1
|
Pařízek A, Hill M, Dušková M, Kolátorová L, Suchopár J, Šimják P, Anderlová K, Kudová E, Rogalewicz V, Vacek J, Koudelková M, Chloupková R, Alblová M, Pařízková P, Laštůvka Z, Barták M. The Endocannabinoid System - The Prediction of Spontaneous Preterm Birth in High-Risk Women: Protocol of a Study. Physiol Res 2023; 72:S381-S387. [PMID: 38116776 DOI: 10.33549/physiolres.935230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Spontaneous preterm birth (sPTB) is a major cause of perinatal morbidity and mortality, even in developed countries. Prediction of sPTB is therefore a valuable tool to reduce the associated risks. The current standard for the prediction of sPTB consists, in addition to anamnestic data, of previous sPTB and previous second trimester miscarriage, measurement of cervical length by transvaginal ultrasound (TVU CL) together with assessment of fetal fibronectin levels in cervicovaginal fluid. Other evaluation parameters, such as the level of endocannabinoids in the pregnant woman's blood, could increase the sensitivity of this management. Endocannabinoids (eCBs) are a part of the endocannabinoid system (ECS); out of them anandamide (arachidonoyl-ethanolamide, AEA), in particular, plays an important role in the regulation of pregnancy and childbirth. We present the protocol for an open, non-randomized study to evaluate concentrations of AEA and other endocannabinoids: 2 linoleoylglycerol (2-AG), 2 linoleoylglycerol (2-LG), 2 oleoylglycerol (2-OG), and 2 arachidonoyldopamine (2-ADOPA or also NADA) in the blood of pregnant women as potential predictors of sPTB. In a total of 230 women with a history of sPTB or miscarriage, eCBs levels between 22 and 28 weeks of gestation will be assessed from maternal blood, in addition to the standard procedure. The aim of the study is to determine the relationship between blood concentrations of the endocannabinoids tested and the risk of sPTB. The results of this study will describe the prognostic significance of maternal blood eCBs levels for sPTB, and could subsequently enable improved screening programs for early identification of sPTB.
Collapse
Affiliation(s)
- A Pařízek
- First Faculty of Medicine, Charles University, Prague, Czech Republic.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Gorelova M, Rysankova K, Donin G, Kneppo P, Rogalewicz V. Comparison of Elicitation Approaches in Early Stage HTA Applied on Artificial Thymus for Patients with DiGeorge Syndrome. Healthcare (Basel) 2023; 11:3002. [PMID: 37998494 PMCID: PMC10671534 DOI: 10.3390/healthcare11223002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/01/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
This paper focuses on research in expert elicitation as a part of the early stage health technology assessment (eHTA). The current state of affairs is analysed and two elicitation approaches are compared-the four fixed intervals method and the histogram method-as applied to an example of early assessment of clinical effectiveness of artificial thymus for patients with DiGeorge syndrome. A survey was carried out consisting of four questions concerning the topic, with the aim to apply the elicitation methods. Eight experts answered the questions using both elicitation methods. Based on their answers, the methods were compared visually and by means of statistical tests. In order to compare the perception of the two elicitation methods, the survey also included questions regarding the experts' subjective preferences. The results of the comparison of the two elicitation approaches did not clearly confirm which method was more beneficial and better; however, it was possible to indicate which of the two methods is better suited for different types of experts. Before selecting an elicitation method as a part of eHTA, it is advisable to effectively consider the technology to be assessed and the type of experts to be invited to share their opinion.
