Understanding the experiences of PHC nurses in caring for older patients in the post-fifth wave of the COVID-19 pandemic: an exploratory qualitative study.

Objective: To ensure the best possible care, the perspective of PHC nurse work experience during the COVID-19 pandemic should be considered when developing nursing care protocols for older patients who receive PHC services. Method: This exploratory qualitative study was conducted with 18 nurses working continuously in PHC between the first and fifth waves of the pandemic. Semi-structured thematic interviews were undertaken. Qualitative thematic content analysis was conducted to identify and group the themes that emerged from the discourse. Interviews were transcribed and analyzed using thematic analysis. Results: The first topic describes the nurses' experiences of physical and mental suffering in caring for older patients in response to the pandemic. The second topic covers the experience of reorganizing PHC work. The third topic focuses on the difficulties of caring for older patients. The final topic includes issues of support needs for nurses in PHC work. Conclusion: The experience and understanding of PHC nurses in caring for older people during the COVID pandemic should lead to significant changes in the system of nursing care for geriatric patients and in the cooperative role within geriatric care specialist teams. Drawing on the experience of COVID-19, it is necessary to work on the weak points of PHC exposed by the pandemic in order to improve the quality of care and life for geriatric patients.

Association between cyberchondria and the use of complementary and alternative medicine (CAM) - a cross-sectional study.

INTRODUCTION AND OBJECTIVE: Cyberchondria has been described relatively recently as a behaviour characterized by excessive Internet searching for medical information related to increasing levels of health anxiety. Complementary and alternative medicine (CAM) refers to a broad set of health care practices that are not part of a country's traditional or conventional medicine, and are not fully integrated into the dominant health care system The aim of this study is to evaluate the relationship between cyberchondria and the use of complementary and alternative medicine. MATERIAL AND METHODS: A cross-sectional study was conducted from 25 April - 25 December 2022. A computer-assisted web interviewing (CAWI) survey technique was used. The study population consisted of 626 respondents who took part in the study. RESULTS: The severity of cyberchondria is associated with 'a greater number of CAM products used' (beta = 0.101; p = 0.043), 'a greater number of self-help techniques used' (beta = 0.210; p<0.001), searching for knowledge about CAM on the Internet (beta-0.199; p<0.001), using sources other than books (beta = -0.114; p = 0.025), younger age (beta = -0.170; p<0.001) and worse education (beta = -0.101; p = 0.033). CONCLUSIONS: The research results indicate that there is a link between cyberchondria and the use of CAM. However, since some components of the CSS-PL scale and self-rated health were not associated with more frequent use of CAM, it is likely that these results may not be fully reliable. The association between cyberchondria and CAM use should be investigated in further studies using comprehensive medical interviews.

The Relationship between Diet and the Occurrence of Depressive Symptoms in a Community Example with High Rates of Social Deprivation: A Cross-Sectional Study.

Research suggests that various biological and psychosocial mechanisms are involved in the heterogeneous and complex relationship between dietary patterns and depressive symptoms. The occurrence of depressive symptoms is thought to be related to socioeconomic status (SES), with those with lower SES being more likely to experience persistent depression. The aim of the undertaken study was to investigate whether socioeconomic and health variables are associated with dietary assessment in a population with high rates of social deprivation and whether a relationship exists between dietary assessment and depressive symptoms (DS). The respondents' nutrition was evaluated through a qualitative method, using the Perinumeric Periodic Table questionnaire by Starzynska. At the same time, the prevalence of DS was assessed employing the Patient Health Questionnaire-9 (PHQ-9). In the DS screening (PHQ-9 ≥ 10), in the entire study population, the risk of DS was 16.1% (n = 605). In our entire study population, up to 61.2% (n = 2297) of the respondents exhibited poor dietary patterns. In the multivariate model, women with almost adequate or poor dietary assessment were 1.62 and 2.18 times more likely to score at least 10 on the PHQ-9 questionnaire, as compared to women whose dietary assessment was good or adequate. In conclusion, it was determined that sociodemographic variables affect nutritional habits. Women who lived in rural areas limited to a vocational education had significantly poorer diets. Moreover, men, younger men, smokers, and those without chronic diseases were characterized by a poorer dietary assessment. Additionally, women who had a better dietary assessment were significantly more likely to have lower scores on the questionnaire assessing the occurrence of DS (PHQ-9 10).

