Problem gambling among Czech adolescents: An exploration of its relationship to early initiation of tobacco smoking

Background and aims: Gambling in adolescence is often related to licit and illicit substance use. Some evidence shows that teenage smokers gamble more than non-smokers. The aim of the study is to analyze the relationship between problem gambling and smoking among Czech adolescents. Methods: Data on 6,082 adolescents (50.1% boys and 49.9% girls) aged 15–19 years were collected a part of the ESPAD study in the Czech Republic in 2015. Logistic regression and linear regression models were used to test the hypothesis that the early onset of daily smoking increases the risk of problem gambling. Results: The age of initiation of daily smoking seems to be a more reliable marker of the risk of problem gambling than smoking status or intensity of smoking. More than 20% of smokers who started smoking daily at the age of 12 years or earlier are at risk of problem gambling, which shows a significantly increased probability compared to non-smokers (OR = 2.7). Other factors that increase the chances of becoming a problem gambler include being male, of higher age, and a student of a secondary school. Discussion and conclusions: The relationship between adolescent smoking and gambling is complex and is likely to be influenced by other underlying factors. Early daily smokers and at-risk gamblers tend in a similar way to risky behavior as a result of impulsivity. Interventions targeting early smoking and other substance-use behavior should not only aim at quitting smoking but could also include preventing smokers from developing problem gambling

Large variations in all-cause and overdose mortality among >13,000 patients in and out of opioid maintenance treatment in different settings: a comparative registry linkage study

BackgroundOpioid maintenance treatment (OMT) has the potential to reduce mortality rates substantially. We aimed to compare all-cause and overdose mortality among OMT patients while in or out of OMT in two different countries with different approaches to OMT.MethodsTwo nation-wide, registry-based cohorts were linked by using similar analytical strategies. These included 3,637 male and 1,580 female patients enrolled in OMT in Czechia (years 2000–2019), and 6,387 male and 2,078 female patients enrolled in OMT in Denmark (years 2007–2018). The direct standardization method using the European (EU-27 plus EFTA 2011–2030) Standard was employed to calculate age-standardized rate to weight for age. All-cause and overdose crude mortality rates (CMR) as number of deaths per 1,000 person years (PY) in and out of OMT were calculated for all patients. CMRs were stratified by sex and OMT medication modality (methadone, buprenorphine, and buprenorphine with naloxone).ResultsAge-standardized rate for OMT patients in Czechia and Denmark was 9.7/1,000 PY and 29.8/1,000 PY, respectively. In Czechia, the all-cause CMR was 4.3/1,000 PY in treatment and 10.8/1,000 PY out of treatment. The overdose CMR was 0.5/1,000 PY in treatment and 1.2/1,000 PY out of treatment. In Denmark, the all-cause CMR was 26.6/1,000 PY in treatment and 28.2/1,000 PY out of treatment and the overdose CMR was 7.3/1,000 PY in treatment and 7.0/1,000 PY out of treatment.ConclusionCountry-specific differences in mortality while in and out of OMT in Czechia and Denmark may be partly explained by different patient characteristics and treatment systems in the two countries. The findings contribute to the public health debate about OMT management and may be of interest to practitioners, policy and decision makers when balancing the safety and accessibility of OMT

Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study.

