Czech Society Research Articles

Dálková monitorace implantovaných elektronických přístrojů v kardiologii. Zákonné požadavky a etické principy - společné stanovisko Pracovní skupiny Výboru pro regulační záležitosti Evropské kardiologické společnosti a Evropské asociace srdečního rytmu. Překlad dokumentu připravený Českou kardiologickou společností

Obecné nařízení o ochraně soukromých údajů (General Data Protection Regulation, GDPR) Evropské unie (EU) stanovuje právní odpovědnost při shromažďování a zpracování osobních informací o osobách žijících v EU. Tento dokument má zvláštní důsledky pro dálkové monitorování implantovaných elektronických přístrojů v kardiologii (cardiac implantable electronic device, CIED). Tato zpráva společné pracovní skupiny Evropské asociace pro srdeční rytmus (European Heart Rhythm Association) a Výboru pro regulační záležitosti Evropské kardiologické společnosti (European Society of Cardiology, ESC) doporučuje jednotný právní výklad GDPR. Výrobce i nemocnice je nutno považovat za společné správce údajů shromážděných dálkovým monitorováním (v závislosti na architektuře systému) a musejí mít uzavřenu vzájemnou smlouvu definující jejich příslušné úlohy; byla vypracována obecná předloha této smlouvy. Alternativou k tomuto uspořádání jsou dva nezávislí správci. Správci údajů jsou i kardiologové v soukromé praxi. Poskytovatelé monitorovacích platforem jako třetí strana mohou působit jako zpracovatelé údajů. Výrobci musejí vždy shromažďovat a zpracovávat minimální objem nezbytných identifikovatelných údajů, a kdykoli je to možné, mít přístup pouze k pseudonymizovaným údajům. Byla popsána zranitelná místa v oblasti kybernetické bezpečnosti při přenosu údajů mezi implantovaným přístrojem u pacienta a vysílačem/přijímačem; výrobci proto musejí používat bezpečné komunikační protokoly. Pacienty je třeba informovat o nakládání s jejich dálkově monitorovanými údaji a jejich použití, a ještě před implantací přístroje je nutno získat jejich informovaný souhlas. Rozbor v současnosti používaných formulářů souhlasu odhalilo velké rozdíly v jejich délce a obsahu a někdy i používání velmi odborných výrazů; proto byl navržen standardní informační list a obecný formulář souhlasu. Kardiologové pečující o pacienty s dálkově monitorovanými CIED by měli mít o těchto otázkách povědomí.

Perioperative nutrition in the light of guidelines (and in the shadow of practice)

Nutritional support is one of the fundamental conditions of asuccessful outcome in malnourished or critically ill patients. Malnutrition is an important negative factor with impacts on postoperative morbidity and lethality in surgical patients. It is often observed in particularly in oncosurgical patients, in the elderly and in patients with chronic intestinal disease. The issue of malnutrition should be medically managed from the very moment the ill person becomes apatient. The effort of correcting malnutrition should extend over the entire perioperative period - from the beginning of the diagnostic procedure, during the hospital stay with surgery as applicable with postoperative nutrition therapy, to nutritional status monitoring after discharge and in the course of subsequent follow-up in the outpatient setting. Recent European and Czech guidelines adopted by the Czech Surgical Society and by the other societies exist for this complex issue. However, the use of these guidelines often encounters barriers in practice, and their implementation rate is thus rather low. Nutrition care is amandatory part of the management of surgical patients both in the outpatient and hospital settings of the entire process. The article is acommented selection of nutritional guidelines of the European Society for Parenteral and Enteral Nutrition (ESPEN) of 2017 for surgical patients, and of those resulting from consensual voting of the working group of the Czech Society for Clinical Nutrition and Intensive Metabolic Care (SKVIMP) of 2018.

Otorhinolaryngology in the COVID-19 era: Are there significant differences between hospital-based and private practices?

