Martina Bašková

Environmental tobacco smoke of youngsters in Czech Republic, Hungary, Poland and Slovakia -- Findings from the Global Youth Tobacco Survey (GYTS)

Summary.Objective:To present data on Environmental Tobacco Smoke (ETS), Global Youth Tobacco Survey (GYTS), Czech Republic, Hungary, Poland and Slovakia.Methods:A questionnaire survey of a representative sample of 16 918 schoolchildren aged 13–15 years (2002–2003).Results:Exposure to ETS was reported more frequently in public places than in homes and more frequently from current smokers (CS) than from never smokers (NS). ETS in homes was lower in Czech (57.6% in CS, 24.7% in NS) than in other countries (the highest in Poland: 93.0% in CS, 80.9% in NS). ETS in public places was highest in Hungary (96.9% in CS, 89.2% in NS), lowest in Czech (90.1% in CS, 57.3% in NS). Most students considered ETS as harmful and presented positive attitudes towards smoking ban.Discussion:ETS in studied countries, save the Czech Republic, exceeded the global prevalence, while the situation is better than in numerous other Eastern European countries.

Economic rewarding of smoking cessation-facilitating drugs – a comparison of over-the-counter and prescribed nicotine replacement therapy

Smoking cessation represents a very difficult task for the smoker, often requiring medical assistance. The introduction of smoking cessation drugs has been crucial to this process. Currently, there are two standardly used treatments: nicotine replacement therapy (NRT) and the antidepressant bupropion. Soon after their introduction, NRTs were sold over-the-counter (OTC), as oppose to on prescription, although in most countries, bupropion remains available only on prescription. Both prescribed and OTC NRTs have similar efficacy (i.e., their use approximately doubles the cessation rate among users and their use has shown a high level of economic rewarding). The most important advantage of OTC NRT is availability, as some patients may not be comfortable with the use of perscribed drugs. The introduction of OTC NRT has led to a substantial rise in their use, increasing the proportion of ex-smokers in the population. However, there are a lack of published, cost-benefit analysis data comparing prescription with OTC NRT. Considering the different economic, social and cultural conditions within particular countries, it is difficult to formulate a common optimal economic model for the distribution of NRT. Authentic studies and trials in this field in order to develop the appropriate policies in each particular country, are clearly required.

Midwifery education in Central-Eastern Europe

Problems in midwifery in many Central-Eastern European countries are very similar; it is possible to speak about the evolving Central-Eastern model of midwifery care. The educational models of this region have a relatively strong theoretical part; however, there is an insufficient practical dimension. Theoretical part of midwifery education in the universities is relatively autonomous and is slowly changing the professional identity of graduates.

Experience of lecturers with simulation training in midwifery education in Slovakia

The simulation training in midwifery has a long tradition. It is aimed at acquiring basic and advanced practical skills such as performing a certain number of births, episiotomy and subsequent suture, assisting during breech birth etc. Midwifery education is currently based on the requirements of the Directives of the European Union exactly specifying number of performed practical procedures and approaches (World Health Organisation (WHO) Europe, 2009). The aim of this paper is to draw attention to the experience with the simulation training from the teachers point of view in the study program Midwifery in Slovakia. The authors describe the locations for training of midwifery skills, training of basic and advanced midwifery skills using simulation, the types of simulators available and used and training approaches. They outline the advantages and disadvantages of using obstetric simulators based on their own experience.

Creation of virtual patients for midwifery education

OBJECTIVE The objective of the study was to create several new, original virtual patients (VPs) in the Slovak language, especially for educational purposes in midwifery. SETTING Virtual patients have been created for the needs of university midwifery education in Slovakia. MODEL The creation of the six virtual patients basically consisted of three fixed stages: preparation, design and development, implementation into the virtual environment. We used the Open Labyrinth (OL) virtual environment, an open-source system for creating VPs. The VPs include six various scenarios of the most common problems seen in midwifery practice: preterm birth, perinatal loss, gestational diabetes, ineffective breastfeeding, postpartum bleeding and sudden home birth. FINDINGS Currently, six original virtual patients are used in university midwifery education in Slovakia. We use them for contact teaching as well as self-study of students. They present the first VPs in Slovakia and the Czech Republic created in academic settings in these countries. CONCLUSIONS The future perspective of a virtual patient as an interactive process between the student and the medium is that it can deepen and improve learning outcomes, solve specific midwifery issues, and reduce mistakes in the clinical environment.