BACKGROUND AND AIMS: Despite advances in our knowledge of effective services for people who use drugs over the last decades globally, coverage remains poor in most countries, while quality is often unknown. This paper aims to discuss the historical development of successful epidemiological indicators and to present a framework for extending them with additional indicators of coverage and quality of harm reduction services, for monitoring and evaluation at international, national or subnational levels. The ultimate aim is to improve these services in order to reduce health and social problems among people who use drugs, such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, crime and legal problems, overdose (death) and other morbidity and mortality. METHODS AND RESULTS: The framework was developed collaboratively using consensus methods involving nominal group meetings, review of existing quality standards, repeated email commenting rounds and qualitative analysis of opinions/experiences from a broad range of professionals/experts, including members of civil society and organisations representing people who use drugs. Twelve priority candidate indicators are proposed for opioid agonist therapy (OAT), needle and syringe programmes (NSP) and generic cross-cutting aspects of harm reduction (and potentially other drug) services. Under the specific OAT indicators, priority indicators included 'coverage', 'waiting list time', 'dosage' and 'availability in prisons'. For the specific NSP indicators, the priority indicators included 'coverage', 'number of needles/syringes distributed/collected', 'provision of other drug use paraphernalia' and 'availability in prisons'. Among the generic or cross-cutting indicators the priority indicators were 'infectious diseases counselling and care', 'take away naloxone', 'information on safe use/sex' and 'condoms'. We discuss conditions for the successful development of the suggested indicators and constraints (e.g. funding, ideology). We propose conducting a pilot study to test the feasibility and applicability of the proposed indicators before their scaling up and routine implementation, to evaluate their effectiveness in comparing service coverage and quality across countries. CONCLUSIONS: The establishment of an improved set of validated and internationally agreed upon best practice indicators for monitoring harm reduction service will provide a structural basis for public health and epidemiological studies and support evidence and human rights-based health policies, services and interventions

Prevention of hepatitis C virus infection among injecting drug users - hepatitis C virus infection treatment rate among injecting drug users, treatment efficacy and related factors on the side of treatment system

Background: Injecting drug users (IDUs) represent considerable group of patients infected with hepatitis C virus (HCV). HCV treatment is an effective tool for reduction of HCV transmissions among IDUs. Nevertheless treatment rate among IDUs is rather insufficient. Treatment uptake, provision and adherence as well as its efficacy in IDUs are determined by number of specific factors. Aims: Mapping an extent of the provision of HCV treatment to IDUs in the Czech Republic, rules and practices for the admission of IDUs into HCV treatment and its provision, describing relevant factors related to drug use. Material and methods: From January to March 2011, a questionnaire survey among centres for treatment of viral hepatitis in the Czech Republic was conducted. 76 identified centres were addressed, of which 45 (59%) responded, and 40 (53%) filled in an online questionnaire. Results: Estimated number of centres treated HCV with combination of pegylated interferon α and ribavirin in the Czech Republic in 2010 was 61, 39 of them treated IDUs. Estimated 780 persons were treated, of whom 370 were (mostly ex-) IDUs. Reported treatment uptake in IDUs was 60% on average (range 0-90%). Treatment is completed by 80% of IDUs on average (0-100%) according to clinicians. Most clinicians reported no difference in the treatment..

Zone-based carsharing and its implementation in a selected Prague location

The goal of this master´s thesis is to select the optimal locations for zone-based roundtrip carsharing in a selected district of Prague. In the first part of the thesis, the author analyzes individual city districts of Prague with a high potential for the introduction of this type of carsharing. First, an analysis of the macroenvironment and microenvironment is performed. Subsequently, the city district is selected which, according to the monitored factors, has the highest potential for the introduction of CS. Within this part of the city, the author will then select the location where zone-based carsharing will be introduced. The selection of the optimal location is based on the FLP concept (Facility Location Problem). The core solution of this problem lies within an optimization algorithm that systematically generates the best location of carsharing parking spot/zone considering the geographical demand of potential users.Cílem této diplomové práce je výběr optimálních lokalit pro zavedení tzv. zone-based roundtrip carsharingu v rámci vybrané městské části Prahy. Autor v první části práce analyzuje jednotlivé městské části Prahy s vysokým potenciálem k zavedení tohoto typu carsharingu. Nejprve je provedena analýza makroprostředí a mikroprostředí. Následně je vybrána ta městská část, která má dle sledovaných faktorů ten nejvyšší potenciál k zavedení CS. V rámci této městské části bude autor následně vybírat lokalitu, kde dojde k zavedení zone-based carsharingu. Výběr optimální lokality je založen na konceptu FLP (Facility Location Problem). Jádrem řešení tohoto problému je optimalizační algoritmus, který systematicky vygeneruje nejlepší umístění stanoviště/zóny carsharingu na základě geografické poptávky potenciálních uživatelů