ObjectivesThe COVID‐19 disease has an incredible impact on both hospital‐based and private practices in the field of otorhinolaryngology and head and neck surgery. Practical issues faced by both types of practices have not been well addressed in most studies. A national survey was conducted in April 2020 to identify the challenges faced by otorhinolaryngologists practicing in the Czech Republic.DesignProspective questionnaire‐based studySettingOnline Google questionnaire sent to the members of the Czech Society of Otorhinolaryngology and Head and Neck SurgeryParticipantsAll doctors practicing Otorhinolaryngology in the Czech Republic with access to the online questionnaire between 15th and 26th April 2020.Main outcome measuresThe primary aims of the study were to evaluate any significant differences between the two types of practice in the field of Otorhinolaryngology. We formulated null hypotheses stating there were no statistical differences in the preparation and availability of personal protective equipment amongst both practices a month after the first case of COVID‐19 in the Czech Republic. Statistical analyses including the Mann‐Whitney U test were performed to test the hypotheses.ResultsAnalysis and results were based on the completion of the entire questionnaire by the doctors. There were no statistically significant differences between both the practices; however, individual analyses of both the practices showed a different outcome.ConclusionDespite our statistical results, it was observed that private practices faced more deficits and were more financially vulnerable. They were also other issues reported by both practices that could compromise the care of patients, functioning of workplaces and support of doctors.

Editorial introductions.

Editorial introductions.

Assessment of the Readiness and Resilience of Czech Society against Water-Related Crises

This assessment of societal readiness and resilience to water-related situations in the Czech Republic focuses on an interdisciplinary approach in the Czech Republic for solving this problem. The goal of the article is to evaluate and characterize the preparedness for handling water-related crises. The analysis is carried out via a SWOT analysis, which is a universal analytical method used to understand and interpret strengths and weaknesses and to identify opportunities and threats. For the calculation of the weight factor of the SWOT analysis, an assessment was determined based on the multicriteria analysis. The pair comparison method was used to determine the relative importance of the parameters of the strengths and weaknesses, opportunities and threats. The Fuller Triangle method was chosen for the system used to make the comparisons of the individual criteria. The uniqueness of the study consists of the issue of water management, which is thus reflected from a non-traditional perspective, being a contemporary model—the paradigm of the view on the preparedness of the planning documentation as one of the characteristics of societal resilience for water-related crises. The result of the research is the fact that a positive approach prevails in the researched area from the perspective of preparedness for water-related crises. For the creation of the conditions, the factors arising from the internal environment currently prevail slightly over those arising from the external environment.

Extremely wicked, shockingly evil and undoubtedly COVID-19: the silent serial killer.

BackgroundThe SARS-COV-2 virus has more than just an infectious role to play in the society. The rapid spread has also led to significant personal, professional, financial and economic recession globally. Health care professionals are getting seriously compromised due to these issues. No published data are available on the indirect effects of COVID-19 on high-risk medical specialties. Otorhinolaryngology is considered as one such specialty. Hence, we designed a national survey to address these issues.Materials and methodsA google questionnaire was sent to all the otorhinolaryngologists in Czech Republic with the help of the Czech Society of Otorhinolaryngology and Head and Neck Surgery to evaluate the problems they encountered during the first wave of COVID-19. Personal, professional and financial losses were also addressed. Online access to the survey was from 15th April 2020 to 26th April 2020.ResultsThe psychosomatic indirect impact of the disease affected female doctors than males. Burnout syndrome was the most commonly reported problem. Around 44.75% of all doctors had a combination of health, financial and economic as well as professional development and educational issues. Doctors from private practices faced higher financial losses.ConclusionsOur study showed that personal, professional and financial disturbances amongst doctors can lead to more serious consequences. With the lack of drastic measures in improving the support system for healthcare workers, the healthcare systems will fail quickly. Adequate support should be made mandatory by health authorities.