The relationship between the strength of religious faith and spirituality in relation to post-traumatic growth among nurses caring for COVID-19 patients in eastern Poland: a cross-sectional study.

Introduction: The COVID-19 pandemic had forced intensive care unit (ICU) nurses to adapt to extreme conditions in a short period of time. This resulted in them experiencing extremely stressful situations. The aim of this study was to assess the relationship between post-traumatic growth (PTG) and religiosity and spirituality (R/S) among nurses caring for COVID-19 patients in intensive care during the pandemic. Materials and methods: 120 nurses working in Lublin, eastern Poland, participated in the cross-sectional study. The questionnaire was made up of three standardised tools: The Post-Traumatic Growth Inventory, The Santa Clara Strength of Religious Faith Questionnaire, The Spiritual Attitude and Involvement List. Results: In terms of spirituality, the study group of nurses achieved the highest score in the Connectedness with Nature subscale (4.37 ± 1.07), while the strength of religious beliefs had a positive correlation with post-traumatic growth only in the Spiritual changes subscale (r = 0.422, p < 0.001). The following dimensions of spirituality were significantly correlated with post-traumatic growth in the multi-factor model that included religiosity and spirituality: Transcendent experiences, Spiritual activities, Meaningfulness, Acceptance, and Trust. We saw that increase in the assessment of the Transcendent experiences, Meaningfulness and Trust subscales significantly mirrors increase in post-traumatic growth, while increase in the assessment of the Spiritual activities and Acceptance subscales significantly mirrors decrease in post-traumatic growth. The above variables explained up to 44% of the dependent variable. Conclusion: Both religiosity and spirituality were significantly associated with post-traumatic growth in the group of ICU nurses, but spirituality appears to have played a larger role. Our findings support the value and significance of the development of spiritual and religious identity as a means of enhancing positive psychological changes in the face of traumatic events.

The Prevalence of Depression Symptoms and Their Socioeconomic and Health Predictors in a Local Community with a High Deprivation: A Cross-Sectional Studies.

Depression is a heterogeneous and etiologically complex psychiatric syndrome thatshows a strong sexual dimorphism and often impacts people with a low socioeconomic status (SES). The aim of the study was to estimate the occurrence of depression symptoms in a local community with a high deprivation rate, the example being the inhabitants of the JanówLubelski County in eastern Poland. A cross-sectional study was carried out on 3752 people aged between 35 and 64. The prevalence of depression symptoms was assessed using the Patient Health Questionnaire-9 (PHQ-9) scale. In the screening for depression symptoms in the entire population we studied, the risk of depression symptoms was 16.1% (n = 605), with women having a significantly higher mean score than men (p < 0.001). Significant predictors associated with the achievement of 10 points and more in the PHQ-9 assessment in the case of women and men were: living alone, education and having comorbidities. Moreover, female participants living in rural areas were significantly more likely to exhibit depression symptoms, whereas smoking was a significant predictor of depressive symptoms in men. It was observed that in the case of obese women, the chance of being in the higher category of the PHQ-9 assessment was 1.41 times higher than in women with normal body weight. However, in the case of men, an increase in age by one year increased the chance of being in a higher category by 1.02 times. Moreover, the odds of falling into a higher category, as assessed by the PHQ-9 questionnaire, among men who drink alcohol more than once a week was 1.7 times higher than in men who do not drink or consume alcohol occasionally. Summarising the results of studies conducted in a local community characterised by a high deprivation rate, socioeconomic and health variables related to SES significantly impacted the incidence of depression, but they differ in terms of gender.

Level of social competencies of nurses in primary health care and their selected work-related determinants-A cross-sectional study.

