The relationship between destination image and destination safety during technological and social changes COVID-19 pandemic

This study aimed to assess the relationship between safety perceptions and destination image in the Central European region during the technological and social environment change brought about by the COVID-19 pandemic. The study sample consisted of respondents from three Central European countries, namely, the Czech Republic, Hungary, and Slovakia. The quantile regression analysis was used to analyze the relationship between the image of the destination and its perceived safety. The results showed that concerns about the safety of the tourism environment could be negatively associated with the image of the infrastructure in Hungary and Slovakia, with value for money in the three countries, and with images of enjoyment in Slovakia. Higher levels of destination safety may be associated with a more positive destination image, with health, facilities and services being the most important dimensions of perceived safety, because of the pandemic. This study contributes to the knowledge of the concept of destination images and the development of tourism.

The relationship between destination image and destination safety during technological and social changes COVID-19 pandemic.

This study aimed to assess the relationship between safety perceptions and destination image in the Central European region during the technological and social environment change brought about by the COVID-19 pandemic. The study sample consisted of respondents from three Central European countries, namely, the Czech Republic, Hungary, and Slovakia. The quantile regression analysis was used to analyze the relationship between the image of the destination and its perceived safety. The results showed that concerns about the safety of the tourism environment could be negatively associated with the image of the infrastructure in Hungary and Slovakia, with value for money in the three countries, and with images of enjoyment in Slovakia. Higher levels of destination safety may be associated with a more positive destination image, with health, facilities and services being the most important dimensions of perceived safety, because of the pandemic. This study contributes to the knowledge of the concept of destination images and the development of tourism.

The Behavioral and Social Dimension of the Public Health System of European Countries: Descriptive, Canonical, and Factor Analysis.

BACKGROUND: The state and prospects of the healthcare industry of a country are among its top priorities because the quality of life and health of its citizens are indicators of its success and competitiveness. The aim of this study is to conduct a theoretical analysis and qualitative and quantitative assessments of indicators by developing an integral indicator in the context of behavioral, social, demographic, and economic factors that characterize the level of healthcare system development in European countries using multivariate statistical modeling methods. METHODS: The study was implemented using Statistica 10 and Statistica Portable statistical packages. The statistical base of the study was formed using descriptive analysis; a group of 10 European countries was identified using a cluster analysis based on the application of an iterative divisive k-means method. The degree and significance of the interrelations between the components characterizing the studied groups of indicators were determined using canonical correlations by conducting a canonical analysis. Factor modeling is conducted by applying the analysis of the main components to determine the relevant indicators for assessing the level of healthcare system development to build integral indicators of the level of healthcare system development in European countries. RESULTS: The need to improve the level of healthcare system development in European countries was confirmed. Shortcomings and possible reserves for potential improvement of the healthcare system were identified. CONCLUSIONS: The results can help public authorities, officials and employees of the healthcare sector organize and conduct effective, timely, high-quality regulation and adjustment of the regulatory and legislative framework to improve healthcare system development.

The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic.

In the ongoing situation, when the world is dominated by coronavirus disease 2019 (COVID-19), the development of self-care programs appears to be insufficient, while their role in mental health may be crucial. The aim of the study was to evaluate the associations between self-care activities and depression in the general Slovak population, but also in its individual gender and age categories. This was achieved by validating the self-care screening instrument, assessing differences, and evaluating the associations using quantile regression analysis. The final research sample consisted of 806 participants [males: 314 (39%), females: 492 (61%)] and data were collected through an online questionnaire from February 12, 2021 to February 23, 2021. Patient Health Questionnaire (PHQ-9) for depression (α = 0.89) and Self-Care Activities Screening Scale (SASS-14) [health consciousness (HC) (α = 0.82), nutrition and physical activity (NPA) (α = 0.75), sleep quality (SLP) (α = 0.82), and interpersonal and intrapersonal coping strategies (IICS) (α = 0.58)] were used as screening measures. Mild depressive symptoms were found in 229 participants (28.41%), moderate depressive symptoms in 154 participants (19.11%), moderately severe depressive symptoms in 60 participants (7.44%) and severe depressive symptoms in 43 participants (5.33%). The main findings revealed the fact that individual self-care activities were associated with depression. This supported the idea that well-practiced self-care activities should be an immediate part of an individual's life in order to reduce depressive symptoms. Sleep quality played an important role, while HC indicated the need for increased attention. Other dimensions of self-care also showed significant results that should not be overlooked. In terms of depression, females and younger individuals need targeted interventions. The supportive educational intervention developed based on the self-care theory can help manage and maintain mental health during a stressful period, such as the COVID-19 pandemic. Health policy leaders should focus on health-promoting preventive self-care interventions, as the demand for them increases even more during the pandemic.