Collapse
Affiliation(s)
- Marija Gorelova
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 272 01 Kladno, Czech Republic
| | | | | | | | | |
Collapse
|
3
|
Kilian C, Rehm J, Allebeck P, Braddick F, Gual A, Barták M, Bloomfield K, Gil A, Neufeld M, O'Donnell A, Petruželka B, Rogalewicz V, Schulte B, Manthey J. Alcohol consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21 countries. Addiction 2021; 116:3369-3380. [PMID: 34109685 DOI: 10.1111/add.15530] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/24/2021] [Accepted: 04/21/2021] [Indexed: 12/17/2022]
Abstract
AIMS To investigate changes in alcohol consumption during the first months of the COVID-19 pandemic in Europe as well as its associations with income and experiences of distress related to the pandemic. DESIGN Cross-sectional on-line survey conducted between 24 April and 22 July 2020. SETTING Twenty-one European countries. PARTICIPANTS A total of 31 964 adults reporting past-year drinking. MEASUREMENTS Changes in alcohol consumption were measured by asking respondents about changes over the previous month in their drinking frequency, the quantity they consumed and incidence of heavy episodic drinking events. Individual indicators were combined into an aggregated consumption-change score and scaled to a possible range of -1 to +1. Using this score as the outcome, multi-level linear regressions tested changes in overall drinking, taking into account sampling weights and baseline alcohol consumption [Alcohol Use Disorder Identification Test (AUDIT-C)] and country of residence serving as random intercept. Similar models were conducted for each single consumption-change indicator. FINDINGS The aggregated consumption-change score indicated an average decrease in alcohol consumption of -0.14 [95% confidence interval (CI) = -0.18, -0.10]. Statistically significant decreases in consumption were found in all countries, except Ireland (-0.08, 95% CI = -0.17, 0.01) and the United Kingdom (+0.10, 95% CI = 0.03, 0.17). Decreases in drinking were mainly driven by a reduced frequency of heavy episodic drinking events (-0.17, 95% CI = -0.20, -0.14). Declines in consumption were less marked among those with low- or average incomes and those experiencing distress. CONCLUSIONS On average, alcohol consumption appears to have declined during the first months of the COVID-19 pandemic in Europe. Both reduced availability of alcohol and increased distress may have affected consumption, although the former seems to have had a greater impact in terms of immediate effects.
Collapse
Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Peter Allebeck
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Mallorca, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Mallorca, Spain
| | - Antoni Gual
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Mallorca, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Mallorca, Spain
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Artyom Gil
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Bernd Schulte
- Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | | |
Collapse
|
4
|
Kilian C, Rehm J, Allebeck P, Barták M, Braddick F, Gual A, Matrai S, Petruželka B, Rogalewicz V, Rossow I, Schulte B, Štelemėkas M, Manthey J. Conducting a multi-country online alcohol survey in the time of the COVID-19 pandemic: Opportunities and challenges. Int J Methods Psychiatr Res 2021; 30:e1875. [PMID: 33951258 PMCID: PMC8209885 DOI: 10.1002/mpr.1875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This contribution provides insights into the methodology of a pan-European population-based online survey, performed without external funding during the COVID-19 pandemic. We present the impact of different dissemination strategies to collect data from a non-probabilistic convenience sample and outline post-stratification weighting schemes, to provide guidance for future multi-country survey studies. METHODS Description and comparison of dissemination strategies for five exemplary countries (Czechia, Germany, Lithuania, Norway, Spain) participating in the Alcohol Use and COVID-19 Survey. Comparison of the sample distribution with the country's actual population distribution according to sociodemographics, and development of weighting schemes. RESULTS The dissemination of online surveys through national newspapers, paid social media adverts and dissemination with the support of national health ministries turned out to be the most effective strategies. Monitoring the responses and adapting dissemination strategies to reach under-represented groups, and the application of sample weights were helpful to achieve an analytic sample matching the respective general population profiles. CONCLUSION Reaching a large pan-European convenience sample, including most European countries, in a short time was feasible, with the support of a broad scientific network.
Collapse
Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antoni Gual
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Silvia Matrai
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | | | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| |
Collapse
|
5
|
Manthey J, Kilian C, Carr S, Bartak M, Bloomfield K, Braddick F, Gual A, Neufeld M, O'Donnell A, Petruzelka B, Rogalewicz V, Rossow I, Schulte B, Rehm J. Use of alcohol, tobacco, cannabis, and other substances during the first wave of the SARS-CoV-2 pandemic in Europe: a survey on 36,000 European substance users. Subst Abuse Treat Prev Policy 2021; 16:36. [PMID: 33902668 PMCID: PMC8072737 DOI: 10.1186/s13011-021-00373-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND SARS-CoV-2 reached Europe in early 2020 and disrupted the private and public life of its citizens, with potential implications for substance use. The objective of this study was to describe possible changes in substance use in the first months of the SARS-CoV-2 pandemic in Europe. METHODS Data were obtained from a cross-sectional online survey of 36,538 adult substance users from 21 European countries conducted between April 24 and July 22 of 2020. Self-perceived changes in substance use were measured by asking respondents whether their use had decreased (slightly or substantially), increased (slightly or substantially), or not changed during the past month. The survey covered alcohol (frequency, quantity, and heavy episodic drinking occasions), tobacco, cannabis, and other illicit drug use. Sample weighted data were descriptively analysed and compared across substances. RESULTS Across all countries, use of all substances remained unchanged for around half of the respondents, while the remainder reported either a decrease or increase in their substance use. For alcohol use, overall, a larger proportion of respondents indicated a decrease than those reporting an increase. In contrast, more respondents reported increases in their tobacco and cannabis use during the previous month compared to those reporting decreased use. No distinct direction of change was reported for other substance use. CONCLUSIONS Our findings suggest changes in use of alcohol, tobacco and cannabis during the initial months of the pandemic in several European countries. This study offers initial insights into changes in substance use. Other data sources, such as sales statistics, should be used to corroborate these preliminary findings.