AIM: The aim of our study was to assess the level of social competencies among primary health care nurses, and to identify the work-related determinants. BACKGROUND: Developing social skills of nurses are necessary to establish better relations with patients. Improving these skills allows for higher quality of patient care, as well as patient and nurse satisfaction. METHODS: For the study, 253 primary health care centres were randomly chosen in the Eastern Poland; 600 questionnaires were sent to the nurses employed in these facilities. After checking whether the data met the requirements, 446 nurses took part in the survey. The data were collected using the Social Competencies Profile, the Copenhagen Psychosocial Questionnaire, and the catalogue of primary health care nurse activities. RESULTS: Older nurses possess lower level of social skills (r = -0.10, p = 0.04). Postgraduate education in the last 2 years differentiated the results of social competencies (p = 0.03) as well as place of residence in the subscale community awareness (p = 0.04). The predictors of social skills among psychosocial work conditions were as follows: Influence at Work (p = 0.02), Possibilities for Development (p < 0.001), Meaning of Work (p < 0.001), Social Support (p = 0.001), Quality of Leadership (p = 0.03), Job Satisfaction (p < 0.001), and General Health (p = 0.001). On the other hand, tasks like Activities in the treatment room (p = 0.003) and Promotion and prevention (p < 0.001) carried out by a nurse anticipated higher level of social skills. CONCLUSIONS: The results of the research proved that work-related factors such as influence at work, professional development, sense of social support, understanding of the meaning of work, perception of the quality of leadership, and higher job satisfaction influence the development of social competencies of nurses; therefore, shaping an appropriate work environment is an important task, especially for leaders and managers of nursing. IMPLICATIONS FOR NURSING MANAGEMENT: We recommend that nursing leaders and health policy makers adopt new strategies and educational programs, which include social skills training as part of the curriculum for the development of the social competencies of nurses.

Factors Predicting Post-Traumatic Positive and Negative Psychological Changes Experienced by Nurses during a Pandemic COVID-19: A Cross-Sectional Study.

It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of this study is to determine the relationship between selected sociodemographic variables and selected subjective cognitive resources, and the positive and negative perception of the consequences of the COVID-19 pandemic in a group of nurses working in Poland. The computer-assisted web interviewing method was conducted between 1 and 15 May 2020. Participants were requested to complete the following questionnaires: The Changes in Outlook Questionnaire (CIOQ), The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Safety Experience Questionnaire (SEQ), and The Meaning in Life Questionnaire (MLQ). Three-hundred and twenty fivenurses working all over Poland participated in the study. Their mean age was 39.18 ± 11.16 years. A higher average level was noted among the surveyed nurses in the Positive Change subscale (18.56 ± 4.04). In a multivariate model, taking into account both sociodemographic and cognitive variables, the level of perceived traumatic stress, the level of social support, a sense of security, reflection on safety and a sense of meaning and meaning in life were independent predictors of a positive perception of the consequences of the COVID-19 pandemic. Those variables explained as much as 37% of the dependent variable, and the nature of the relationship was positive. While we are still a long way from understanding the full range of the long-term impact of the COVID-19 pandemic on mental health and psychosocial well-being, it is possible that in this challenging context there are many individual resources available to perceive the effects of the current pandemic positively. Therefore, they should be strengthened through the development and implementation of intervention programs to improve the mental state of nurses.

Factors Influencing the Concentration of Exhaled Nitric Oxide (FeNO) in School Children Aged 8-9-Years-Old in Krakow, with High FeNO Values ≥ 20 ppb.

Background and Objectives: Measurement of fractional exhaled nitric oxide (FeNO) concentration is currently used as a non-invasive biomarker to assess airway inflammation. Many factors can influence the FeNO level. However, there have been no reports concerning factors attributed to FeNO levels in different age groups of children, especially those with high FeNO values. Therefore, this study aimed to assess the influence of selected factors on nitric oxide concentration in exhaled air in children aged 8-9 attending class 3 of public primary schools in Krakow with high FeNO values ≥ 20 ppb. Materials and Methods: The population-based study covered all third-grade pupils attending primary schools in the city of Krakow. Five thousand, four hundred and sixty children participated in the first screening stage, conducted from October 2017 to January 2018. Then, 792 participants with an FeNO level ≥ 20 ppb were selected. Finally, those selected pupils were invited to participate in the second stage, diagnostic, in April 2018. Four hundred and fifty-four children completed the diagnostic stage of the study, and their data was included in the presented analysis. Results and Conclusions: Significantly higher FeNO levels were observed in children diagnosed with the following diseases: asthma, allergic rhinitis, atopic dermatitis, and allergy (p < 0.05). In addition, it was observed that a higher FeNO concentration characterised children taking antihistamines compared to children not taking those medications (p = 0.008). In multivariate models, we observed that regardless of sex, age, BMI value, home smoking, and whether they were taking medications, children who had allergic rhinitis, or atopic dermatitis, or allergies had significantly higher FeNO levels. The strongest relationship was noted with allergic diseases. The results of our study may be of importance to clinicians when interpreting FeNO results, for example, when making a therapeutic decision.