Perception of testing for COVID-19 during the first wave of the pandemic in Slovakia with emphasis on population age groups.

OBJECTIVE: The aim of this study was to evaluate the perception of the respondents in selected areas of testing for COVID-19 during the first waves of this disease with an emphasis on the age categories. METHODS: The research sample consisted of 806 Slovak respondents and the collection of data took place in February 2021. The study examined six areas, of which five focused on the perception of testing and one area focused on examining the risk of population behaviour. All areas were examined in the first as well as in the last testing for COVID-19. In terms of age, we focused on 4 age categories: up to 24 years, 25-44 years, 45-59 years, and over 60 years. Data were obtained by online survey, using descriptive analysis and nonparametric analysis of differences. RESULTS: The results of the analysis show that age is a socioeconomic characteristic that is of great importance for the creation and implementation of epidemiological processes and programmes and therefore epidemiologists should pay increased attention to it when creating prevention programmes. Younger people perceived testing more positively than older ones, even though the course of the disease caused by COVID-19 is much more severe in older people. The difference in the perception of testing between age categories was confirmed in the first as well as in the last test study. Respondents perceived the last test more negatively and thus they showed slightly riskier behaviour compared to the first test. CONCLUSIONS: We perceive testing as an efficient way in the fight against pandemics generally, but we point out that testing should be well accomplished in a managerial way, otherwise testing can have a negative impact on society's confidence.

Internet Addiction in Socio-Demographic, Academic, and Psychological Profile of College Students During the COVID-19 Pandemic in the Czech Republic and Slovakia.

Internet addiction is a serious problem among young adults that requires increased attention, especially at a time of distance learning during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the relationships between internet addiction and selected socio-demographic, study-related, and psychological characteristics of college students. Internet addiction was measured using the Internet Addiction Test both overall and in its individual subscales (Salience, Excessive Use, Neglect Work, Anticipation, Lack of Control, and Neglect Social Life). The selected characteristics represented (1) socio-demographic profile (gender, age, residence, family), (2) academic profile (housing during the semester, form of study), and (3) psychological profile (depressive symptoms-the Patient Health Questionnaire, stress-the Perceived Stress Scale, anxiety symptoms-the Generalized Anxiety Disorder). Data collection took place during the first wave of the COVID-19 pandemic in 2020 at Czech and Slovak colleges, with 1,422 students from the Czech Republic and 1,677 students from Slovakia participating in the research. The analytical processes were carried out through descriptive analysis, non-parametric difference analysis, and multiple negative binomial regression. Mild internet addiction was found in 387 (27.2%) Czech and 452 (27.0%) Slovak students. Moderate internet addiction was identified in 49 (3.4%) students from the Czech Republic and in 100 (6.0%) students from Slovakia. Two (0.1%) Czech and three (0.2%) Slovak students reported severe internet addiction. Increased likelihood of internet addiction overall, as well as in most individual subscales, was found particularly among male students and students who lived away from home during the semester. Depressive symptoms and stress could also be considered significant predictors in both countries. These results are important for the development of effective strategies and prevention programs, as Internet addiction may be a serious problem in the future, given the current times. When assessing internet addiction among college students, it would also be appropriate to evaluate the individual internet addiction subscales and their specifics.