Body-Image Dissatisfaction and Weight-Control Behaviour in Slovak Adolescents

OBJECTIVES The aim of the study was to examine body-image dissatisfaction in adolescents aged 13-15 years reporting to be on a diet and to assess gender and age differences in weight-reduction behaviour in Slovak adolescents. METHODS Data on a representative sample of 2,765 adolescents (mean age 14.37 years) from the Slovak part of Health Behaviour in School Aged Children Study carried out in 2014 were analysed. Self-reported body-image dissatisfaction and engagement in weight-reduction behaviour of 13 to 15-year-old adolescents was assessed using multiple logistic regression models. RESULTS More that 20% of boys and 35% of girls perceived themselves to be too fat. Girls reported being on a diet more frequently than boys (28.8% vs. 14.9%). The most frequent weight-reduction behaviours were drinking more water (67.7%), eating more fruits and vegetables (67.1%), and consuming fewer sweets (60.5%) and soft drinks (51.7%). Girls prevailed above boys in the use of these dietary methods. Age differences were not apparent, except for smoking, believed to help in weight reduction and used upmost by 15-year-olds (8.9%) followed by 14 and 13-year-olds, 6.0% and 4.1%, respectively. CONCLUSIONS Body-image dissatisfaction and weight-control behaviour are issues particularly in girls, however, they did not necessarily correspond with actual obesity. The most commonly used weight-reduction behaviours are in the same way important aspects of a healthy lifestyle. There is room to improve obesity control, particularly within primary health care.

CONSUMPTION OF SWEETENED SOFT DRINKS AND ENERGY DRINKS IN ADOLESCENTS IN SLOVAKIA: IMPLICATIONS FOR PAEDIATRIC NURSING

Aim: The study analyzed the consumption of sweetened soft drinks and energy drinks as well as attitudes towards their consumption. Design: Health Behaviour in School-aged Children (HBSC) is a cross-sectional school-based study focused on the target group of 11-, 13- and 15-year-old adolescents. It employs a universal, internationally standardized questionnaire. Methods: The study analyzes results of the HBSC survey carried out in Slovakia in 2014. A total of 10,179 schoolchildren from grades 5 through 9 participated (a response rate of 78.8%). Gender and age differences were analyzed in 11-, 13- and 15year-old respondents. Results: The consumption of soft drinks varied from 16.9% (11-year-old girls) to 29.0% (15-year-old boys). More than 8 in 10 respondents accepted the consumption of soft drinks. As much as 34.4% of boys and 18.8% of girls aged 15 years reported the use of energy drinks at least weekly, with boys showing higher rates than girls in all age groups and the rates increasing with age. Conclusion: In Slovakia, consumption of sweetened soft drinks and energy drinks is widely popular and socially accepted among adolescents. There is a need for more effective interventions including adoption of appropriate legislative norms. Pediatric nursing plays an important role through outpatient primary as well as hospital care.

Birth after cesarean section

Summary Background The number of incoming expectant women who have previously experienced cesarean section has increased. This work sought to find the frequency and connections between vaginal deliveries, cesarean sections, and iterative cesarean sections from 2004 to 2008. Material/Methods In all, 828 women with previous cesarean sections were included. From this group, 8282 vaginal deliveries were performed. During these years, 828 women had a history of the cesarean section; in these women, iterative cesarean sections were indicated. To evaluate knowledge of educational material designed for women being prepared for the iterative delivery, we used information compiled on experience from 2002 to 2003; the same approach was used to evaluate the nursing process on interventions and diagnoses of cesarean sections. Results From 2004 to 2008, 11 279 deliveries were performed in the Perinatological Center in České Budějovice; this was significant (P<.001). The same result was obtained in the relation for the total number of deliveries and those performed by the iterative cesarean section. The number of iterative cesarean sections in women who had already experienced the cesarean section (828) and delivered by cesarean section again is 620. Other data were not significant. Only 2 to 3 pregnancies next to the first cesarean section were statistically significant in 2004 and 2005. Conclusions If a trial of labor after cesarean does not proceed to vaginal birth, the woman will need support and encouragement to express feelings about another cesarean birth.