Prevalence of Depression and Anxiety in Nurses during the First Eleven Months of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

The high risk of coronavirus (COVID-19) infection can increase the physical and psychological strain on nurses in professional practice, which can lead to mental health problems. The purpose of this systematic review and meta-analysis is to establish and estimate the combined incidence of depression and anxiety among nurses during the COVID-19 pandemic using standard measurement tools. A systematic search of the electronic databases PubMed, Web of Science, and SCOPUS was carried out to identify cross-sectional studies in the period from 3 March 2020 to 18 February 2021. Two reviewers independently and critically evaluated the studies which have been included, using the Agency for Healthcare Research and Quality checklist. We have identified twenty-three studies (n = 44,165) from nine countries. The combined incidence of depression among nurses was 22% (95% CI 0.15-0.30, I2 = 99.71%), and anxiety symptoms 29% (95%CI 0.18-0.40, I2 = 99.92%). No significant difference was observed in the percentage of depression and anxiety between the study subjects working on the frontlines vs. those in a mixed group (those working on the frontlines and behind the lines). This meta-analysis shows that over one-fifth of nurses in professional practice during the COVID-19 epidemic suffer from depression disorders, and almost one-third experience anxiety symptoms. This underscores the importance of providing comprehensive psychological support strategies for nurses working in pandemic conditions. Further longitudinal research is necessary to assess the severity of mental health symptoms related to the COVID-19 epidemic factor.

Translation and Cross-Cultural Adaptation of the International Questionnaire to Measure the Use of Complementary and Alternative Medicine (I-CAM-Q) for the Polish and Cross-Sectional Study.

According to the World Health Organization (WHO), complementary and alternative medicine (CAM) encompasses a broad set of health care practices that are not part of a country's traditional or conventional medicine and are not fully integrated into the prevailing health care system. The aim of this study is the linguistic and cross-cultural adaptation of the Polish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q) and the assessment of the occurrence and factors related to CAM among patients in Poland. A methodological model of translation and cross-cultural adaptation of research tools according to Beaton et al. with a Delphi-Technique was used for the linguistic and cultural adaptation of the Polish version of I-CAM-Q. The Delphi consensus was achieved in the scale assessment between the experts in two rounds (with a score of above 80% of expert agreement). Data was collected using an online survey within 38 thematically different groups on Facebook, among 524 participants. Over half (59.7%, n = 313) of the respondents used the services of at least one CAM practitioner. On the other hand, 50.8% (n = 266) of the respondents declared using physician's advice. The use of herbs and plant products was reported by 84.7% (n = 444), and vitamins and minerals by 88.4% (n = 463) of respondents. The most commonly used self-help practices among the respondents were relaxation techniques (49.6%), praying for one's health (43.3%) and meditation (41.2%). The consensual methodology of validating the Polish version of the I-CAM-Q scale allowed for creation of a conceptually and linguistically equivalent tool with the original international instrument. A high frequency of CAM use was found among the respondents. Therefore, strategies should be implemented to improve patient-physician communication on the use of CAM in Poland.

Impact of the Empathic Understanding of People and Type D Personality as the Correlates of Social Skills of Primary Health Care Nurses: A Cross-Sectional Study.