Internet Addiction, Symptoms of Anxiety, Depressive Symptoms, Stress Among Higher Education Students During the COVID-19 Pandemic.

Poor mental health is a growing concern among young people during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the associations of Internet addiction with depressive symptoms, anxiety symptoms, and stress in higher education students during the COVID-19 pandemic, as well as to examine these mental health problems in the context of study-related characteristics. The research sample consisted of 3,099 participants from the Czech Republic (CZ: 1,422) and Slovak Republic (SK: 1,677). The Internet Addiction Test (IAT), the Generalized Anxiety Disorder (GAD-7) scale, the Patient Health Questionnaire for depressive symptoms (PHQ-9), and the Perceived Stress Scale (PSS) were used to measure mental health problems. The analyses also included demographic data (gender and age) and study-related characteristics (form of study, degree of study, field of study, distance between college and home, and housing during the semester). Based on the results of frequency and descriptive analyses, the prevalence of mental health problems was high. The most serious levels of Internet addiction (IAT cut-off point ≥ 50), to which attention should be paid, were found in 3.5% of Czech and 6.2% of Slovak students. Using the standard cut-off point of GAD-7 ≥ 10, 14.1% of Czech and 11.6% of Slovak students were identified with anxiety symptoms. Regarding the PHQ-9 with the cut-off point ≥ 10, 23.4% of Czech and 19.1% of Slovak students had depressive symptoms, which should be addressed. Using the PSS cut-off point ≥ 27, 12.9% of Czech students and 9.1% of Slovak students perceived high stress. The quantile regression analysis showed that Internet addiction was positively associated with anxiety symptoms, depressive symptoms, and stress in all of the analyzed cases (p-value < 0.001). In terms of study-related characteristics, the binomial logistic regression analysis revealed that risk factors for mental health problems in Czech and Slovak students were mainly full-time form of study and living away from home during the semester. Internet addiction, anxiety symptoms, depressive symptoms, and stress are issues that require increased attention, and professionals and policy-makers should implement interventions to effectively prevent and help students with psychological problems.

Somatic Symptoms, Anxiety, and Depression Among College Students in the Czech Republic and Slovakia: A Cross-Sectional Study.

Studying in college can be a challenging time for many students, which can affect their mental health. In addition to academic pressure and stressful tasks, another aggravating factor in student life is the ongoing coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to examine the prevalence of anxiety, depression, and somatic symptoms in Czech and Slovak college students during the COVID-19 pandemic and to evaluate possible socio-demographic determinants of mental health problems. A total of 3,099 respondents participated in this cross-sectional study (Czech Republic: 1,422, Slovakia: 1,677). The analyzes included the Patient Health Questionnaire for somatic symptoms (PHQ-15), the Generalized Anxiety Disorder instrument (GAD-7), and the Patient Health Questionnaire for depression (PHQ-9). Socio-demographic factors were gender, age, family structure, marital status, form of study, degree of study, year of study, field of study, distance between home and college, residence, and housing during the semester. Among Czech students, prevalence of somatic complaints, anxiety and depression was 72.2, 40.3, and 52%, respectively. Among Slovak students, prevalence of somatic complaints, anxiety and depression was 69.5, 34.6, and 47%, respectively. During the COVID-19 pandemic, the most severe mental health problems were identified in a non-negligible part of the sample (Czech Republic: PHQ-15 = 10.1%, GAD-7 = 4.9%, PHQ-9 = 3.4%; Slovakia: PHQ-15 = 7.4%, GAD-7 = 3.5%, PHQ-9 = 2.7%). Regarding the differences between the analyzed countries, a significantly higher score in somatic symptoms, anxiety, and depression was identified in the Czech Republic. Significant differences in mental disorders were found in most socio-demographic characteristics. The main results of the logistic regression analysis revealed that risk factors for mental health disorders in Czech and Slovak students were female gender, younger age, third degree of study, and study of Informatics, Mathematics, Information and Communication Technologies (ICT). Especially in the case of these high-risk groups of students, public policies should consider a response to impending problems. The findings are an appeal for a proactive approach to improving the mental health of students and for the implementation of effective prevention programs, which are more than necessary in the Czech and Slovak college environment.

