Knowledge and preventive practices regarding COVID-19 disease among Ukrainian refugees in Poland.

Russia's invasion of Ukraine contributed one of the largest migration movements in the 21st century. Refugees may become a source of severe acute respiratory syndrome coronavirus 2 infections for the residents of host countries. The study aim was to assess knowledge and preventive practices regarding coronavirus disease 2019 (COVID-19) among Ukrainian refugees in Poland. The cross-sectional study was conducted between March and April 2022 among Ukrainian refugees registering consecutively in Zielona Góra, Poland. Knowledge and preventive practices were assessed by giving 1 point for each correct answer by anonymous, self-administered questionnaire. The response rate was 96%, 190 participated (mean age 37.8 ±â€…15.5 years; 57.9% females); 61.6% self-reported their socio-economic status (SES) as high, 38.9% reported high level of education. The mean COVID-19 knowledge score was 3.06 ±â€…1.95; 19.5% scored >50%. The knowledge level was higher among migrants with high SES (P = .003). The mean preventive practices score was 2.56 ±â€…1.38; 54.0% scored ≥ 60%. 40.5% declared social distancing, 62.6% followed coughing etiquette, 69.0% home isolate themselves during COVID-19. 57.9% always used masks in public space, however 74.2% wore masks with uncovered nose. Refugees with higher education, high SES and knowledge level had significantly greater preventive practices scores (P = .002; P = .02; P = .03, respectively). The knowledge and preventive practices level was insufficient. Educational campaigns oriented to raising knowledge and prevention behavior skills should be implemented, especially targeting high-risk groups to avoid spread of COVID-19.

Comparison of Graph Fitting and Sparse Deep Learning Model for Robot Pose Estimation.

The paper presents a simple, yet robust computer vision system for robot arm tracking with the use of RGB-D cameras. Tracking means to measure in real time the robot state given by three angles and with known restrictions about the robot geometry. The tracking system consists of two parts: image preprocessing and machine learning. In the machine learning part, we compare two approaches: fitting the robot pose to the point cloud and fitting the convolutional neural network model to the sparse 3D depth images. The advantage of the presented approach is direct use of the point cloud transformed to the sparse image in the network input and use of sparse convolutional and pooling layers (sparse CNN). The experiments confirm that the robot tracking is performed in real time and with an accuracy comparable to the accuracy of the depth sensor.

Does Vaccinating against Influenza in a Given Epidemic Season Have an Impact on Vaccination in the Next Season: A Follow-Up Study.

To improve the uptake of influenza vaccine in the elderly, it is important to understand the factors that predict vaccination. The study objective was to explain influenza vaccination uptake in the next season (2019/2020) in a sample of primary care clinic patients from Gryfino, Poland, vaccinated in 2018/2019 with the free-of-charge quadrivalent vaccine. A baseline and a follow-up survey assessed respondent intentions to receive a vaccine (2018), then (2020) vaccine uptake and its predictors. Patients (n = 108, 54.6% males, Mage = 66.7 ± 6.7) filled in a researcher-administered questionnaire. A majority (69.3%) intended to get vaccinated in the next season, with 25.9% receipt. Of those willing to be immunized, only 31.9% were vaccinated in the next season; of those whose decision was dependent on reimbursement, none received influenza vaccine; of undecided patients, 23.1% were vaccinated. Multivariable analysis indicated that living with a partner (OR 6.22, p = 0.01), being employed (OR = 4.55, p = 0.05) and past vaccination behavior (OR 4.12; p = 0.04) were predictors of vaccine uptake. The findings show limited follow-through on initial influenza vaccination plans for the nearest season in previously vaccinated elderly patients. Future interventions should additionally focus on unanticipated barriers to vaccination, such as those revealed in this study, to increase vaccination coverage rates.

COVID-19 Vaccination within the Context of Reactogenicity and Immunogenicity of ChAdOx1 Vaccine Administered to Teachers in Poland.