Efficient functioning at work depends on social skills. The aim of this study was to assess the relationship among empathy, type D personality traits, and the level of social skills among Primary Health Care (PHC) nurses. A cross-sectional study was carried out involving 446 PHC nurses. In the multidimensional model, after taking into account disruptive variables (age, place of residence, postgraduate education and self-assessment of health), as in one-dimensional models, respondents with a higher level of empathic understanding of other people were found to have a higher level of social skills (b = 0.76; SE = 0.11; p < 0.001), while a lower level of social skills was observed among respondents with traits which are characteristic of type D personality (b = −11.86; SE = 2.28; p < 0.001). The results of the study show that personal predispositions, such as empathy or type D personality, may support or hinder the shaping of social skills of nurses. Therefore, it is essential to create an individualised approach when nurses are undergoing social skills training.

Relationship between Serum Kallistatin and Afamin and Anthropometric Factors Associated with Obesity and of Being Overweight in Patients after Myocardial Infarction and without Myocardial Infarction.

Extensive clinical and epidemiological evidence has linked obesity to a broad spectrum of cardiovascular disease (CVD), including coronary disease, heart failure, hypertension, cerebrovascular disease, atrial fibrillation, ventricular arrhythmias, and sudden death. In addition, increasing knowledge of regulatory peptides has allowed an assessment of their role in various non-communicable diseases, including CVD. The study assessed the concentration of kallistatin and afamin in the blood serum of patients after a myocardial infarction and without a cardiovascular event, and determined the relationship between the concentration of kallistatin and afamin and the anthropometric indicators of being overweight and of obesity in these groups. Serum kallistatin and afamin were quantified by ELISA tests in a cross-sectional study of 160 patients who were divided into two groups: study group (SG) (n = 80) and another with no cardiovascular event (CG) (n = 80). Serum kallistatin concentration was significantly higher in the SG (p < 0.001), while the level of afamin was significantly lower in this group (p < 0.001). In addition, a positive correlation was observed in the SG between the afamin concentration and the waist to hip ratio (WHR), lipid accumulation product (LAP) and the triglyceride glucose index (TyG index). In the CG, the concentration of kallistatin positively correlated with the LAP and TyG index, while the concentration of afamin positively correlated with all the examined parameters: body mass index (BMI), waist circumference (WC), hip circumference (HC), waist to hip ratio (WHtR), visceral adiposity index (VAI), LAP and TyG index. Serum kallistatin and afamin concentrations are associated with the anthropometric parameters related to being overweight and to obesity, especially to those describing the visceral distribution of adipose tissue and metabolic disorders related to excessive fatness.

Oxidative stress-induced growth inhibitor 1 in alcohol-induced liver cirrhosis.

INTRODUCTION AND OBJECTIVE: Human oxidative stress-induced growth inhibitor 1 (OSGIN1) is a protein identified in 2001 which belongs to the OKL38 protein family. The aim of the study was to investigate the levels of this protein depending on the severity of alcohol-induced liver cirrhosis. MATERIAL AND METHODS: The study group consisted of 60 patients: 30 patients with cirrhosis in the P-Ch A and B stage and 30 in the P-Ch C stage. The control group consisted of 18 healthy individuals without liver diseases, who did not abuse alcohol. Oxidative stress induced growth inhibitor 1 (OSGIN1), fibroblast growth factor 1 (FGF1) and fibroblast growth factor 21 (FGF21) were determined in blood serum using enzyme-linked immunosorbent assay (ELISA) kits. All absorbance readings were conducted using an Epoch Microplate Spectrophotometer (BioTek Instrumentals, Inc., Winooski, VT, USA). OSGIN1, FGF1 and FGF21 concentrations were determined using Sandwich enzyme immunoassay kits (by Cloud Clone Corp., Katy, TX, USA). Statistica 13.3 (TIBCO Software, Inc.) was used for data analysis. RESULTS: The concentration of OSGIN1 was 0.028 ± 0.017 in the control group which increased with the advancement of liver cirrhosis (stage of Pugh-Child): 0.075 ± 0.098 in the P-Ch A + B group and 0.121 ± 0.134 in the P-Ch C stage. Multiple comparison tests confirmed statistically significant differences in OSGIN1 concentration between the control group and P-Ch C (p <0.02). Significant correlations were noted between OSGIN1 and FGF1 (r = 0.39; p = 0.004) and between OSGIN1 and FGF21 (r = 0.53; p <0.0001). CONCLUSIONS: The study revealed that the level of OSGIN1 increased significantly in the P-Ch C stage of liver cirrhosis. It is possible that OSGIN1 may be used for the non-invasive diagnosis of ALD, but its possible diagnostic value is still very uncertain.