Sustainable Health and Wellbeing in the European Union.

Background: Altogether, 17 Sustainable Development Goals (SDGs) are an urgent call for action to end poverty, protect the planet, and ensure prosperity for all. Goal 3 is crucial in terms of good health and wellbeing. The main aim of this study is to analyze and evaluate differences among indicators of SDG 3: Sustainable health and wellbeing in the EU countries. Methods: The status and development of the EU Member States regarding their successes or failures in terms of Goal 3 were subjected to analysis. Altogether, 11 indicators were used to rank the EU countries using the TOPSIS and ranking methods. The ranks were assigned to the countries in two periods. The first period is related to the time from 2010 till 2014, and the second period from 2015 till 2019. Results: The EU countries achieved a positive development in 10 of 11 indicators that monitor the achievement of the EU in terms of Goal 3. The only variable that changed negatively was the obesity rate. Positivity was observed in the decline of the standardized preventable and treatable mortality, which declined from 317.3 in the first period to 295 in the second period; the drop of the population weighted annual mean concentration of fine particulate PM2.5, from 16.4 to 13.6 µg/m3, and also in the increase of the share of people with good or very good perceived health, which was combined with a decrease of the self-reported unmet need for medical examination and care. The best-rated country in terms of SDG 3 was, in both periods, Sweden, while the worst-rated was Latvia. Conclusions: Governments and institutions in the EU can intervene to increase the accessibility and quality of the health care system, but every citizen should try to do their best to reduce some of the risk factors, such as smoking or obesity, to try living healthier and to help to achieve higher ambitions in terms of sustainable health and wellbeing.

Perception of COVID-19 Testing in the Entire Population.

In the Slovak Republic, a mass testing of the entire population was performed. Estimates show that this testing cost more than 400 million EUR and thousands of euros were paid for one positively identified case. Thus, it is possible to state a high cost for such a project, which has been criticized by many parties. On the other hand, from a public health point of view, mass testing has helped fight the pandemic. Both the health and economic perspectives are important in assessing the success of a pandemic strategy, but the social perspective is equally important. In fact, the situation is perceived from the position of public leaders who make decisions, but also from the position of the society that bears individual political decisions. It is not appropriate to forget about the society that is most affected by restrictions, testing, health status, but also the burden on the state budget. The objective of the presented research was to examine the perception of testing for coronavirus disease 2019 (COVID-19) in the Slovak population. Non-parametric difference tests and correspondence analysis were used for statistical processing. The research sample consisted of 806 respondents and data collection took place in February 2021. The main findings include significant differences in perceptions between the first and the last participation in testing in terms of gender, age, testing experience, and time aspect. The last participation in testing showed lower rates of positive aspects related to the internal motivation to test compared to the first participation. In contrast, external stimulation by government regulations related to restrictions in the absence of a negative result was higher in the last participation in testing. There were also differences between the first and the last test in the level of doubts about the accuracy of the test result, while a higher level was found at the last testing participation. It can be concluded that the frequency of testing and its requirements need to be approached very carefully over time, as it is likely that the positive perceptions may deteriorate. The recommendations include clear and timely government communication, trust building and health education.