In February 2021, Polish teachers were offered the ChAdOx1-S vaccine as a priority group. However, there have been concerns among educators regarding the efficacy of this vaccine, as compared to the other types of vaccines (e.g., mRNA). The objective of this study was to investigate the reactogenicity and the immunogenicity of this vaccine. Participants, specifically teachers, were invited for serological testing ≥ 4 weeks post-vaccination. Antibodies against the receptor-binding domain (RBD) were measured. Of the 192 participants, the mean age was 50.5 ± 8.3 years and the mean (range) dosing interval was 69.6 ± (25−111) days. Adverse reactions included feeling feverish (44.8%), headache (41.7%), malaise/chills (38.0%), and injection-site tenderness (37.5%); these were reported more frequently after the first dose (84.9%). Fewer males than females (54.8% vs. 80.1%) and fewer older participants (65.7% vs. 90.4%) reported side effects (p < 0.002; p < 0.0001, respectively). All participants presented detectable anti-RBD IgG; the median (range) reading was 525.0 BAU/mL (20.6−5680.0); 1008.02 BAU/mL (115.3−5680.0) in those with prior SARS-CoV-2 infection; and 381.42 BAU/mL (20.6−3108.8) in those without (p = 0.001). In 27.6%, the anti-RBD IgG level was >500 BAU/mL. A multivariate logistic regression revealed that previous infection and longer dose intervals were predictors of higher immunologic responses (p < 0.0001; p = 0.01, respectively). The results demonstrated good tolerability and immunogenicity of the ChAdOx1-S vaccine. Our study justified the longer dose interval to enhance a higher antibody response. Our findings may also support the prioritization of uninfected individuals in regions where COVID-19 vaccine-sparing strategies are required.

A Peer-Based Educational Intervention Effects on SARS-CoV-2 Knowledge and Attitudes among Polish High-School Students.

To support high school students to develop knowledge they need to adhere to control measures during the pandemic, a peer-based educational intervention on SARS-CoV-2 was developed and its impact was evaluated. Multistage random sampling was used. The 50 min peer-based intervention was conducted by final year medical students. Baseline and post-intervention knowledge and attitudes were assessed. Significance was tested by McNemar's/Wilcoxon rank tests. Of 518 participants (mean age 17.8 years ± 0.43), 81.0% did not receive any school-based education on SARS-CoV-2. After intervention, the knowledge score improved from 65.2% to 81.6%, attitudes from 63.2% to 70.8% (both p < 0.0001). The effect size after the intervention compared to pre-intervention showed moderate improvement of knowledge, but not attitudes (d = 0.46 and d = 0.18, respectively). Pre- and post-intervention, females, students in non-science programs, living in cities < 250,000 inhabitants had lower knowledge, while fewer males, non-science program students, living in smaller cities presented positive attitudes. Before intervention, 67.0% students correctly named SARS-CoV-2 preventive methods and 73.6% were concerned COVID-19 is a serious disease; these improved after intervention (to 80.1% and 86.3%; p < 0.0001). The intervention was not very successful in increasing the intent to vaccinate for COVID-19 (pre-intervention 52.9%, post-intervention 56.4%; p < 0.007). Peer-based teaching for high school students can be effective in increasing SARS-CoV-2 knowledge and awareness. More efforts are needed to improve attitudes and enhance acceptance of vaccination against COVID-19.

Can Boosted Randomness Mimic Learning Algorithms of Geometric Nature? Example of a Simple Algorithm That Converges in Probability to Hard-Margin SVM.

In the light of the general question posed in the title, we write down a very simple randomized learning algorithm, based on boosting, that can be seen as a nonstationary Markov random process. Surprisingly, the decision hyperplanes resulting from this algorithm converge in probability to the exact hard-margin solutions of support vector machines (SVMs). This fact is curious because the hard-margin hyperplane is not a statistical solution, but a purely geometric one-driven by margin maximization and strictly dependent on particular locations of some data points that are placed in the contact region of two classes, namely the support vectors. The proposed algorithm detects support vectors probabilistically, without being aware of their geometric definition. We give proofs of the main convergence theorem and several auxiliary lemmas. The analysis sheds new light on the relation between boosting and SVMs and also on the nature of SVM solutions since they can now be regarded equivalently as limits of certain random trajectories. In the experimental part, correctness of the proposed algorithm is verified against known SVM solvers: libsvm, liblinear, and also against optimization packages: cvxopt (Python) and Wolfram Mathematica.