Relationship Between Air Pollution and the Concentration of Nitric Oxide in the Exhaled Air (FeNO) in 8-9-Year-Old School Children in Krakow.

The consequences of air pollution pose one of the most serious threats to human health, and especially impact children from large agglomerations. The measurement of nitric oxide concentration in exhaled air (FeNO) is a valuable biomarker in detecting and monitoring airway inflammation. However, only a few studies have assessed the relationship between FeNO and the level of air pollution. The study aims to estimate the concentration of FeNO in the population of children aged 8-9 attending the third grade of public primary schools in Krakow, as well as to determine the relationship between FeNO concentration and dust and gaseous air pollutants. The research included 4580 children aged 8-9 years who had two FeNO measurements in the winter-autumn and spring-summer periods. The degree of air pollution was obtained from the Regional Inspectorate of Environmental Protection in Krakow. The concentration of pollutants was obtained from three measurement stations located in different parts of the city. The FeNO results were related to air pollution parameters. The study showed weak but significant relationships between FeNO and air pollution parameters. The most significant positive correlations were found for CO8h (r = 0.1491, p < 0.001), C6H6 (r = 0.1420, p < 0.001), PM10 (r = 0.1054, p < 0.001) and PM2.5 (r = 0.1112, p < 0.001). We suggest that particulate and gaseous air pollutants impact FeNO concentration in children aged 8-9 years. More research is needed to assess the impact of air pollution on FeNO concentration in children. The results of such studies could help to explain the increase in the number of allergic and respiratory diseases seen in children in recent decades.

A Histological and Morphometric Assessment of the Adult and Juvenile Rat Livers after Mild Traumatic Brain Injury.

Traumatic brain injury (TBI) is one of the most severe problems of modern medicine that plays a dominant role in morbidity and mortality in economically developed countries. Our experimental study aimed to evaluate the histological and morphological changes occurring in the liver of adult and juvenile mildly traumatized rats (mTBI) in a time-dependent model. The experiment was performed on 70 adult white rats at three months of age and 70 juvenile rats aged 20 days. The mTBI was modelled by the Impact-Acceleration Model-free fall of weight in the parieto-occipital area. For histopathological comparison, the samples were taken on the 1st, 3rd, 5th, 7th, 14th, and 21st days after TBI. In adult rats, dominated changes in the microcirculatory bed in the form of blood stasis in sinusoidal capillaries and veins, RBC sludge, and adherence to the vessel wall with the subsequent appearance of perivascular and focal leukocytic infiltrates. In juvenile rats, changes in the parenchyma in the form of hepatocyte dystrophy prevailed. In both groups, the highest manifestation of the changes was observed on 5-7 days of the study. On 14-21 days, compensatory phenomena prevailed in both groups. Mild TBI causes changes in the liver of both adult and juvenile rats. The morphological pattern and dynamics of liver changes, due to mild TBI, are different in adult and juvenile rats.

The Relationship Between the Metabolic Syndrome and the Place of Residence in the Local Community on the Example of the Janów Lubelski District in Eastern Poland: A Population-Based Study.