БАЛКАНСКОЕ НАПРАВЛЕНИЕ СОВРЕМЕННОЙ ВНЕШНЕЙ ПОЛИТИКИ ЧЕШСКОЙ РЕСПУБЛИКИ

The article examines one of the directions of the foreign policy of the Czech Republic - the Balkan one. Based on the analysis of government documents on foreign policy, it is noted that this vector cannot be considered a priority. Nevertheless, the development of the situation in the Balkans is of considerable interest in Czech society. The main topic discussed in the article is the integration of the Balkan states into the European Union. The article reveals the connection between the foreign policy strategy of the Czech Republic and the current state of the Czech political scene, where the discussion on the recognition of Kosovo's independence plays a significant role. In connection with the active use of the «southern Balkan route» by migrants, certain problems of the migration policy of the Czech Republic are considered in the context of the fight against illegal migration. The main research method is content analysis of foreign policy documents of the Czech government and speeches of Czech politicians. The author concludes that the Czech Republic actively supports the process of European integration of the Balkan states, considering it an indispensable condition for the stable economic and political development of all countries in the region and a guarantee of the preservation of peace and security in Europe as a whole.

O posmrtné historii mozku historika a politika Františka Palackého

František Palacký (1798–1876), a historian and politician, was one of the most eminent personalities of the Czech society of the 19th century. He died on 26 May 1876 in Prague and on 30 May 1876, in the evening before the burial, the Palacký’s head was dissected and his brain was extracted and preserved as a liquid preparation. Then, it was deposited in the Museum of the Kingdom of Bohemia (present National Museum) in Prague; currently it is stored in a jar concealed in a wall niche of a column (next to a large statue of Palacký) in the Pantheon hall of the historical building of the National Museum on the Wenceslaus square in Prague. The investigation of the Museum archive brought some documents which elucidate certain parts of the history of the Palacký’s brain preparation, although its whereabouts during other periods still remain hidden. For several years after its extraction, the Palacký’s brain was deposited in the Museum library, and between the years 1878–1899 (most probably in 1892 at the latest), it was handed over to the Department of Zoology of the Museum, where it remained until 1931. Next fate of the brain is uncertain until 1958, when it was installed in the wall niche in the Pantheon hall, where it remains till now (with an interruption in the last five years), but again under the responsibility of the Department of Zoology and Department of Anthropology, respectively.

공간적 전회의 관점에서 본 선술집의 기능: 얀 네루다(Jan Neruda)의 단편을 중심으로

The paper examines the pub and its various functions in Jan Neruda’s stories in the context of the Spacial Turn. Studies of taverns and pubs are, for the most part, conducted within the fields of economics, social sciences etc. They are only rarely found within the field of literary studies, either because the pub is seen as too ordinary a place or because, due to the current focus on globalization, space is considered less important than other elements, such as time. Nevertheless, the pub is a ubiquitous phenomenon and a crucial element of the human society. It is of particular importance when studying Czech society or literature, since due to the Czech beer culture, the pub or tavern is often the place of action.<BR> Jan Neruda, one of the most famous Czech authors of the 19th century, was a journalist, columnist, essayist and, above all, poet and prose writer. The pub features notably in many of his short stories, e.g. Mr. Rysanek and Mr. Schlegl and At the Three Lilies.<BR> In Mr. Rysanek and Mr. Schlegl, the titular protagonists sit across each other in a tavern and drink a beer every day, despite the fact that they have not exchanged a word for more than 10 years. Then Mr. Rysanek does not show up one day due to an illness, and their relationship changes. Rather than being just an ordinary place, the pub is an organic space with comic function. At the Three Lilies depicts the relationship between a girl who dances passionately in a pub, and a man who watches her closely. The space in the story is a dynamic and erotic one, creating a contrast between light and darkness, or life and death. In some stories such as An Old Bachelor or Episode on Christmas Eve a pub is described as a space with melancholy function.<BR> The paper is intended to initiate a more in-depth exploration of a space that used to be considered a mere background of a story, in various literary works.