Use of masks in public places in Poland during SARS-Cov-2 epidemic: a covert observational study.

BACKGROUND: Face masks have been employed in the COVID-19 pandemic plans as a public and personal health control measure against the spread of SARS-CoV-2. In Poland, obligatory wearing of masks in public spaces was introduced on April 10th, 2020; a relaxation of previous universal measures was announced on May 29th, 2020, limiting use to indoor public places. OBJECTIVE: To assess use of masks or other protective devices in public spaces in Poland during the SARS-Cov-2 epidemic. METHODS: A non-participatory covert observational study was conducted on three dates, (10.05/18.05/25.05.2020) at public spaces in 13 regions with different risks. Ten consecutive individuals were observed by each of 82 medical students (n = 2460 observations), using a structured checklist. RESULTS: Among 2353 observed persons, the female/male ratios were 1.0, 1.1, and 1.0 on the three dates. Almost three quarters - 73.6% (n = 552/750) were using masks on date 1, 66.5% (544/818) on date 2; and 65.7% (516/785) on date 3. Cloth masks predominated on all dates (64.7-62.3%-62.6%), followed by medical (23.4-28.5%-26.9%). Being female (OR = 1.77-1.47-1.53 respectively) and location in a closed space (OR = 2.60-2.59-2.32) were each associated with higher usage. Participants in sports were about two times less likely to use masks (OR = 0.64-0.53-0.53) as compared to other activities. The proportion using masks correctly decreased gradually over time (364/552; 65.9%; 339/544; 62.3% and 304/516; 58.9%). More females wore masks correctly (date 1: 205/294; 69.7% vs 159/258; 61.6%, and date 3: 186/284; 65.5% vs 118/232; 50.9%; p = 0.045; p = 0.0008 respectively). Uncovered noses (47.3-52.7%) and masks around the neck (39.2-42.6%) were the most frequent incorrect practices. CONCLUSIONS: Practices were not in line with official recommendations, especially among males, and deteriorated over time. Cloth masks were predominantly used in public spaces. Health promotion, through utilizing all available communication channels, would be helpful to increase compliance.

Frequency of Occupational Bloodborne Infections and Sharps Injuries among Polish Paramedics from Selected Ambulance Stations.

To evaluate the prevalence of bloodborne infections (BBIs) and assess the incidence and selected risk factors for sharps injuries (SIs), a cross-sectional serosurvey was performed between December 2018 and October 2019 among 286 paramedics (76.5% males; mean age, 37 years) from 17 randomly selected ambulance stations in the West Pomeranian region of Poland. An ELISA system was used to detect anti-HBc, anti-HCV, and anti-HIV. HBV vaccination uptake was 95.6%; 7.3% (95% CI: 4.6-11.0%) paramedics were anti-HBc positive, and anti-HCV/anti-HIV seropositivity was not reported. Almost one-fourth of paramedics reported having had ≥1 SI during the preceding year (Me = 6.0, range 1-100). Most recent exposures primarily took place during an emergency procedure (76.7%), in an ambulance (45.2%), caused by hollow-bore needles (73.8%), and were not reported (50.0%). Additionally, 52.2% of paramedics reported needle recapping, and 52.6% did not use safety engineered devices (SEDs) at work. Mean knowledge score was low (2.6 ± 1.7); 3.4% had never participated in infection-control (IC) training, and those not trained were more likely to suffer a SI (odds ratio (OR) 4.64; p = 0.03). Due to frequent SIs, of which half are unreported, paramedics remain at risk of acquiring occupational BBIs. SI risk could be reduced by providing training on IC procedures, ensuring better compliance with safe work practices, and supplying more SEDs.

