The impact of the COVID-19 pandemic on the health and working conditions of nurses and its implications for policies: a cross-sectional study in Slovakia.

BACKGROUND: Increased workload and of the health workforce (HW) strained the capacity to maintain essential health services (EHS) during the Coronavirus Disease 2019 (COVID-19) pandemic, while putting them at increased risk of COVID-19 and other consequences to their health. The aim of this study was to assess the impact of COVID-19 on the health, wellbeing, and working conditions of nurses in Slovakia and to identify gaps in policies to be addressed to increase preparedness of the HW for future emergencies. METHODS: A nation-wide cross-sectional study was conducted among nurses during November-December 2021, referring to the period of January 2021 to November 2021. To assess the differences between impact on HW on various levels of care, respondents were grouped by type of facility: hospital-COVID-19 wards; Hospital-non-covid ward; Outpatient or ER; Other care facilities. RESULTS: 1170 nurses participated, about 1/3 of them tested positive for COVID-19 by November 2021, mostly developing mild disease. Almost 2/3 reported long-covid symptoms and about 13% reported that they do not plan to get vaccinated against COVID-19. The median of the score of the impact of workload on health was 2.8 (56% of the maximum 5), the median score of mental health-wellbeing was 1.9 (63% of a maximum of 3). The studied impacts in all domains were highest in nurses working in COVID-19 hospital wards. Significant disruptions of health care were reported, with relatively high use of telemedicine to mitigate them. Overall, about 70% of the respondents thought of leaving their job, mostly due to working stress or inadequate pay. CONCLUSIONS: Our study showed that the COVID-19 pandemic poses a substantial burden on the health, wellbeing and working conditions of nurses in Slovakia and that a large proportion of nurses considered leaving their jobs because of work overload or low salaries. Human resource strategies should be adopted to attract, retain and continuously invest in HW development including in emergency preparedness and response. Such an approach may improve the resilience and preparedness of the health system in Slovakia for future emergencies.

[Stereotactic body radiation therapy: radiobiological characteristics, physical-technical prerequisites, clinical applications]. / Extrakranielle Stereotaxie: strahlenbiologische Besonderheiten, physikalisch-technische Voraussetzungen, klinische Einsatzmöglichkeiten.

Radiotherapy of small targets with very high single doses administered in 1 to approximately 12 fractions-carried out under image guidance and with the intention of "tumour ablation"-is called stereotactic body radiation therapy (SBRT) for extracranial tumours or metastases. Radiobiologically, besides damaging the DNA of the tumour cells, the tumour vessels are also occluded and immunological effects are triggered. The safe performance of SBRT requires a very high physical-technical effort in order to ensure sufficient protection of healthy organs. Clinically, SBRT offers a wide range of applications in curative therapy (e.g. non-small-cell lung cancer stage I). Furthermore, it is a conservative, effective and well-tolerated option for the treatment of individual metastases and an optimal combination partner in the therapy of oligometastatic tumours.

Prediction of the Epidemiological Situation of Tuberculosis in Slovakia by 2040- Data Update.

BACKGROUND: Despite the available diagnostics and treatment, tuberculosis (TB) is a serious infectious disease currently occurring. Even some high-income countries in the world do not fully control it at this time. The reason for this situation is the lack of elimination programs to address the situation. The aim of the update of the prediction data was to create a presumption of TB development in Slovakia by 2040. METHODS: We used the time series prediction method with exponential equalization. The basis for the calculation were historical data on the incidence of TB from 1960 to 2018 in Slovakia (data for the last 58 yr). This time series has a clearly declining level. In view of this trend, we have set a threshold, whether and when the incidence in the future will fall below 5.0 patients per 100,000 inhabitants. RESULTS: In case of a favorable development, the limit of our incidence drop below 5.0 cases per 100 000 inhabitants in 2022, when the incidence will be 4.91 per 100 000 inhabitants. In 2040, the predicted incidence of TB should be 1.78 per 100 000 inhabitants. A gradual decline may also be related to a decrease in the population of the Slovak Republic. CONCLUSION: Slovakia belongs to those countries of the world where TB is under control. Increased surveillance of high-risk communities through community interventions and countries' readiness for global migration can help to influence factors that may aggravate the epidemiological situation of TB.

Automation of radiation treatment planning : Evaluation of head and neck cancer patient plans created by the Pinnacle3 scripting and Auto-Planning functions.

BACKGROUND: Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. MATERIALS AND METHODS: AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. RESULTS AND DISCUSSION: Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). CONCLUSION: On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced.