Validity and Reliability of the Polish Version of the Tilburg Frailty Indicator (TFI).

BACKGROUND: In the last decade, studies on frailty have become increasingly frequent in the literature on aging, and also the number of available questionnaires regarding frailty has increased over the years. Therefore, the choice of which questionnaire to use is becoming more difficult. OBJECTIVE: The aim of this study was to assess the psychometric properties of the Polish version of the Tilburg Frailty Indicator (TFI), an instrument that identifies frailty in the elderly population. DESIGN: Setting, and Participants. The study was carried out in a community-based setting in Wroclaw, Poland. Nurses and doctors (general practitioners) administered the TFI in primary care facilities. Participants included a sample of 212 community dwelling elderly aged 60 or older (mean age:70.6 SD≥7.16). MEASUREMENTS: The validation (assessment of face validity, content validity) was carried out in accordance with the literature. The Tilburg Frailty Indicator (TFI) consists of two different parts. One part addresses the potential determinants of frailty and the other specifically addresses the components of frailty, covering its physical, psychological and social domains. Scale reliability was estimated using two methods: Cronbach's alpha, measuring the scale's internal consistency, and the test-retest method, determining the scale's absolute stability. To assess test-retest reliability, the same group was re-interviewed by the same observer within 10-14 days of the first interview. RESULTS: The test-retest reliability showed a high level of agreement for all items of the instrument, with values ranging from 96 to 100%. The Cronbach's Alpha internal consistency was 0.74. CONCLUSION: The Polish version of the TFI proved to be a valid and reproducible tool for assessment of Frailty Syndrome for the Polish population. We would recommend to be used as the screening tool to assess frailty.

Seasonal variation in ischaemic stroke frequency in Podlaskie Province by season.

PURPOSE: The aim of the present study was to assess seasonal differences in ischaemic stroke among patients hospitalized in Department of Neurology in Bialystok during 2002-2005. MATERIAL AND METHODS: To examine the seasonal incidence of ischaemic stroke, we analyzed data from the Department of Neurology in Bialystok in a retrospective study. The year was divided into four seasons: spring (March, April, May), summer (June, July, August), autumn (September, October, November), and winter (December, January, February). Seasonal differences were studied in relation to the following clinical characteristics: age, gender, history of stroke, and time of stroke onset. RESULTS: Age of patients with ischaemic stroke ranged 19 between 101 years, a mean age was 72.4 +/- 12 years. Incidence of ischaemic stroke increased in the last years. We noted a higher incidence of ischaemic stroke in older patients (mean 74.36 years old) during winter months than in patients (71.40 years) in summer months. Gender had no effect on incidence of ischaemic stroke. Significant seasonal variation of ischaemic stroke in all years (p = 0.0010) and for 2005 year (0.0090) were found. Incidence of ischaemic stroke was depend on month of year. Significant increase of ischaemic stroke was noted in December. The lowest incidence of stroke was observed in August and September. CONCLUSION: Incidence of ischaemic stroke increased in the last years. The present findings suggest an increase in the incidence of ischaemic stroke in winter in December.

Comparative analysis of quality of life women in menopause period in Poland, Greece and Belorussia using MRS Scale. Preliminary report.

PURPOSE: The aim of this study was the assessment of climacteric symptoms, the activity and quality of life of women in menopausal period from Poland, Greece and Belorussia using a Menopause Rating Scale (MRS). MATERIAL AND METHODS: The study was conducted among women in age after 45 years, from Poland (55), Belorussia (50) and Greece (85). MRS was obtained from the Professor Heinemann from Center of Epidemiology and Health Studies in Berlin. The scoring scheme is simple, i.e. the score increases point by point with increasing severity of subjectively perceived symptoms in each of the 11 items (severity 0--no complaints, 4 scoring points--severe). The respondent provides her personal perception by checking one of 5 possible boxes of "severity" for each of the items. RESULTS: Mild and no complaints in similar degree were reported by all women from these three countries. We found significant (p < 0.001) differences between severe complaints reported by Greek women compared with complaints respondents from Belorussia and Poland. Moderate complaints were reported more frequently by women from Poland (32.56%) and Belorussia (34%) compared with women from Greece (28.55%). Severe complaints were noted more rarely in 1.6% Greek women compared with 2.6% Belorussian and 3% Polish respondents. No significant differences between no complainants, mild, moderate, marked and severe between women from Belorussia, Poland and Greece. CONCLUSIONS: Generally we did not observe significant differences between reported complaints by women from Belorussia, Poland and Greece.

Quality of life and its relationship to the degree of illness acceptance in patients with diabetes and peripheral diabetic neuropathy.

PURPOSE: Assessment of quality of life, especially from the psychological point of view, is likely to be strongly influenced by the degree of acceptance of one's own illness and the resultant negative emotional reactions associated with the illness itself. The aim of the present study was to determine the relationship between quality of life and the degree of acceptance of illness in diabetic patients with and without peripheral diabetic neuropathy. MATERIAL AND METHODS: 59 patients with diabetes were included in the study; they consisted of patients both with and without peripheral diabetic neuropathy. The degree of acceptance of illness was assessed using the Acceptance of Illness Scale (AIS) and quality of life (HRQOL - health-related quality of life) was measured using the SF-36v2. RESULTS: Quality of life in people with diabetes was reduced and related to their levels of illness acceptance. Factors affecting illness acceptance in patients with peripheral diabetic neuropathy included feelings of being a burden to their family and friends (p < or = 0.05) and the belief that people in their company are made anxious by the patient's illness (p < or = 0.05). These patients also defined their health status as being worse than that of diabetic patients without additional disease complications. CONCLUSIONS: Quality of life and illness acceptance were found to be strongly related. In general, patients with chronic peripheral diabetic neuropathy express lower degrees of acceptance of their illness than diabetic patients without peripheral diabetic neuropathy. Their subjective assessment of health status is also significantly worse than that of diabetic patients without neuropathy.

Exposure the doctors to aggression in the workplace.

PURPOSE: To evaluate the frequency, source and type of aggression towards doctors, depending on their place of work and position. MATERIAL AND METHODS: The study was conducted among 501 doctors from the area of Podlaskie Province. To evaluate the level and type of aggression towards doctors in their workplace we used a questionnaire prepared for the needs of this study by modifying the questionnaire "The frequency and consequences of exposing nurses to workplace aggression", which had been drafted by the Institute of Labour Medicine in Lódz. The results were analysed with the application of the chi-square and the Kruskal-Wallis tests. RESULTS: The most common form of aggression was voice raising, which happened to 80% of doctors employed in inpatient medical centres and 91% doctors from outpatient centres. More than a half of the subjects have heard threats from their patients. Verbal aggression from doctors' superiors happened most often in surgery wards (48%), neurology wards (40%), admission rooms (33%). The causes of aggression most often quoted by doctors include: staff shortages (9%), stress--tiredness (9%). CONCLUSIONS: Workplace aggression towards doctors may be inflicted both by patients and colleagues. The aggression in the medical environment can take on different forms and create a threat in the workplace. Doctors working in hospital wards (psychiatry, surgery, neurology) are the ones who are the most exposed to aggression.

Nursing problems of patients with systemic sclerosis.

UNLABELLED: Systemic sclerosis (SSc) is a chronic autoimmune disease connective tissue and one of the most common collagen diseases. There are several clinical types of scleroderma which differ in their course, possible complications and prognosis. The most characteristic form SSc is limited and diffuse systemic sclerosis. The SSc is characterized by the progressive fibrosis of the skin and internal organs, leading to their failure, morphology and blood vessels disorders. PURPOSE: The aim of our work is to identify the main health problems of patients suffering from systemic sclerosis depending on its clinical form: limited systemic sclerosis (ISSc) and diffuse systemic sclerosis (dSSc); to determine the influence of disease duration on symptom intensification in patients with LSSc and dSSc. MATERIAL AND METHODS: The study group consisted of 63 patients with systemic sclerosis diagnosed according to the criteria of the American Rheumatism Association (ARA), 47 of whom had limited systemic sclerosis (ISSc) (74.6%) and 16--diffuse systemic sclerosis (dSSc) (25.4%). CONCLUSIONS: The key thing in the complex therapy is to recognize the individual care problems of the patient, to assess his ability to cope with the disease in daily life and to plan care, support, education and help of other professionals. The main aim of individual nursing care is to alleviate ailments, prevent infections, observe life-threatening conditions and to educate the patient as regards self-care and self-observation.

Complementation analyses of Pseudomonas solanacearum extracellular polysaccharide mutants and identification of genes responsive to EpsR.

Many plant-pathogenic bacteria require extracellular polysaccharides (EPS) for successful infection. For example, mutations tht prevent EPS production in the bacterial wilt pathogen, Pseudomonas solanacearum, will reduce the ability to wilt plants. While several P. solanacearum EPS genes have been identified and characterized, a systematic analysis of EPS mutants has not previously been performed. We have screened over 12,000 transposon-tagged mutants and categorized 66EPS::lacZ mutants into nine complementation sets. Five of these are composed of previously characterized EPS structural and regulatory loci; four contain newly described EPS loci. One of the four novel complementation sets has been determined to be defective for both EPS and lipopolysaccharide production. We also used the EPS::lacZ mutants to examine the interaction between P. solanacearum EPS genes. Overexpression of the previously described regulator EpsR was found to down-regulate the expression of genes encoding production of the major acidic form EPS.

Antioxidant enzyme activities in different brain areas of the neurological mutant--pt rabbit.

Cu, Zn-superoxide dismutase (Cu,Zn-SOD), Mn-superoxide dismutase (Mn-SOD), catalase (CAT), peroxidase (POX), glutathione peroxidase(GP) and glutathione reductase (GR) activities were assayed in the brains of genetically selected neurological mutant rabbits pt and their controls. Paralytic tremor (pt) is a spontaneous mutation in rabbit that affects irregular and defective myelination of CNS. Antioxidant enzyme levels were different in three brain regions: brain hemispheres, cerebellum, and brain stem. In brain hemisphere and cerebellum of pt rabbits Mn-SOD and Cu, Zn-SOD activities were elevated. Catalase activity in brain hemispheres and peroxidase activity in the brain stem of pt rabbits were reduced. It was also noticed, that in the pt rabbit the ratio CAT/Cu, Zn-SOD was lower by 20% in the brain hemispheres and by 13% in the cerebellum and the ratio POX/Cu, Zn-SOD was lower by 31.8% in the brain stem. These findings indicated that pt mutations are associated with changes in the antioxidant defense system in the rabbit brain.