Collapse
Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sinclair Carr
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Miroslav Bartak
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Tuborgvej 160, 2400, Copenhagen, NV, Denmark
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Health Promotion Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608, USA
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
| | - Antoni Gual
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office) 9 Leontyevsky Pereulok, Moscow, Russian Federation, 125009
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle Upon Tyne, NE2 4AX, UK
| | - Benjamin Petruzelka
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Vladimir Rogalewicz
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Dept of Alcohol, Tobacco and Drugs, N-0213, Oslo, Norway
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, Russian Federation, 119991
| |
Collapse
|
6
|
Gueye T, Dedkova M, Rogalewicz V, Grunerova-Lippertova M, Angerova Y. Early post-stroke rehabilitation for upper limb motor function using virtual reality and exoskeleton: equally efficient in older patients. Neurol Neurochir Pol 2020; 55:91-96. [PMID: 33314016 DOI: 10.5603/pjnns.a2020.0096] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/17/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY To evaluate the effectiveness of virtual reality therapy (VRT) Armeo Spring® upper limb exoskeleton (Armeo), in early post-stroke rehabilitation with a focus on the elderly. CLINICAL RATIONALE FOR THE STUDY Convalescence from a stroke is a complex process driven by a spontaneous recovery supported by multifactorial activation. Novel technology-based rehabilitation methods are being introduced to support brain plasticity. MATERIALS AND METHODS Using a randomised controlled study design, participants within 30 days after stroke with arm paresis were, in addition to a daily rehabilitation programme, assigned to an intervention group (45 minutes Armeo IG n = 25; mean age 66.5 years) performing VRT, or to a conventional physiotherapy (45 minutes) control group (Armeo CG, n = 25, mean age 68.1 years). Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM) and Fugl Mayer Assessment Upper Extremity Scale (FMA-UE) were performed before and after the three-week therapy with 12 therapeutic sessions. Results of participants < 65 and ≥ 65 years old were compared. RESULTS Paretic upper arm function improved significantly in both the IG and CG groups, the improvement in FMA-UE was significantly higher in the IG compared to the CG (p = 0.02), and patients ≥ 65 years old presented an equal magnitude of improvement in paretic arm function compared to younger patients. CONCLUSIONS AND CLINICAL IMPLICATIONS Early post-stroke rehabilitation strategies using, in addition to the daily rehabilitation programme, VRT with visual biofeedback is more effective on upper extremity motor performance than conventional physiotherapy, and the effectiveness does not diminish with patient age. This may be a promising addition to conventional physiotherapy in older stroke patients as well as in younger.
Collapse
Affiliation(s)
- Tereza Gueye
- Department of Rehabilitation Medicine, Faculty Hospital Kralovske Vinohrady, Šrobárova 1150/50, 100 34 Prague 10, Czech Republic. .,Department of Rehabilitation Medicine, General University Hospital and First Faculty of Medicine, Charles University, Albertov 7, 128 02 Prague 2, Czech Republic. .,Stroke Rehabilitation Unit, Geriatrics Department, First Faculty of Medicine, Charles University, Londýnská 15, 120 00 Prague 2, Czech Republic.