Changes in Alcohol Consumption and Determinants of Excessive Drinking During the COVID-19 Lockdown in the Slovak Republic

As a result of the coronavirus disease 2019 (COVID-19) pandemic, countries have been forced to adopt strong restrictions, such as lockdown, which can lead to serious consequences for public health, including the problematic use of addictive substances. The aim of this cross-sectional study was to examine changes in alcohol consumption and to identify determinants against the background of excessive drinking during the COVID-19 lockdown in the Slovak Republic. The research included 445 respondents (33% males and 67% females), and the data collection through the questionnaire took place from April 29, 2020 to July 1, 2020. Measures such as drinking frequency, amount of alcohol and excessive drinking were used to examine alcohol consumption. Descriptive analysis and binary logistic regression were used to meet the main aim. The findings provide a closer look at the situation in the Slovak Republic and contribute to comprehensive international knowledge. The frequency of excessive drinking did not change in about half of respondents (53% of males and 69% of females). More respondents decreased their excessive drinking than increased, both among males (31 and 16%, respectively) and females (25 and 6%, respectively). Similar results were found for drinking frequency and amount of alcohol. Amongst Slovak respondents, an increase in excessive drinking was more common among males, younger people, smokers, and smokers who increased smoking during the lockdown. Especially in the case of vulnerable populations, public policies should consider a response to impending problems. The findings of this study encourage the implementation of effective and evidence-based prevention programs, which are more than necessary in the Slovak Republic.

The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic

In the ongoing situation, when the world is dominated by coronavirus disease 2019 (COVID-19), the development of self-care programs appears to be insufficient, while their role in mental health may be crucial. The aim of the study was to evaluate the associations between self-care activities and depression in the general Slovak population, but also in its individual gender and age categories. This was achieved by validating the self-care screening instrument, assessing differences, and evaluating the associations using quantile regression analysis. The final research sample consisted of 806 participants [males: 314 (39%), females: 492 (61%)] and data were collected through an online questionnaire from February 12, 2021 to February 23, 2021. Patient Health Questionnaire (PHQ-9) for depression (α = 0.89) and Self-Care Activities Screening Scale (SASS-14) [health consciousness (HC) (α = 0.82), nutrition and physical activity (NPA) (α = 0.75), sleep quality (SLP) (α = 0.82), and interpersonal and intrapersonal coping strategies (IICS) (α = 0.58)] were used as screening measures. Mild depressive symptoms were found in 229 participants (28.41%), moderate depressive symptoms in 154 participants (19.11%), moderately severe depressive symptoms in 60 participants (7.44%) and severe depressive symptoms in 43 participants (5.33%). The main findings revealed the fact that individual self-care activities were associated with depression. This supported the idea that well-practiced self-care activities should be an immediate part of an individual's life in order to reduce depressive symptoms. Sleep quality played an important role, while HC indicated the need for increased attention. Other dimensions of self-care also showed significant results that should not be overlooked. In terms of depression, females and younger individuals need targeted interventions. The supportive educational intervention developed based on the self-care theory can help manage and maintain mental health during a stressful period, such as the COVID-19 pandemic. Health policy leaders should focus on health-promoting preventive self-care interventions, as the demand for them increases even more during the pandemic.

Expert model of risk assessment for the selected components of smart city concept: From safe time to pandemics as COVID-19.

The purpose of the paper is to create an information, fuzzy risk assessment model to support the decision-making of Municipality management for the establishment and management of measures in the safe mode (regular) of City, emergency and disaster situations, in the selected components of Smart City concept. Research on this topic was motivated by the need for support, especially in emergency situations, such as the COVID-19 pandemic. It is proposed that the evaluation be carried out at local level within the framework of the Smart City concept and selected components integrated into the entity, including the Smart Security, Smart Healthcare, and Smart Environment components supported by the Smart WebGIS subsystem. The model also assesses proposed solutions for self-government financing to ensure the acceptable risk, and economic impact of decisions on the city budget within the Smart Budget aspects of selected components. Decision-making is based on intellectual analysis, processing of fuzzy data and use of fuzzy inference. The output of the model is the assessment of the risk of the municipality subsystems, taking into account the threshold for the functioning of the municipality subsystems, the linguistic interpretation of the level of risk and the acceptability of the tolerable risk resource. The model algorithm was used to create a web application to support the Municipal management for the above-mentioned agenda, from safe time to pandemics.