Changes in disease burden in Poland between 1990-2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Systematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990-2017, and compare Poland with other Central European (CE) countries. METHODS: The results of GBD 2017 for 1990 and 2017 for Poland and CE were used to assess rates and trends in years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs). Data came from cause-of-death registration systems, population health surveys, disease registries, hospitalization databases, and the scientific literature. Analytical approaches have been used to adjust for missing data, errors in cause-of-death certification, and differences in data collection methodology. Main estimation strategies were ensemble modelling for mortality and Bayesian meta-regression for disability. RESULTS: Between 1990-2017, age-standardized YLL rates for all causes declined in Poland by 46.0% (95% UI: 43.7-48.2), YLD rates declined by 4.0% (4.2-4.9), DALY rates by 31.7% (29.2-34.4). For both YLLs and YLDs, greater relative declines were observed for females. There was a large decrease in communicable, maternal, neonatal, and nutritional disease DALYs (48.2%; 46.3-50.4). DALYs due to non-communicable diseases (NCDs) decreased slightly (2.0%; 0.1-4.6). In 2017, Poland performed better than CE as a whole (ranked fourth for YLLs, sixth for YLDs, and fifth for DALYs) and achieved greater reductions in YLLs and DALYs than most CE countries. In 2017 and 1990, the leading cause of YLLs and DALYs in Poland and CE was ischaemic heart disease (IHD), and the leading cause of YLDs was low back pain. In 2017, the top 20 causes of YLLs and YLDs in Poland and CE were the same, although in different order. In Poland, age-standardized DALYs from neonatal causes, other cardiovascular and circulatory diseases, and road injuries declined substantially between 1990-2017, while alcohol use disorders and chronic liver diseases increased. The highest observed-to-expected ratios were seen for alcohol use disorders for YLLs, neonatal sepsis for YLDs, and falls for DALYs (3.21, 2.65, and 2.03, respectively). CONCLUSIONS: There was relatively little geographical variation in premature death and disability in CE in 2017, although some between-country differences existed. Health in Poland has been improving since 1990; in 2017 Poland outperformed CE as a whole for YLLs, YLDs, and DALYs. While the health gap between Poland and Western Europe has diminished, it remains substantial. The shift to NCDs and chronic disability, together with marked between-gender health inequalities, poses a challenge for the Polish health-care system. IHD is still the leading cause of disease burden in Poland, but DALYs from IHD are declining. To further reduce disease burden, an integrated response focused on NCDs and population groups with disproportionally high burden is needed.

School life and influenza immunization: A cross-sectional study on vaccination coverage and influencing determinants among Polish teachers.

OBJECTIVE: The general public influenza vaccination coverage in Poland is one of the lowest in the EU (3.7% in 2017/2018). Teachers have the potential to be a target group for immunization programs against influenza infection, however, there is yet to be a study in Poland, or even in the EU that has assessed influenza vaccine uptake among this group. The study objective was to evaluate influenza vaccination coverage and to assess influencing determinants amongst Polish teachers. METHOD: A cross-sectional questionnaire-based study was conducted among 277 teachers from 9 primary schools of two regional capitals of two Polish regions: Szczecin and Lublin. RESULTS: A quarter of teachers have ever received influenza vaccine; 4.5% reported receiving vaccination in the 2018/2019 season. The main reasons for not being vaccinated were a lack of confidence in its effectiveness (56.9%) and concerns related to adverse effects (30.6%). Forty four percent (43.8%) of teachers believed that they are at risk of influenza infection, only 62.5% indicated vaccination as an effective method of preventing influenza. Previous information about influenza (OR = 15.70), high knowledge level about influenza (OR = 2.56), family physician recommendation (OR = 2.39), belief that influenza vaccination should be mandatory for teachers (OR = 3.29), and having a vaccinated family member (OR = 2.68) were each associated with higher odds of immunization. Willingness to be vaccinated against influenza in the next season was strongly associated with current vaccination status (OR = 7.16). CONCLUSIONS: Influenza vaccination coverage among Polish teachers is alarmingly low; vaccine receipt was associated with teacher attitudes and beliefs. Future interventions related to maximizing vaccination coverage in this group should take advantage of the involvement of family physicians and specifically focus on teachers who have never been vaccinated before. As knowledge about influenza positively influences vaccination decisions, education strategies should focus on reducing knowledge gaps to alter attitudes and increase uptake.