| | - Miriama Dedkova
- Department of Rehabilitation Medicine, Faculty Hospital Kralovske Vinohrady, Šrobárova 1150/50, 100 34 Prague 10, Czech Republic
| | - Vladimir Rogalewicz
- Department of Rehabilitation Medicine, General University Hospital and First Faculty of Medicine, Charles University, Albertov 7, 128 02 Prague 2, Czech Republic
| | - Marcela Grunerova-Lippertova
- Department of Rehabilitation Medicine, Faculty Hospital Kralovske Vinohrady, Šrobárova 1150/50, 100 34 Prague 10, Czech Republic
| | - Yvona Angerova
- Department of Rehabilitation Medicine, General University Hospital and First Faculty of Medicine, Charles University, Albertov 7, 128 02 Prague 2, Czech Republic
| |
Collapse
|
7
|
Angerova Y, Marsalek P, Chmelova I, Gueye T, Uherek S, Briza J, Bartak M, Rogalewicz V. Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective. Int J Rehabil Res 2020; 43:376-382. [PMID: 32991353 PMCID: PMC7643793 DOI: 10.1097/mrr.0000000000000440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022]
Abstract
The purpose of this prospective study was to determine whether the cost and cost-effectiveness of early rehabilitation after stroke are associated with the degree of initial disability. The data for cost calculations were collected by the bottom-up (micro-costing) method alongside the standard inpatient care. The total sample included 87 patients who were transferred from acute care to early rehabilitation unit of three participating stroke centers at the median time poststroke of 11 days (range 4-69 days). The study was pragmatic so that all hospitals followed their standard therapeutic procedures. For each patient, the staff recorded each procedure and the associated time over the hospital stay. The cost and cost-effectiveness were compared between four disability categories. The average cost of the entire hospitalization was CZK 114 489 (EUR 4348) with the daily average of CZK 5103 (EUR 194). The cost was 2.4 times higher for the immobile category (CZK/EU: 167 530/6363) than the self-sufficient category (CZK/EUR: 68 825/2614), and the main driver of the increase was the cost of nursing. The motor status had a much greater influence than cognitive status. We conclude that the cost and cost-effectiveness of early rehabilitation after stroke are positively associated with the degree of the motor but not cognitive disability. To justify the cost of rehabilitation and monitor its effectiveness, it is recommended to systematically record the elements of care provided and perform functional assessments on admission and discharge.
Collapse
Affiliation(s)
- Yvona Angerova
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Praha
| | - Pavel Marsalek
- Department of Rehabilitation, Krajská zdravotní, a.s., Masaryk Hospital in Ústí nad Labem, Ústí nad Labem
| | - Irina Chmelova
- Clinic of Rehabilitation and Physical Medicine
- Department of Rehabilitation, Faculty of Medicine, University of Ostrava, Ostrava
| | - Tereza Gueye
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Praha
| | - Stepan Uherek
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno
| | - Jan Briza
- Surgical Clinic, General University Hospital, Praha
| | - Miroslav Bartak
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Praha
- Faculty of Health Studies, J. E. Purkyně University in Ústí nad Labem, Czech Republic
| | - Vladimir Rogalewicz
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Praha
| |
Collapse
|
8
|
Petruzelka B, Vacek J, Gavurova B, Kubak M, Gabrhelik R, Rogalewicz V, Bartak M. Interaction of Socioeconomic Status with Risky Internet Use, Gambling and Substance Use in Adolescents from a Structurally Disadvantaged Region in Central Europe. Int J Environ Res Public Health 2020; 17:ijerph17134803. [PMID: 32635320 PMCID: PMC7369899 DOI: 10.3390/ijerph17134803] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/17/2020] [Accepted: 06/26/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS The current level of knowledge concerning the effect of socioeconomic status (SES) on internet use, gambling, and substance use in structurally disadvantaged regions is scarce. The objective of this study was an investigation of the relationship between SES and risky internet use, gambling and substance use in a structurally disadvantaged region in Central Europe. METHODS A cross-sectional survey was conducted among high school students (n = 1063) in a Czech structurally disadvantaged region in autumn 2017. Binary Logistic Regression models were applied to data from the modified Excessive Internet Use scale (mEIUS), a standard tool for measuring the risk of addictive behavior on the internet and the risk of excessive gaming. Other data were collected using the Lie/Bet (problematic gambling), CAGE (acronym of the key words: cut, angry, guilty and eye-opener), and the Cannabis Abuse Screening Test (CAST) (problematic alcohol/cannabis use) tools. RESULTS There were statistically significant differences between at-risk and not-at-risk groups in addictive behavior on the internet and gaming, while none were found in problematic gambling. Individual dimensions of SES showed significant effects on substance use. Regarding parenting styles, significant differences were found only in the risk of addictive behavior on the internet or gaming between the authoritarian and authoritative styles. Being engaged in behavioral addictions with one´s parents increased the odds of the behavioral addiction risk and decreased the odds of the substance addiction risk. Engagement with one´s parents in substance addictions decreased the odds of the behavioral addiction risk and increased the odds of the substance addiction risk. DISCUSSION AND CONCLUSIONS The results point at specific relations between SES and the risk of addictive behaviors on the internet and gaming within structurally disadvantaged regions. The results of SES and/or structurally disadvantaged region measures obtained in research, policy-making, and care-provision may improve the focus of actions taken.