Axiology of “Russian“ in the prose of Jaroslav Rudiš

The article is devoted to the assessment of the “Russian” aspect in Czech history and culture based on the prose of Jaroslav Rudiš. Jaroslav Rudiš, one of the most prominent contemporary Czech writers, was born in Turnov (1972). Since the publishing of “The Sky under Berlin” (2002), his work has positively attracted the attention of critics and has won a wider community of readers, which is evidenced by several reprints of his books and a considerable interest in the new one. Jaroslav Rudiš distinguishes himself from the other modern Czech authors by the ability to soberly, aptly and relevantly describe the problems of contemporaries. His characters are people who personally experienced the “whiff ” of the history and felt changes in Czech society over the second half of the 20th century. Despite the fact that Rudiš does not write explicitly about Russia, does not talk about the eternal themes of Russian philosophy and culture and does not discuss positive or negative aspects of Russian influence on international politics, he shows the impact of the “Russian” aspect on the course of the newest Czech history quite accurately and ironically, although infrequently. Russia and the “Russian” in the prose of the author are mentioned in connection with the events in the lives of individual heroes who perceive the Russian aspect as given and periodically interacting with their lives depending on the circumstances. The views of his characters are ambiguous: they are not strictly negative with regard to important events, but they are not thoughtlessly positive, when the breathtaking spirit and depriving rational thinking of the wonderful creative ability of the Russian soul are praised. The tonality of Rudiš’s prose is comparable to Dovlatov’s irony of the “Reserve” or to the poetry of the Yerofeyev’s “Moscow − Petushki”. The study of Rudish’s prose was carried out by the method of excerpt from the available Czech texts of the writer. Axiological characteristics (more than 120 citations from 7 works of the author) relevant for representing the image of the “Russian” in Czech literature were analyzed from the point of view of imagological criteria.the religious feeling.

Oncosurgery in the Czech Republic

The article describes the development of oncosurgery in the Czech Republic since the beginning of the century, as well as other perspectives regarding this specialty. The development of surgical treatment of solid malignant tumours in the Czech Republic was evaluated according to the National Cancer Register database and compared to the neighbouring countries, and the educational system of surgeons in oncosurgery was assessed. Although surgery plays akey role in cancer therapy, starting from the beginning of this millennium it has been pushed aside as aservice specialty for other disciplines in oncology. In 2002, these changes were supported by the activities of the newly founded Division of Oncosurgery under the Czech Society for Oncology, which became part of the Czech Surgical Society in 2016. An official educational programme of surgeons in oncology was successfully implemented and since 2011, aspecialization examination in oncosurgery has been introduced, organized by the subdepartment of oncosurgery of the Institute of Postgraduate Medical Education (IPVZ), Prague. To date, this examination has been completed by 112 physicians and approximately the same number is currently registered in the educational programme. Currently, 34 centres are accredited for education in oncosurgery. The establishment of Complex Oncology Centres based on an initiative of the Czech Society for Oncology of 2006 only addressed pharmaceutical and radiation oncology. Despite progress in oncosurgery, more clearly defined conditions for this specialty are needed. Conclusion: The education of surgeons in oncosurgery should be continued. It is necessary to expand the number of centres with accreditation for oncosurgery and develop aconcept for oncosurgery in the Czech Republic which would be associated with rational concentration of this treatment in connection with organization and provision of continuous urgent and acute surgical care in the Czech Republic, including control mechanisms to ensure its quality. This proposal should be discussed by the Czech Surgical Society in order to further enhance the quality of oncosurgery in the Czech Republic.

Little Moscow on the Vltava river – Russian communities in the Czech Republic in the context of socio-political order and homeland security

The central concern of this paper is the growing influx of Russian migrants to the Czech Republic and the consequences for political and social order. With nearly 40,000 migrants, Russians are the fourth biggest foreign community in Czechia. Due to their material status, the history of bilateral relations, and the significant role of their homeland in Czech politics, the growing Russian community poses a problem for Czech society. The fear of Russian dominance – in political as well as economical dimensions – as well as resentment about the communistic era, is still present among Czech people. Although most Russians come to Czech to study or to do business and are not engaged in political activity, relations between migrants and the host society can be strained. Mutual prejudices make themselves felt in moments of the political crisis between two countries, such as the recent row over Soviet monuments in Prague. However, this doesn’t necessarily mean that the Russian community could easily become a tool for Kremlin propaganda. Russians appreciate the opportunity to live in a rich, liberal and democratic society and even though they keep strong emotional ties with their homeland they are not keen to affirm all of Moscow’s deeds.

