi-structured interviews as a part of the international Health Behaviour in School-aged Children study. The sample consisted of 15 Slovak adolescents (mean age: 15.33; 20% boys). To analyse our data, we used consensual qualitative research and thematic analysis.FindingsOur findings confirmed that adolescents are aware of the risks associated with the use of digital technology. Regarding their specific types of the perceived risks, we identified four main themes: 1. dependence on the functionality of technology; 2. problematic control; 3. vulnerability in the virtual environment; 4. health risks. Adolescents thus want technology that is functional, safe and does not endanger their health.ConclusionDespite the fact that adolescents know of the risks they may experience due the digital technology, they still use it. Preventive strategies should focus on functionality, safety and healthiness; furthermore, they should support the constant development of adolescents’ digital awareness and raising their awareness about effective and non-threating use of technology.

Abstract Previous research shows the beneficial effects of an intradialytic resistance training (IRT) on muscle function in haemodialysis patients. However, patients vary highly in their functional responses to IRT, may be due to effects of age and sex heterogeneities in adaptation. Therefore, the aim of this study was to investigate the degree to which the effects of IRT on the muscle function of haemodialysis patients vary by age and sex. We included 57 patients who completed a 12-week IRT (EXG) and 33 patients who received no IRT (CNG) during haemodialysis. Muscle function (MF) was assessed using dynamometry before and after a 12-week intervention and after a 12-week follow-up. After the 12-week intervention, we found a moderation effect of age in the relative (%) change (p = 0.011) and absolute (Δ) change (p = 0.027) of MF, and a moderation effect of sex in %MF (p = 0.001), but not in ΔMF (p = 0.069). Regarding patients’ age, the change of MF was only significantly different between EXG and CNG patients aged 60–70 years (%MF, EXG: + 34.6%, CNG: − 20.1%, p

Abstract 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.

Purpose: Clinical guidelines call for the inclusion of exercise interventions in every patient's dialysis session, but these recommendations are rarely adopted. Healthcare providers play a key role in this. Therefore, the aim of this study was to explore how healthcare providers perceive the benefits, risks and barriers of intradialytic exercise (IDE). Methods: We conducted 21 individual, semi-structured interviews with 11 nurses, 5 nephrologists, 3 training assistants and 2 managers from two dialysis centres in Slovakia. Verbatim transcripts of digitally recorded interviews were thematically analysed using MAXQDA®. Results: Participants reported the benefits of IDE as improvements in patients' physical and psychosocial functioning, independence and self-efficacy, clinical profile and quality of therapy. As risks of IDE, they most frequently reported exercise-related damage to vascular access, insufficient individualization of training and musculoskeletal injuries. The presence of psychological problems among patients was reported as a major barrier for initiating and maintaining patients' exercise. Other reported barriers included limitations in financial and personnel resources of haemodialysis care. Conclusions: Safe and sustainable implementation of IDE, which might improve a patient's well-being, need to be prescribed in alignment with the patient's clinical profile, be delivered individually according to the patient's characteristics and requires adjustments in the available resources. [ABSTRACT FROM AUTHOR]

Abstract Objective There is evidence that experiencing childhood trauma and life stressors across the lifespan together with lower resilience is associated with chronic pain-related conditions. The aim of this study was to explore the potential mediating role of resilience in the relationship between childhood trauma and long-term pain and to explore a possible moderating role of serious life stressors in the last year. Methods The participants, drawn from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male), were asked to report various long-term pain conditions, childhood trauma (Childhood Trauma Questionnaire, CTQ), life stressors (Life Stressor Checklist Revised, LSC-R) and resilience (Brief Resilience Scale, BRS) in a cross-sectional face-to-face study conducted in 2016. A conditional process SEM model of moderated mediation was performed. Results The occurrence of life stress events affecting the participant’s last year moderated the relationship between childhood trauma, resilience and health. In the group of participants who experienced at least one life stress event affecting their last year, resilience fully mediated the effect of past childhood trauma on long-term pain. In participants who did not experience life stressors with an impact on the last year, the direct path from childhood trauma to health through resilience lost its significance. Conclusion The subjective meaning of stress events on one’s life has an impact on the trajectory between childhood trauma and health and acts as a moderator. Resilience may buffer the negative effect of trauma on later long-term pain.