Seroprevalence of anti-HBc, risk factors of occupationally acquired HBV infection and HBV vaccination among hospital staff in Poland: a multicenter study.

BACKGROUND: Due to numerous blood exposures hospital staff are at risk of acquiring hepatitis B virus (HBV) infections. This study aimed at estimating prevalence of HBV, associated risk factors and HBV vaccination among Polish health care workers (HCWs). METHODS: A cross-sectional sero-survey was conducted (October 2016-January 2018) in 10 randomly selected hospitals from two provinces: of low and high incidence of HBV, with the use of an anonymous, self- administered questionnaire. Blood samples were screened for hepatitis B core antibodies (anti-HBc) with enzyme immunoassay. RESULTS: Of the 306 participating HCWs, 88.6% were females, 69.9% nurses (mean age 47.8 ± 9.0 years). HBV vaccination was reported by 94.2%, participants (4.7% with 2 doses, 58.1% with 3 doses, 37.2% took a booster), but of these 75.1% reported no post-immunization serology. The sero-prevalence of anti-HBc was 12.1% (95%CI 8.4-15.7%); only 11.1% had ever screened themselves for HBV infection. Out of 37 anti-HBc positive HCWs, 29 reported being vaccinated for HBV; 10.5% vaccinated HCWs were anti-HBc positive. Regarding other occupational risk factors, 27.8% had experienced a sharp injury (SI) in the last year, 80.0% of incidents were not reported. The use of safety devices (SD) was 86.3%; 35.9% participants used to recap a needle. Older age (OR = 4.24), lack of HBV vaccination (OR = 7.42), working at the province of high HBV incidence in the general population (OR = 2.69) were each predictors of participant's HBV infection. CONCLUSIONS: High anti-HBc seroprevalence was found in hospital staff with older generation particularly constituting a risk group. Unsatisfactory vaccination coverage and the use of SDs, needle recapping and under-reporting of SIs were main modifiable risk factors regarding HBV infection. The study provides evidence of the protective role of HBV vaccine, as well as the possible effect of HBV incidence in the general population on HCW's anti-HBc seropositivity. Universal vaccination, followed by strict policies to confirm immunity, better compliance with infection-control practices and widespread implementation of SDs should be enforced to protect hospital staff from occupationally acquired HBV infections.

Parental Knowledge about Meningococcal Disease and Vaccination Uptake among 0⁻5 years Old Polish Children.

In Poland, in addition to mandatory, free of charge vaccines, listed in the national immunization schedule, numerous self-paid vaccinations are recommended, including meningococcal vaccination (MV). To assess MV uptake among ≤5-year-old children and to evaluate parental knowledge and attitudes regarding invasive meningococcal disease (IMD). A cross-sectional study was conducted in 2018 among 350 parents (mean age: 32.3 years), attending three randomly selected primary care clinics in Szczecin region, Poland. Anonymous questionnaires were administered to the parents by researchers, present at the time the survey was conducted, to self-complete on a voluntary basis. Chi-square or Fisher's exact for categorical and Mann⁻Whitney U test for continuous variables. Variables significantly (p < 0.05) associated with 'good knowledge' in the bivariate analysis were used to build a logistic regression model. It was found that the response rate was 93.4%, and MV uptake among children was 29.5%. The main knowledge sources were medical staff and media; 72.5% had ever received information about IMD. Only 18.8% of parents self-assessed their knowledge regarding IMD as good; 61.8% scored >50% in the knowledge test 58.9% knew the mode of transmission, 58.7% recognized the severity of meningitis, and 79.7% knew that bacterial meningitis is a vaccine-preventive disease. Knowledge regarding IMD was higher among parents with higher educational level (OR = 3.37; p = 0.01), from urban facilities (OR = 2.20; p = 0.02), who received previous information about IMD (OR = 2.85; p = 0.01) and self-assessed their knowledge as good (OR = 2.59; p = 0.04). Low MV coverage among children up to five years old and knowledge gaps about IMD call for awareness campaigns which may increase the coverage. Although educational interventions should cover all parents, those from provincial facilities, representing lower education level need special attention.