Alcohol Use Disorders among Slovak and Czech University Students: A Closer Look at Tobacco Use, Cannabis Use and Socio-Demographic Characteristics.

The main objective of the research was to examine the associations between problematic alcohol use, tobacco use and cannabis use among Czech and Slovak university students during the early COVID-19 pandemic. The research sample consisted of 1422 participants from the Czech Republic (CZ) and 1677 from the Slovak Republic (SK). The analyses included university students who drank alcohol in the past year (CZ: 1323 (93%); SK: 1526 (91%)). Regarding the analysed measures, the Alcohol Use Disorders Identification Test (AUDIT) and its subscales, the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) and the Cannabis Abuse Screening Test (CAST) were selected to identify substance-related behaviour. Age, gender and residence were included in the analyses as socio-demographic variables. Correlation and regression analyses were used to achieve the main objective of the research. The main results revealed that the use of tobacco and cannabis were positively associated with alcohol use disorders among Czech and Slovak university students. Additionally, males were more likely to report alcohol use disorders. In the Czech Republic, it was found that students living in dormitories were characterized by a lower AUDIT score. The opposite situation was found in the Slovak Republic. Czech and Slovak policy-makers are encouraged to develop alcohol use prevention programs for university students in line with these findings.

Model of Evaluation and Selection of Expert Group Members for Smart Cities, Green Transportation and Mobility: From Safe Times to Pandemic Times

This paper presents the development of technologies to support the decision-making of local government executives and smart city concept managers in selecting and evaluating the competencies of new members for advisory groups for solving problems that are implemented in safe times in individual areas or in crises, such as pandemics. The reason for developing effective urban transformation strategies and for the transparent selection of independent experts (non-politicians) for policymaking, decision-making, and implementation teams is not only the heterogeneity of smart city dimensions together with the necessary complexity and systems approach, but also the nature of the capacities and tools needed for smart city concepts. The innovative hybrid competency assessment model is based on fuzzy logic and a network for neuro-fuzzy assessment. It is a technological model for evaluating the competencies of specialists, taking into account the influence of human factors on the processes of personnel selection and system management. An innovative web platform named “Smart City Concept Personnel Selection” has been designed, which can be adapted to various users of municipalities or regional institutions for the transparent selection of qualified personnel for effective decision-making and the use of public funds during safe times or emergencies, such as the COVID-19 pandemic.

Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension.

The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n = 1523 Slovak university students). Descriptive, regression, and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9), and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, while in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.

The efficiency of hospitals: platform for sustainable health care system

Hospitals and other providers of health services are facing enormous pressure to reduce costs while providing better services for patients without lowering their quality. By utilising a two-stage dynamic Data Envelopment Analysis (DEA) approach, we explore whether there is a compromise between the production of services and the quality of services in the process of providing health care at the level of hospitals in Slovakia. While the first stage deals with the production efficiency of the hospitals, the second stage deals with the quality of service using patient-reported safety and satisfaction measures. The efficiency of hospitals in Slovakia is assessed, using hospital-level data from the database of INEKO for the years 2015 and 2018. In order to dynamically analyse the efficiency changes during the analysed period, the Malmquist index was used. The results revealed that overall technical efficiency increased over the analysed period. We can also see an increase within the service production division as well as service quality division. The results obtained represent a significant platform for the creators of health policy at the national level, and for the creators of the strategic regional health plans as a basis of continuous creation of mechanisms that are inevitable for providing a sustainable system of the Slovak health care at the regional level. The global threats of epidemics, such as COVID-19 pandemic, address the question of public health systems’ sustainability, which enormously increases.