BackgroundThe COVID-19 pandemic led to accepting a lot of various protective pandemic management-related measures (PanMan), which may have had a large impact on health care workers (HCWs) but evidence is scarce. We therefore explored the impact of measures during the second wave. We assessed the associations of PanMan with the Quality of Life (QoL) of hospital HCWs.MethodsWe collected data from 215 HCWs (77.7% females, mean age 44.4), who were working at the COVID-related departments of one large hospital in eastern Slovakia via a questionnaire, specifically developed in direct collaboration with them. We assessed PanMan related factors, such as COVID-19 experience, information overload, non-adherence of the public, work stress, barriers and facilitators of health care provision, and QoL related factors, such as impact on family life and activities, housekeeping, relationships with relatives and mental well-being. To analyse the data, we used logistic regression models adjusted for age and gender.ResultsPanMan greatly impacted the QoL of HCWs, in particular family life, housekeeping and mental well-being (odds ratio, 6.8-2.2). The most influential PanMan factors were COVID-19 experience (3.6-2.3), work stress (4.1-2.4) and barriers in health care provision (6.8-2.2). Perceiving work stress had a negative impact on all QoL domains, even on relationships with the greatest impact. Conversely, the PanMan factors reducing the negative impact on QoL were training and colleagues' support (0.4-0.1).ConclusionPanMan had a strong negative impact on the QoL of hospital HCWs during the second wave of the COVID-19 pandemic.

BackgroundTechnology plays a significant role in the lives of adolescents. Our knowledge is predominantly based on research exploring the risks associated with it, but adolescents also feel that technology supports their lives. This has received less consideration. Therefore, we aim to examine how adolescents perceive the benefits of digital technology.MethodsWe used qualitative data collected as part of the international Health Behaviour in School-Aged Children study. We conducted online, semi-structured interviews with 15 Slovak adolescents who came from three different types of secondary schools based on their graduation systems (mean age: 15.33; 20% boys). The data were analyzed using consensual qualitative research and thematic analysis.ResultsWe identified five main themes based on the comments of adolescents: 1. I know (source of information, formal and non-formal education); 2. I can (smart device, helpful tool); 3. I am connected/included (social interactions); 4. I have my comfortable place (leisure time, creating my alternative world); and 5. I work on my future (self-development).ConclusionAdolescents perceived digital technology as mostly supportive and a helpful tool in their lives. The potential benefits of digital technology should be better reflected in public perception and policy, as the societal debate is mostly dominated by perceived disadvantages and risks.

BackgroundParents play an important role in the psychosocial care of their children. Previous research has primarily examined their role in care entry, whereas evidence on their role in other stages of the care process is scarce and lacking particularly in regard to the perspective of care providers. Our aim was therefore to examine how psychosocial care providers perceive the role of parents in the process of psychosocial care for adolescents.MethodsWe used data from 25 semi-structured interviews with psychosocial care providers on the roles of parents in the care process. We analyzed data using consensual qualitative research and thematic analysis.ResultsFour main themes were identified: (1) parents as a source of adolescents’ problems; (2) parents trying to escape from responsibility for adolescents with problems; (3) parents as an active part of the care for adolescents; and (4) parents as a barrier to effective care.ConclusionPsychosocial care providers should specifically address the role of the parents in psychosocial care to improve outcomes. Specific interventions are needed to support the involvement of parents in care, as their role is important. Moreover, professionals can be better trained in working with multi-problem families also to resolve some of the negative perceptions of these parents.

BackgroundInjuries are the major cause of disability and death during adolescence, representing a significant public health burden among youth. Body-related factors such as body composition and cardiovascular fitness (CVF) may affect adolescents’ vulnerability to injuries. As evidence is lacking, we aimed to explore the associations of medically attended injuries with adolescents’ physical activity (PA) and body-related factors, and whether these associations are modified by age, gender and family affluence.MethodsWe used data on 888 11- to 15-year-old adolescents (mean age = 13.5, 56% boys) from the Health Behaviour in School-aged Children study conducted in 2018 in Slovakia. We used binary logistic regression analysis to assess the association of medically attended injuries with adolescents’ PA and body-related factors (body composition, CVF), considering age, gender and family affluence.ResultsAdolescents were more likely to report medically attended injuries if they were physically very active (odds ratio/confidence interval OR/CI:2.76/1.83–4.15) or active (OR/CI:1.91/1.27–2.87) rather than inactive. Body-related factors were not associated with medically attended injuries among adolescents. Moreover, age, gender and family affluence did not modify the association of medically attended injuries with adolescents’ PA and body-related factors. The only exception was the modifying effect of gender: the association of medically attended injuries with being very active was stronger in boys (OR/CI: 3.04/1.32–6.99).ConclusionVery physically active adolescent boys are the most vulnerable group of adolescents in terms of injuries. PA promotion programmes should further consider gender-specific strategies aimed at preventing injuries.