Factors that Predict Parental Willingness to Have Their Children Vaccinated against HPV in a Country with Low HPV Vaccination Coverage.

Background: Adolescent HPV (Human Papilloma Virus) vaccination is yet to be introduced as a mandatory program in Poland. Polish literature on factors associated with adolescent HPV vaccination is scant, despite the fact that uptake is one of the poorest in the European Union. Objectives: To assess HPV awareness and identify independent predictors for parental willingness to have their children vaccinated against HPV. Methods: All parents of first grade students from three selected high schools in Zgorzelec, Poland, who participated in parent-teacher meetings at the time the study was conducted, had their children unvaccinated regarding HPV, and who gave informed consent to participate were included. There were 600 first grade students; 9 were vaccinated against HPV. This left 591 parents who met the eligibility criteria; the response rate was 76.1%. Results: Awareness of HPV was reported by 55.3% of 450 parents (mean age 42 years, 70.9% females); 85.1% expressed their willingness to vaccinate their children against HPV; 31.3% identified HPV as a sexually transmitted pathogen, and 36.2% identified it as a risk factor of cervical cancer. Multivariable logistic regression analyses indicated that being employed (OR 2.09; 95% CI: 1.10-3.86), having positive attitudes toward vaccines (OR 3.02; 95% CI: 1.34-6.49), previous information about HPV (OR 2.02; 95% CI: 1.17-3.51), and concerns about the side effects of the HPV vaccine (OR 0.60; 95% CI: 0.35-0.99) were independent predictors of parents' willingness to vaccinate. Conclusions: Attitudes regarding their child being vaccinated against HPV were positive among Polish parents, even though awareness and knowledge of HPV in this group were low. Most of the significant factors that influenced their willingness were modifiable, such as being informed about HPV and having positive attitudes toward vaccines. Future interventions should focus specifically on vulnerable subgroups, such as unemployed parents.

Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study.

OBJECTIVES: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time. METHODS: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively. RESULTS: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older (p = 0.002) and had lower scores for pre-fracture ADL/IADL (p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months (p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores. CONCLUSIONS: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function and preserving functional capacity in older persons at high risk of HF.

Attitudes, Beliefs and Predictors of Male Circumcision Promotion among Medical University Students in a Traditionally Non-Circumcising Region.

Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013-2016 at the Medical University in Szczecin, Poland, among final year Polish/foreign students from Northern Europe, using a standardized questionnaire. Results: There were 539 participants, median age 25 years, 40.8% males, and 66.8% were Polish nationals. The MC rate was 16.7%. Regarding HIV/AIDS knowledge, 66.6% of the students scored more than 75%; and, 34.2% knew that MC reduces the risk of HIV infection. One in eleven respondents (9.1%) believed that circumcised men felt more intense sexual pleasure. More than half of the respondents (54.8%) declared that they would recommend MC to adult patients at risk for HIV. The belief that circumcised men felt more intense sexual pleasure, and knowledge on MC regarding HIV risk reduction was associated with greater odds of recommending adult MC (OR = 3.35 and OR = 2.13, respectively). Conclusions: Poor knowledge of its benefits and a low willingness to promote the procedure-strongly dependent on personal beliefs-suggest that medical students may need additional training to help them to discuss MC more openly with adult men at risk for HIV infection. Knowledge may be an effective tool when making decisions regarding MC promotion.