PURPOSE: The aim of this study was to estimate the incidence concerning metabolic syndrome (MetS) in a local community with a low socioeconomic status and a medium and high cardiovascular risk on the example of residents of Janów Lubelski district, eastern Poland. The second goal of the research was to analyze the relationship between residence and the occurrence of MetS. METHODS: We conducted a cross-sectional study of 4040 people living in eastern Poland. A group of 3046 people with medium and high cardiovascular risk was selected among the respondents and included in further analyzes. The research adopted the definition criteria proposed by the National Cholesterol Education Program - Third Adult Treatment Panel (NCEP ATP III) to implement diagnostic evaluation of MetS. RESULTS: It was observed that metabolic syndrome was significantly more frequent among the inhabitants of rural areas (40.56%; n=810) compared to those living in the city (35.27%; n=370) p=0.005. Among the inhabitants of rural areas, the percentage of people with elevated glucose levels was significantly higher, fasting blood glucose (FGB) p<0.001, elevated blood pressure (HBP) p<0.001, elevated serum triglycerides (TGs) p=0.01, and abnormal waist circumference (WC) p=0.003 compared to urban inhabitants. After adjusting for potential confounding variables (age, education, smoking, marital status, and level of physical activity), in both women and men, the odds of developing metabolic syndrome were approximately 30% higher in rural areas compared to urban residents (women: odds ratio (OR)=1.25, 95% confidence intervals (CI)=1.01-1.56; men: OR=1.30, 95% CI=1.01-1.67). CONCLUSION AND RECOMMENDATIONS: A higher incidence of metabolic syndrome was observed among respondents living in rural areas than those living in cities. Similarly, across the gender strata, metabolic syndrome is more commonly diagnosed among men and women living in rural areas. Healthcare workers, especially in rural areas, should engage in education, prevention, and the promotion of a healthy lifestyle.

Assessment of Concentrations of Heavy Metals in Postmyocardial Infarction Patients and Patients Free from Cardiovascular Event.

Cardiovascular diseases (CVDs) constitute the first cause of death among the population of developing and developed countries. Atherosclerosis, which is a disorder with multifactorial etiopathogenesis, underlies most CVDs. The available literature includes ample research studies on the influence of classic cardiovascular (CV) risk factors. However, environmental exposure to heavy metals, among other substances, is still an unappreciated risk factor of CVDs. This study aimed to assess the concentration of some heavy metals (copper (Cu), zinc (Zn), manganese (Mn), cobalt (Co), and iron (Fe)) in the blood serum of postmyocardial infarction (post-MI) patients and patients free from myocardial infarction (MI) as well as estimate the relationship between the occurrence of MI and increased concentration of heavy metals. The concentration of heavy metals (Cu, Zn, Mn, Co, and Fe) was assessed using the inductively coupled plasma mass spectrometry technique in a group of 146 respondents divided into two groups: post-MI group (study group (SG), n = 74) and group without cardiovascular event (CVE) having a low CV risk (control group (CG), n = 72). The concentration of the analyzed heavy metals was higher in SG. All the heavy metals showed a significant diagnostic value (p < 0.001). The highest value of area under the curve (AUC) was observed for manganese (Mn) (0.955; 95% confidence interval (CI) = 0.922-0.988), while the lowest value was found for zinc (Zn) (0.691; 95% CI = 0.599-0.782). In one-dimensional models, high concentrations of each of the analyzed heavy metals significantly increased the chances of having MI from 7-fold (Cu) to 128-fold (Mn). All the models containing a particular metal showed a significant and high discrimination value for MI occurrence (AUC 0.72-0.92). Higher concentrations of Cu, Zn, Mn, Co, and Fe were found to considerably increase the chances of having MI. Considering the increasingly higher environmental exposure to heavy metals in recent times, their concentrations can be distinguished as a potential risk factor of CVDs.

Ultrastructural Changes of Blood Cells in Children with Generalized Purulent Peritonitis: A Cross-Sectional and Prospective Study.

In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo significant ultrastructural changes that cause impaired gas exchange, changes in reactivity, and decompensation of organs and systems functions. This paper presents a cross-sectional prospective study aimed at researching the ultrastructure of blood cells in children experiencing abdominal septic shock against the background of generalized purulent peritonitis of appendicular origin. This study was conducted with 15 children aged 6-12 who were undergoing treatment for generalized appendicular purulent peritonitis, with first- or second-stage abdominal septic shock, in emergency care. The changes in the ultrastructure of erythrocytes did not correspond to changes characteristic of eryptosis, which confirms their occurrence under the influence of such pathogenic factors as intoxication, metabolic, water-electrolyte balance, and acid-base disorders. Ultrastructural changes of granulocytes indicate their hyperactivation, which leads to the exhaustion of membrane synthetic resources, membrane destruction, ineffective expenditure of bactericidal factors on substrates that are not subject to destruction. In lymphocytes, disorganization of the nuclear membrane and intracellular membranes, uneven distribution of chromatin, the hypertrophied Golgi apparatus, and a large number of young mitochondria, lysosomes, ribosomes, vesicles manifesting the disruption of metabolism, stress and decompensation of energy supply and protein synthesis systems, have been demonstrated. In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo substantial ultrastructural changes causing gas exchange disruption, changes in reactivity, as well as decompensation of organs and system functioning.