Marketing Plan of a Selected Sports Club

Bakalářská práce se zaměřuje na vytvoření marketingového plánu pro sportovní klub. Jedná se o volejbalový klub, jehož hlavní náplní je práce s mládeží. V teoretické části práce jsou popsány pojmy a metody, které slouží jako podklad pro vytvoření marketingového plán. V praktické části jsou pak tyto metody využity. Je zde provedena analýza marketingového mixu organizace a situační analýza. Syntézu všech provedených obsahuje SWOT analýza, která slouží jako základ pro vytvoření plánu na příští sezónu 2020/21. Nakonec je plán rozpracován do konkrétního marketingového programu.The bachelor thesis focuses on creating a marketing plan for a sports club. It is a volleyball club whose main task is to work with youth. The theoretical part of the thesis describes the concepts and methods that serve as a basis for creating a marketing plan. In the practical part, these methods are used. There is an analysis of the marketing mix of the organization and a situation analysis. The synthesis of all performed is included in the SWOT analysis, which serves as a basis for creating a plan for the next season 2020/21. At the end, the plan is developed into a specific marketing program

The Risks of online gambling for younger males : insights from Czech national surveys

Compared to offline gambling forms, online gambling has been hypothesized to lead to a heightened risk of developing gambling pathology. Suggestions about who the risks apply to have varied. In light of the finding that online gambling and the associated financial difficulties are reported mostly by younger males, some hypotheses identify younger males as an at-risk group. An alternative possibility is that younger males simply display a trend that will emerge population-wide as online gambling proliferates. In this chapter, hypotheses about the population-wide and young-male-specific risks of online gambling are assessed using data from three nationwide Czech surveys. The hypotheses relating specifically to young men are, first, that young men are greater risk-takers who enjoy “practicing” in anonymous environments, and, second, that young men are more prone to overspending as a result of losing track of time during play.20 page(s

Cannabis decriminalization and the age of onset of cannabis use

_Background_ In the Czech Republic in 2010 a law was introduced decriminalizing personal possession of small quantities of several illicit drugs, including cannabis. _Methods_ We use 2012 survey data to examine the effect of a change in cannabis policy on the age of onset of cannabis use. We estimate the effect of the policy change using a mixed proportional hazards framework that models the transition to first cannabis use. _Results_ The change in cannabis policy did not affect the transition to first cannabis use. _Conclusion_ We find no evidence of cannabis decriminalization affecting the age of onset of cannabis use

Prenatal methamphetamine exposure and adverse neonatal outcomes: A nationwide cohort study

Background: There is limited knowledge on the adverse outcomes in newborns after maternal methamphetamine (MA) use during pregnancy. Objectives: To compare neonatal outcomes in newborns exposed to MA with the newborns of opioid-exposed mothers and of mothers from the general population (GP). Method: A cohort study using nationwide registries in Czechia (2000–2014). Women hospitalized with a main diagnosis of MA use disorder during pregnancy (n = 258) and their newborns were defined as MA-exposed. The comparison groups consisted of women (n = 199) diagnosed with opioid use disorder during pregnancy, defined as opioid-exposed, and women (n = 1,511,310) with no substance use disorder diagnosis (GP). The neonatal outcomes studied were growth parameters, gestational age, preterm birth, and Apgar score. To explore the associations between MA exposure and neonatal outcomes, regression coefficients (b) and odds ratios from multivariable linear and binary logistic regression were estimated. Results: MA-exposed women had similar socio-economic characteristics to opioid-exposed, both of which were worse than in the GP. After adjustment, MA exposure was associated with a more favourable birthweight when compared to the opioid-exposed (adjusted mean differences [aMD] b = 122.3 g, 95% CI: 26.0–218.5) and length (aMD b = 0.6 cm, 0.0–1.1). Unadjusted results from the comparison with the GP showed that the MA group had poorer neonatal outcomes, especially in the growth parameters. Adjustment for background characteristics had a profound effect on the comparison with the GP. After adjustment, MA exposure was associated only with a slightly reduced birthweight (aMD b = −63.0 g, −123.0 to −3.1) and birth length (aMD b = −0.3 cm, −0.6 to 0.0). Conclusions: Although the observed negative outcomes were large in the MA-exposed newborns, the adjustment had a profound effect on the comparison with the GP, indicating the large influence of lifestyle and socio-economic factors in these high-risk pregnancies. MA-exposed newborns had better neonatal outcomes compared to opioids-exposed