A cross-sectional sero-survey on preoperative HBV vaccination policy in Poland.

BACKGROUND: A two-dose preoperative vaccination schedule against HBV has been the widely accepted policy in Poland. However, its effectiveness has not yet been assessed. OBJECTIVE: To evaluate a two-dose preoperative HBV vaccination policy by an assessment of the proportion of patients who don't present a protective level of anti-HBs (<10.0 mIU/ml). METHODS: Consecutive patients from surgical/gynecologic wards of 12 randomly selected hospitals in West Pomerania, Poland, hospitalized between 2010 and 2013, vaccinated against HBV with a two-dose regimen, were asked to complete an anonymous questionnaire. Serum samples were assayed for anti-HBs with the use of third-generation testing methods. To compare sensitivity versus specificity across a range of values for the ability to predict a dichotomous outcome (a protection against HBV infection) a Receiver operating characteristic (ROC) curve was determined. RESULTS: There were 193 patients, 58.5% women, median age 52 years. Almost a half (46.0%) of the patients were operated on within 0-60 days of taking the second vaccine dose, 16.2% - 61-180 days after, 37.8% >180 days after. Anti-HBs titer was below a protective level in 49.2% of participants (0.0 mIU/ml in 17.8%, 0.1-9.9 mIU/ml in 31.4%); none of them were aware of this fact. Age ≤ 52 years (OR = 1.89) and having surgery more than 37.5 days after HBV vaccination (OR = 2.70) were associated with greater odds of being protected against HBV infection through vaccination. For the time frame between the second dose implementation and surgery 23 days, a sensitivity of 84% and specificity of 22% for obtaining protection against HBV infection was found, for the time frame >37.5 days - sensitivity remained high (80%), while specificity increased (41%); there was an apparent peek on the ROC curve between 38 and 60 day. In the group vaccinated 0-37.5 days before surgery, less patients had the protective level of anti-HBs titer than in vaccinated 38-60 days before surgery (32.3% vs 60.0%; p = 0.03). CONCLUSIONS: The success rate in achieving adequate immune protection with two dose HBV vaccination schedule in preoperatively vaccinated patients is relatively low, especially among those vaccinated less than five weeks prior to surgery. In more than a third of cases the standard three-dose regimen could have been implemented, as participants had time to complete a third dose. Current recommendations regarding a preoperative policy with a 2-dose vaccination schedule in Poland should be revised; the best time to perform surgery after the implementation of the second dose of vaccine in the context of patient protection against HBV infection would be between 38 and 60 days.

Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation.

The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. METHODS: A cross-sectional study was conducted (November 2015-April 2016) among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65-89) who agreed to participate, 34.8% (95% Confidence Interval: 28.6-41.0%) were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001). A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69), living in the urban area (OR = 7.69), having comorbidities (OR = 2.70), having a vaccinated family member (OR = 3.57), and being informed about vaccination (OR = 5.00) were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59) with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas.

A Cross-Sectional Study on Selected Correlates of High risk Sexual Behavior in Polish Migrants Resident in the United Kingdom.

Objective: To assess the correlates of the high risk sexual behaviors of Polish migrants in the United Kingdom (UK) after 2004, and to compare such behaviors before/after immigration. Methods: In 2013, a cross-sectional study was conducted through the use of a Computer-assisted web interviewing surveying technique with the use of a self-administered questionnaire. Results: Among 408 respondents (56.9% women), with a median age of 32 years, significantly more admitted to having unprotected sexual contact with a casual partner while in the UK (p < 0.0001) than while in Poland; more were engaged in sex after the use of recreational drugs and alcohol (p < 0.0001 and p = 0.001 respectively). Being a male was associated with greater odds of unprotected sex, sex after the use of alcohol, and having multiple partners. Being single and having only been a resident for a short time in the UK, presenting a lower self-esteem, were predictors of unprotected sex. A total of 19.6% of the respondents admitted to having been tested while in Poland, a lower (p < 0.0001) frequency than while in the UK (49.5%); this referred to both genders; 1.2% (95% CI: 0.79-2.83%) reported that they were HIV positive. Conclusions: Migration can create a vulnerability to STIs, especially for single male migrants with low self-esteem, staying in the UK for less than two years. The results point to strengthening strategies which help reduce high risk sexual behavior among Polish migrants, and to introduce interventions to promote an awareness of HIV sero-status.