The Severity of Traumatic Stress Associated with COVID-19 Pandemic, Perception of Support, Sense of Security, and Sense of Meaning in Life among Nurses: Research Protocol and Preliminary Results from Poland.

The COVID-19 pandemic can not only affect physical health, but also mental health, resulting in sleep problems, depression, and traumatic stress. Our research investigates the level of posttraumatic stress, perceived social support, opinions on positive and negative consequences of the pandemic, sense of security and sense of meaning among nurses in the face of this new and not fully understood global epidemiological phenomenon. For this purpose, computer-assisted web interviews were conducted between May 1 and May 15, 2020. Participating nurses completed the following research tools: The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Changes in Outlook Questionnaire (CIOQ), The Safety Experience Questionnaire (SEQ) and The Meaning in Life Questionnaire (MLQ). Three hundred and twenty-five nurses of an average age of 39.18 ± 11.16 years and working throughout Poland joined the study. The average overall IES-R score in the study group was 1.78 ± 0.65. Among the dimensions of traumatic stress, the highest score was obtained in the "avoidance" dimension was 1.86 ± 0.73. Amongst participating nurses, the highest support rates were provided by significant others (22.58 ± 5.22). Higher average scores were noted among participants in the subscale measuring positive psychological changes (18.56 ± 4.04). The mean MLQ score was 5.33 ± 0.87. A slightly higher result was observed in the subscale "presence" (5.35 ± 1.14). The results of the research implemented during the period of severe psychological pressure associated with the COVID-19 pandemic provided information on symptoms of traumatic stress in the examined group of nurses. Their sense of security has been lowered and accompanied by an intensified reflection on issues concerning security. However, their current sense of meaning in life remains higher than the tendency to searching for it. The surveyed nurses received individual support mostly from significant others (i.e., other than family and friends). They see positive changes resulting from painful experiences related to the COVID-19 pandemic, which can be characterized by adaptation in the form of post-traumatic growth.

Oxidative/Antioxidative Status in Patients after Myocardial Infarction and in Those without Cardiovascular Event Depending on Anthropometric Factors Defining Body Weight.

Obesity is one of the factors leading to the development of atherosclerosis. This metabolic disorder is associated with an increased production of reactive oxygen species, which affect the oxidative stress levels. The aim of this study was to evaluate oxidative/antioxidative status and to investigate the correlation between redox markers and anthropometric parameters and body composition in adult patients after myocardial infarction and in individuals without a cardiovascular event in the past. Descriptive data on socio-demographic, clinical, and anthropometric features and blood samples were collected and categorized into two equal groups: after myocardial infarction (study group (SG), n = 80) and without a cardiovascular event (control group (CG), n = 80). The oxidative/antioxidative status was assessed in plasma on the basis of total oxidative/capacitive status (PerOx), total antioxidative status/capacity (ImAnOx), and oxidized low-density lipoprotein (oxLDL). The oxLDL was significantly higher in the CG group compared to the SG group (p = 0.02). No significant differences were found with regard to PerOx and ImAnOx values between the groups studied. A significant positive correlation between PerOx and percentage of adipose tissue (FM%) and body adiposity index (BAI) was found in the two studied groups. ImAnOx significantly positively correlated with visceral adiposity indexes(VAIs) in SG and FM% in CG. OxLDL negatively correlated with body mass index and waist to hip circumference ratio in CG. The total oxidative/antioxidative status is related to the amount of adipose tissue and the BAIs of the subjects. It was observed that it correlates more frequently with the visceral distribution of body fat.