BackgroundGlobally, governments adopted protective measures to stabilize the worsening COVID-19 pandemic situation. These measures had a large impact on health care workers (HCWs) and could make the work environment more stressful for them. Therefore, we explored the associations of the psychological responses of HCWs and pandemic management among Slovak health care workers during the second wave of the pandemic.Materials and MethodsWe obtained data about psychological responses, COVID-19 experiences, information overload, non-adherence of the public, work stress and barriers and facilitators of health care provision from HCWs at the COVID-19-related departments of one hospital that mainly covered eastern Slovakia (215 health care professionals, 77.7% females, M/SD = 44.4). Data were analyzed using logistic regression models adjusted for gender.ResultsPandemic management was most strongly associated with psychological responses, such as irritability, sadness, anxiety, dizziness, and back pain, in health care workers. The non-adherence of the public had the strongest associated psychological impact on HCWs, mostly affecting anxiety and irritability (odds ratios, ORs varying from 3.9 to 7.0). From the barriers and facilitators of health care provision, the use of personal protective equipment had the most impact psychologically, whereas efficient department management was most protective, with ORs around 0.3.ConclusionPandemic management has a large impact on health care workers, and promoting resilience may seriously decrease job-related stress and associated psychological responses of HCWs.

BackgroundAdverse childhood experiences (ACEs) can cause serious mental problems in adolescents and therefore may expected to be associated with higher use of psychosocial care, potentially varying by type of specific ACE. The aim of our study is to explore the association of the number of ACE and types of specific ACE with entering and using psychosocial care.MethodsWe used data from the Slovak Care4Youth cohort study, comprising 509 adolescents from 10 to 16 years old (mean age 13.2 years, 48.6% boys). We used logistic regression models adjusted for age, gender, and family affluence to explore the associations of number and type of specific ACE with the use of psychosocial care.ResultsHaving three or more ACE as well as experiencing some specific ACE (death of a mother/father, death of somebody else you love, problems of a parent with alcohol or drugs, conflicts or physical fights between parents, and separation/divorce of parents) increased the likelihood of using psychosocial care. Regarding experience with the death of somebody else you love, we found a decreased likelihood of the use of psychosocial care.ConclusionExperiencing ACE above a certain threshold (three or more) and parent-related ACE increase the likelihood of adolescent care use.

BackgroundThe aim of this study is to explore the association of family socioeconomic status (SES) and internal and external schoolwork support with adolescents’ school satisfaction and whether schoolwork support modifies these associations.MethodsData come from the cross-sectional Health Behavior in School-aged Children study collected in 2018 from Slovak 15-year-olds (N = 1127; 52.7% boys). SES was measured by Family Affluence Scale (low; middle; high). School satisfaction was measured via school engagement and attitudes toward education. Schoolwork support was measured regarding two groups of sources inside and outside the family, separately. Logistic regression models were used to explore the associations of SES and schoolwork support with school satisfaction as well as the moderating effect of schoolwork support.ResultsAdolescents with low SES were more likely to feel indifferent toward school and education (odds ratios/95%-confidence interval: 1.77/1.26–2.49), and similarly, adolescents who did not have schoolwork support inside or outside the family (1.38/1.02–1.87, and 1.50/1.01–2.22, respectively). Schoolwork support moderated the associations of SES with school satisfaction. Adolescents with low and middle SES without support inside or outside the family were more likely to feel indifferent than satisfied (2.72/1.21–6.10; 3.00/1.27–7.06; and 2.86/1.05–7.80; 6.04/1.72–21.24, respectively).ConclusionAdolescents from low and middle SES without schoolwork support inside or outside the family are more likely to feel indifferent toward school and education.