Ethnic politics towards Germans during the period of their spontaneous eviction in 1945 in the state politics of memory of the Czech Republic

The article examines the directions of the state politics of memory in the Czech Republic regarding the problem of recognising and understanding the violence by the Czechs against the German population in 1945 and the subsequent CzechGerman reconciliation, which became an important factor of the peaceful and productive interaction of the Czech Republic and Germany in the united Europe. The adoption of a new perspective of historical memory at the stage of post-socialist transformation was primarily due to the initiatives of Czech historians and activists to study the problem of violence at the final stage of World War II on the Czech lands and the subsequent expulsion of Germans. This approach in turn was reflected in the official position of the presidents of the Czech Republic V. Havel and V. Klaus during the signing of the CzechGerman agreements and declarations, which made it possible to eliminate conflicts of perception of a common traumatic past among the current generations of Czechs and Germans. The memory of the violence against German-speaking citizens of Czechoslovakia is broadcast both through the formation of memory objects (monuments, feature films) and within the framework of local public initiatives. The review of the initiatives to perpetuate the victims of the Brno death march, undertaken in the concluding part of the article, reveals the contradictory nature of reconciliation in relation to the memory of post-war violence in contemporary Czech society.

“Big or Not at All”: Two American Counter-Olympic Events of 1936

Abstract Historians have written a great deal about the 1936 Berlin Olympics and its many controversies, especially the boycott movement. Little attention has been paid to what happened to those counter-Olympic efforts in the aftermath of the boycott movement. This article discusses two counter-Olympic festivals in the United States in the summer of 1936. The Workers’ Olympiad in Cleveland, Ohio, a modest affair organized by a local Czech gymnastics society over the Fourth of July weekend, was a noteworthy event within the Czech American community but faced too much competition from other higher-profile athletic events to make a significant national impact. The World Labor Athletic Carnival, organized by Jewish labor leaders in New York City, attracted a number of Olympic-caliber athletes but struggled to mount a legitimate challenge to the Berlin Games. The shortcomings of these counter-Olympic efforts suggest some of the failings of workers’ sport in the United States more generally.

Face to face with COVID-19: highlights of challenges encountered in various ENT practices across the Czech Republic (a national survey).

The SARS-CoV-2 virus causing the COVID-19 disease created considerable complications and disruptions due to it's pandemic spread. The nature of the disease left certain clinical specialties more vulnerable than others, causing serious problems with organization of care of patients. Most studies concentrated on protocols and strategies to control the situation and reduce further spread amongst medical fields. Only few were designed to identify the various issues faced by doctors. We decided to design a questionnaire addressing relevant matters for doctors working in the field of ear, nose and throat (ENT). This was then sent to all the members of the Czech Society of Otorhinolaryngology. All ENT doctors were invited to fill out the survey within a stipulated time. The aim of the study was to evaluate the impact of a pandemic situation amongst such a high risk specialty. Our results showed a significant difference between the first cases of COVID-19 and progress of the disease during April 2020 in terms of workplace preparation, adequacy of personal protective equipment and other disposable aids. There was also inadequate support of medical personnel within the ENT practices. Furthermore, financial losses were also experienced due to mainly patient-related problems. In conclusion, the obtained results were used to formulate some recommendations for the public, patients, medical staff and employers. These suggestions will hopefully help avoid a repetition of the glitches if faced with another pandemic situation.

Gendered visions of family life and parenthood among Czech young people: restricted or transforming imaginations?

ABSTRACT This article explores young people’s imaginations of their future family life. Based on qualitative research among young people in North Bohemia, it considers social reproduction and change within the domain of gendered labour and parenting. This is done on the backdrop of post-1989 transformation of Czech society, where drives towards individualisation and diversification of the life course stand against discourses and policies supporting separate gender roles. Through the analytical lenses of gendered relationality, combined with Yanagisako and Delaney’s concepts naturalisation/de-naturalisation, we uncover multiplex structures of imaginations and their specific regional–historical conditioning. While preferences for gender separate roles are quite strong among both young men and young women, there is also a willingness to cross gendered boundaries and share tasks, in particular when it comes to household labour. For childcare, the gendered boundaries appear more rigid in young people’s imaginations; infant care is deemed female and the image of the father as main or equal caregiver is rejected. However, the male main or equal caregiver is not unimaginable. Although undesirable, he is definitely present in the imaginations of both genders, something that leads us to argue that social transformation may also be on its way within this domain.