Collapse
Affiliation(s)
- Benjamin Petruzelka
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
| | - Jaroslav Vacek
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
| | - Beata Gavurova
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
- Correspondence:
| | - Matus Kubak
- Faculty of Economics, Technical University of Košice, 04001 Košice, Slovak Republic;
| | - Roman Gabrhelik
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
| | - Miroslav Bartak
- Department of Addictology, General University Hospital in Prague, Apolinářská 447/4, 128 00 Prague, Czech Republic; (B.P.); (J.V.); (R.G.); (V.R.); (M.B.)
- Department of Addictology, Charles University, First Faculty of Medicine, Apolinářská 447/4, 128 00 Prague, Czech Republic
- Department of Social work, J.E. Purkyně University in Ústí nad Labem, Moskevská 54, 400 96 Ústí nad Labem, Czech Republic
| |
Collapse
|
9
|
Burget F, DouŠa P, Kloub M, KozÁk T, Pleva L, Rogalewicz V. [Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index]. Acta Chir Orthop Traumatol Cech 2020; 87:438-446. [PMID: 33408010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE OF THE STUDY This thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents. MATERIAL AND METHODS The key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. Another sub-group consists of hospitals in areas with a higher frequency of terrorist attacks and a separate group is formed by 5 hospitals in the Czech Republic. Based on the results of the questionnaire survey, the preparedness of hospitals for dealing with mass casualty incidents is compared in both the groups according to the advancement of the country and also in the subgroup of hospitals in the Czech Republic and in countries with frequent terrorist attacks. The maximum achievable score evaluating the hospital readiness is 20 points. The data obtained by the questionnaire survey is evaluated using statistical methods. RESULTS Higher preparedness of hospitals was found in developed countries, with a hospital preparedness score of 12.9 points compared with 5.9 points in developing countries' hospitals. Hospitals in the Czech Republic show a similar readiness for mass casualties as the other hospitals in developed countries, with the mean score of 12.2 points. Hospitals in countries with a higher number of terrorist attacks did not show a higher readiness to deal with crisis situations associated with mass casualties - the mean score of 9.4 points. DISCUSSION The following discussions and evaluations, together with personal experience and thorough knowledge of real-life solutions, became the basis for recommendations of triage procedures, organization of surgery and traumatology departments and material equipment of medical facilities in the Czech Republic. CONCLUSIONS By applying the results of the habilitation thesis it is possible to achieve an optimal solution and increase the reliability in the preparedness of hospitals in dealing with crisis situations, especially to eliminate the discrepancy between theory and practice. Key words: mass casualty incidents, triage, hospital preparedness, disaster management response.
Collapse
Affiliation(s)
- F Burget
- Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index
| | | | | | | | | | | |
Collapse
|
10
|
Buriskova K, Rogalewicz V, Ostadal P. Cost-Effectiveness Of Extracorporeal Cardiopulmonary Resuscitation In Patients With Refractory Cardiac Arrest. Value Health 2014; 17:A488. [PMID: 27201445 DOI: 10.1016/j.jval.2014.08.1435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- K Buriskova
- Czech Technical University in Prague, Kladno, Czech Republic
| | - V Rogalewicz
- Czech Technical University in Prague, Kladno, Czech Republic
| | - P Ostadal
- Nemocnice Na Homolce, Praha 5, Czech Republic
| |
Collapse
|
11
|
Verkerke GJ, van der Houwen EB, Broekhuis AA, Bursa J, Catapano G, McCullagh P, Mottaghy K, Niederer P, Reilly R, Rogalewicz V, Segers P, Verdonschot N. Science versus design; comparable, contrastive or conducive? J Mech Behav Biomed Mater 2013; 21:195-201. [PMID: 23566771 DOI: 10.1016/j.jmbbm.2013.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 01/07/2013] [Accepted: 01/13/2013] [Indexed: 11/18/2022]
Abstract
Science and design are two completely separated areas of expertise with their own specialists. Science analyses the existing world to create new knowledge, design uses existing knowledge to create a new world. This tunnel-vision mentality and narrow-minded approach is dangerous for problem solving, where a broad view on potential solutions is required to realise a high-quality answer on the defined problem. We state that design benefits from scientific methods, resulting in a more effective design process and in better products, while science benefits from a design approach, resulting in more efficient and effective results. Our philosophy is illustrated using examples from the field of biomedical engineering. Both methods can benefit tremendously from each other. By applying scientific methods, superior choices will be made in the design process. With design, more accurate, effective and efficient science will be performed.
Collapse
Affiliation(s)
- Gijsbertus J Verkerke
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|