Objectives: To explore the role of resilience as a mediator in the association between adverse childhood experiences (ACE) and emotional and behavioural problems (EBP) among adolescents.Methods: We used data from the Slovak 2018 Health Behaviour in School-aged Children study, comprising 2,839 adolescents aged 13–15 (mean age 13.93; 49.6% boys). We used multivariate linear regression performed on 5000 bootstrap samples adjusted for age, gender, family affluence to explore mediation of the associations between ACE (measured using the adapted Adverse Childhood Experience Questionnaire) and EBP (measured using the Strengths and Difficulties Questionnaire) by resilience (measured with the Child and Youth Resilience Measure).Results: We found ACE [B = 0.78; 95% confidence interval (CI): 0.67|0.90] and resilience (B = −0.73; 95% CI: −0.79|−0.67) to be significantly associated with EBP. The association of ACE and EBP was mediated by resilience. The mediated indirect effect of resilience was ab = 0.25; 95% CI: 0.18|0.32.Conclusion: Resilience seems to play a mediator role in the relationship between ACE and EBP. Helping adolescents with ACE to build and use internal and external sources of resilience can decrease the negative impact of ACE on EBP.

Abstract Cardiovascular comorbidities are independent risk factors for mortality in dialysis patients. MicroRNA signaling has an important role in vascular aging and cardiac health, while physical activity is a primary nonpharmacologic treatment for cardiovascular comorbidities in dialysis patients. To identify the relationships between muscle function, miRNA signaling pathways, the presence of vascular calcifications and the severity of cardiovascular comorbidities, we initially enrolled 90 subjects on hemodialysis therapy and collected complete data from 46 subjects. A group of 26 subjects inactiv group (INC) was monitored during 12 weeks of physical inactivity and another group of 20 patients exercise group (EXC) was followed during 12 weeks of intradialytic, moderate intensity, resistance training intervention applied three times per week. In both groups, we assessed the expression levels of myo‐miRNAs, proteins, and muscle function (MF) before and after the 12‐week period. Data on the presence of vascular calcifications and the severity of cardiac comorbidities were collected from the patients’ EuCliD® records. Using a full structural equitation modelling of the total study sample, we found that the higher the increase in MF was observed in patients, the higher the probability of a decrease in the expression of miR‐206 and TRIM63 and the lower severity of cardiac comorbidities. A reduced structural model in INC patients showed that the higher the decrease in MF, the higher the probability of the presence of calcifications and the higher severity of cardiac comorbidities. In EXC patients, we found that the higher the increase in MF, the lower the probability of higher severity of cardiovascular comorbidities.

Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL.Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test.Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were

Objectives: To explore the association of family-related adversities with physical fighting, and whether this association is mediated by hopelessness.Methods: The sample consisted of 3712 Slovak adolescents (mean age: 13.9, 50.7% girls). Participants answered questions regarding experienced family-related adversities, involvement in physical fighting in the last 12 months and the Hopelessness Questionnaire. First, the association of family adversities in general with fighting and of each of family-related adversity separately was assessed using linear regression models and second, mediation was assessed using the a*b product method with bootstrapped 95% confidence intervalsResults: Adolescents who had experienced at least one family adversity reported more frequent fighting. Similarly, each of reported family adversities (death of a parent, substance abuse problems of a parent, conflicts/physical fights, divorce) was associated with more frequent fighting among adolescents. The mediation effect of hopelessness was found in each association of family-related adversity with fighting.Conclusion: These findings suggest that interventions to support adolescents who had experienced family adversities could among other things be directed at better coping with hopelessness.

Background: Interventions to improve physical activity (PA) among adolescents continue to be a public health priority. To promote PA more effectively, we need to identify the main factors contributing to (not) engagement in PA in the perspective of adolescents themselves. Thus, we explored the barriers and enablers for sufficient moderate-to-vigorous physical activity (MVPA) in adolescents from their point of view. Methods: We used qualitative data collected as part of the international Health Behaviour in School-Aged Children study. We obtained data from 14–17 years old adolescents from the first year of Slovak high school. We conducted 11 online, semi-structured individual and group interviews with 24 participants in total (7 boys; mean age = 15.17, SD = 0.87) in Slovakia. We analysed the data using consensual qualitative research and thematic analysis. Results: In the statements of adolescents, four main themes were identified regarding factors contributing to (not) engagement in PA among adolescents. 'Myself as a source' represents the importance of adolescents' own efforts, knowledge, physical predispositions and PA experience. 'How PA can be done' represents school as an opportunity for PA, and PA teachers and sports coaches as specialists who can create an enabling environment for sports. 'Others as a source' represents the social circle that can set a positive sports example and can encourage adolescent's efforts in PA. 'Factors outside' represents other factors that can inspire adolescents, e.g. by giving them a comfortable space and time to exercise, or can be a barrier to PA. Conclusion: The potential factors that include adolescents' perspectives can be more leveraged in designing supportive, inclusive, enjoyable, and skills-appropriate PA programmes. [ABSTRACT FROM AUTHOR]