“Almost Equal”: Confronting Norms and Normality in Experiencing Visual Disability

This article examines the everyday experience of visually disabled people with norms and normality and confronts it with three approaches discussed in disability studies: (i) the medical model, (ii) the social model, and (iii) critical disability studies. The most available model to the people in the study, as well as the most widespread approach in Czech society, is the medical model. However, the text shows that although other approaches are rather marginal, their logic is present in the everyday experience of the communication partners in the research. They can espouse the rigid, medical model, while, at the same time, confronting the construction of norms that both the social model and critical disability studies defy. This finding reveals both the normative and subversive character of disability, manifested in visually impaired experience.

Symbolic and social boundaries of the integration of Russian immigrants in Czechia

The integration of immigrants into Czech society is a key topic in the public debate as well as essentially a political issue. The most numerous groups, within a half-million migrant population, include Slovaks, Ukrainians, Vietnamese, and Russians. Such composition points out that Czechia is predominantly attractive to non-EU immigrants. This article focuses on the integration process of Russian immigrants into Czech society. Representing highly educated and financially well-secured migrants who come as entire families, the Russians are distinct from other Eastern European immigrants. However, various factors hinder their integration. The paper discusses the factors that shape symbolic and social boundaries in this integration process: (1) the development of Czech-Russian relationships that have been influenced by dramatic past events, (2) the representation of Russians in Czech media, (3) their specific socio-economic status, and (4) Czech immigration and integration policies. Negative experience, socio-economic inequalities, strict implementation of immigration policies towards third-country immigrants, and an unfavourable media discourse affect the attitudes of the majority toward the Russians and limit meaningful encounters.

Znaczenie eurosceptycyzmu na scenie politycznej Republiki Czeskiej

The Importance of Euroscepticism on the Political Scene of the Czech Republic. Conditions and Consequences &#x0D; Czech society is one of the most eurosceptic in the European Union. One of the reasons is a low degree of trust in authority (government, parliament) in general, also at the supranational level. Consequently, Czech political parties have eurosceptic slogans in their programs that do not prevent voters from supporting them, both in the elections to the Czech and European Parliaments. The political system is dominated by parties presenting the so‑ called „soft euroscepticism” (according to Taggart’s and Szczerbiak’s approach), such as: Action of Dissatisfied Citizens (ANO 2011), Civic Democratic Party (ODS) or Communist Party of Bohemia and Moravia (KSČM). In the 2017 election, they received a total of almost 50% of the vote. However, euroscepticism is not a threat to the Czech presence in the EU. Extremely eurosceptic parties do not enjoy great public support.

"All‑in‑one" koncept funkčně vedené revaskularizace myokardu v katetrizační laboratoři

The concept of functional revascularization based on proving ischemia has been strongly recommended in the practical guidelines of both European and Czech Societies of Cardiology. In daily practice, application of this concept decreases the rate of coronary interventions. Though the best clinical evidence has been provided in patients with chronic coronary syndromes, recent data strongly advocate its usage also in patients with acute coronary syndromes. Invasive pressure-derived indices: hyperemic FFRmyo (fractional flow reserve of myocardium) and resting iFR (instantaneous wave-free ratio) require an interventional procedure by wiring the diseased vessel. FFRmyo 0.80 and iFR 0.89 mean functionally significant coronary disease mostly indicated for revascularization. Besides that, there are several non-invasive functional tests that may be used for detecting ischemia: perfusion scintigraphy, cardiovascular magnetic resonance, positron emission tomography and recently developed FFRCT or quantitative flow ratio (QFR). In routine practice, the concept of functional revascularization avoids unneccessary coronary interventions and, in case of functionally non-significant disease/stenoses, the patients may be treated conservatively with a very good prognosis. Currently, the &#8222;functionally complete revascularization&#8220;, instead of the anatomic one, might become the goal of our treatment as the all-in-one concept in the cathetrization laboratory.