Prevalence of HBV Infection and Knowledge of Hepatitis B Among Patients Attending Primary Care Clinics in Poland.

It is well known that community awareness of hepatitis B (HB) can lead to vaccination and testing. The study objectives were to assess the prevalence of HBV infection and knowledge of HB among adult patients attending randomly selected primary care clinics. A cross-sectional sero-survey was conducted in March 2013 in the Zgorzelec region, Poland, with the use of an investigator-developed questionnaire containing 22 questions regarding HB knowledge. Serum samples were assayed for anti-HBc total and anti-HBs with enzyme immunoassay. The prevalence of anti-HBc total among 410 participants (median age 56 years) was 10.3 % (95 % CI 7.6-13.8 %), nobody was aware of an infection. The main sources of HB knowledge were the media and medical staff. The mean knowledge score was 14.8 ± 4.9; 76.7 % of the respondents had scores >50 %. Particular gaps were detected relating to knowledge of unprotected sexual intercourse and MTCT; 45.6 % patients were not aware of the potential asymptomatic course of HBV infection, 41.2 % about chronic HB treatment. A patient's low educational level was negatively associated with a high knowledge level; the willingness for further education on HB and HBV vaccination in the past were independently associated with good knowledge. In conclusion, the HBV infection remains a public health threat in Poland, since the prevalence of infection markers in asymptomatic adult patients was high. Knowledge gaps call for awareness campaigns which may increase testing and diagnosis, audiences representing lower education level should be targeted first. Knowledge on HB might serve as an effective tool in decision making regarding vaccination.

A cross-sectional serosurvey on hepatitis B vaccination uptake among adult patients from GP practices in a region of South-West Poland.

BACKGROUND: Hepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination is widely recommended for those not covered by the national immunisation program. OBJECTIVE: To assess the coverage and influencing determinants of HBV vaccination among adult patients attending GP clinics as well as to establish serological status in terms of HBV infection. METHODS: Patients who were seen consecutively in March 2013 at four randomly selected GP practices located in Zgorzelec county, in south-western part of Poland, were invited to participate and complete questionnaires on socio-demographic data and other factors related to vaccination. A pilot study was done in one urban GP practice in the city of Gryfino (Gryfino county), the results have been included in the study. Patients' immunisation status was assessed basing on vaccination cards and anti-HBs titer with the use of third-generation testing methods. In addition, serum samples were assayed for anti-HBc total. RESULTS: Response rate: 99.3 %. Of 410 participants (66.1 % females, median age 56 years), 55.4 % (95%CI:50.5-60.1 %) were previously vaccinated; in those 11.5 % took 2 doses, 66.1 % - 3 doses,18.1 % - 4 doses. Elective surgery was the main reason (57.7 %) for HBV immunization, 4.8 % - were vaccinated due to recommendations by GPs. The multivariable logistic regression model revealed that living in a city (OR 2.11), and having a surgery in the past (OR 2.73) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6 % (95%CI:9.3 %-19,5 %), and 7.2 % (95%CI:4.4-11.8 %) among those vaccinated. CONCLUSIONS: Low HBV immunization coverage among adult patients from GP clinics and the presence of serological markers of HBV infection among both - those unvaccinated and vaccinated call for comprehensive preventative measures against infection, including greater involvement of family doctors. Although interventions should cover the whole population, inhabitants living in the rural areas should be a group of special interest. Preoperative immunization for HBV seems to be an efficient public health tool to increase the vaccination uptake.