Acculturation, trust to health care system, and attitudes to COVID-19 vaccination: A comparative study between Polish immigrants in Norway, Polish in Poland, and Norwegians in Norway.

Fast deployment of safe and efficient COVID-19 vaccines has changed the course of the pandemic in many countries reducing COVID-19 death rates and allowing countries to abandon strict measures such as social distancing and restrictions to public events. The vaccination strategy, however, is based on the expected high vaccination rate in the population. Several studies have indicated vaccination hesitancy to be higher in ethnic minority communities, which can lead to unnecessary suffering and loss of lives, worsening pre-existing health inequalities and marginalization of ethnic minority groups. The aim of the present study was to investigate the relationships between acculturation to Norwegian culture, trust in health authorities, and attitude to COVID-19 vaccine among Polish immigrants in Norway. An internet-based survey including questions about attitude to COVID-19 vaccination and trust in the health care system was filled by 150 Polish immigrants in Norway, 256 Polish living in Poland, and 264 Norwegians living in Norway. In addition, the Polish immigrants also answered questions about acculturation to Norway. The results showed that the Polish immigrants in Norway had less positive attitudes to COVID-19 vaccination than the Norwegians, while they did not differ from Polish living in Poland. The Polish immigrants also indicated lower trust in the Norwegian health care system than the Norwegians. In regression analysis, the trust in the values of the health care system was the most important predictor of COVID-19 vaccination attitudes in all three samples. A path model showed that trust in the values of the health care system mediated the effects of acculturation to Norway on COVID-19 vaccination attitudes among Polish immigrants. These results underline the importance of taking ethnic minorities and immigrants into account in the health care system to reduce COVID-19 vaccination hesitancy.

Comparison of ultrasound therapy and radial shock wave therapy in the treatment of venous leg ulcers - clinical, pilot study.

INTRODUCTION: Venous insufficiency and venous leg ulcers each year affect more and more people, especially in developed countries. The challenge of our time is to find an effective method of treating venous leg ulcers, which will further shorten treatment time and reduce the cost of treatment. AIM: To compare the effects of treating venous leg ulcers using ultrasound therapy, radial shock wave therapy and standard care. MATERIAL AND METHODS: Group A consisted of 17 patients. Patients were treated with ultrasound therapy US power density 0.5 W/cm2, pulsed wave with a duty cycle of 1/5, and 1 MHz frequency. Group B consisted of 17 patients. Patients were treated with the radial shock wave R-ESWT using surface energy density 0.17 mJ/mm2, 100 impulses/cm2, frequency of 5 Hz and a pressure of 0.2 MPa. Group C (control group) consisted of 17 patients. Patients in this group received standard care: gauze dressing saturated in 0.9% sodium chloride and elastic bandages changed daily for 4 weeks. RESULTS: Ultrasound therapy with 1 MHz and energy power density 0.5 W/cm2 for 4 weeks resulted in an average reduction of 68% of the area of ulceration. We used for venous leg ulcers 4-week treatment with radial shock wave therapy resulting in a 38% mean percentage reduction of the ulceration area. Standard care reduces the area of ulceration by only 16%. CONCLUSIONS: The use of ultrasound therapy for the treatment of venous leg ulcers is more effective than the use of radial shock wave therapy or standard care alone.

Randomized, controlled clinical pilot study of venous leg ulcers treated with using two types of shockwave therapy.

Background. Venous leg ulcers are difficult to heal wounds. The basis of their physiotherapeutic treatment is compression therapy. However, for many years, the search for additional or other methods to supplement the treatment of venous ulcers, which would shorten the duration of treatment, is underway. One of such methods is the shockwave therapy. Methods. The purpose of our study was to compare radial shockwave therapy (R-ESWT) with focused shockwave therapy (F-ESWT) in venous leg ulcers treatment. Patients were randomly assigned to tree groups. In the first group the radial shockwave therapy (0.17mJ/mm2, 100 impulses/cm2, 5 Hz), in the second group the focused shockwave therapy (0.173mJ/mm2, 100 impulses/cm2, 5 Hz) was used and in third group standard care was used. Patients in shockwave therapy groups were given 6 treatments at five-day intervals. Total area, circumference, Gilman index, maximum length and maximum width of ulcers were measured. The patients from the third group wet gauze dressing with saline and gently compressing elastic bandages were used (standard wound care SWC). Results. Analysis of the results shows that a complete cure of ulcers was achieved in 35% of patients who were treated with radial shockwave, 26% of patients with focused shockwave used. There is statistically significant difference between the standard care and radial shockwave therapy as well as between the standard care and focused shockwave therapy. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers (p> 0.05). Conclusion. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers. Treatment of venous leg ulcers with shockwaves is more effective than the standard wound care.

Shockwave therapy in selected soft tissue diseases: a literature review.

OBJECTIVE: The aim of our study is to present the current state of knowledge on the use of shockwave therapy (SWT) in the treatment of soft tissue wounds, by reviewing the available literature. METHOD: Medical databases were searched for articles using the keywords: 'shockwave AND wound healing', 'shockwave AND ulcers', 'shockwave AND burns', 'shockwave AND bedsores', 'shockwave AND diabetic foot ulcer', 'ESWT AND wound healing', 'shock wave AND diabetic gangrene'. RESULTS: A total of 14 scientific articles were included in the study which described the methodology of treatments and list the type of generator, physical parameters used during the procedure, number of treatments and the type of treated wounds. From these articles, 191 soft tissue wounds were analysed. CONCLUSION: Evidence from the articles analysed in this study suggests a beneficial effect of SWT to treat diabetic foot ulcers, venous leg ulcers, pressure ulcers and burns. SWT can be used in combination with standard treatment in soft tissue wounds.

Women's Endorsement of Models of Sexual Response: Correlates and Predictors.

Few studies have investigated endorsement of female sexual response models, and no single model has been accepted as a normative description of women's sexual response. The aim of the study was to establish how women from a population-based sample endorse current theoretical models of the female sexual response--the linear models and circular model (partial and composite Basson models)--as well as predictors of endorsement. Accordingly, 174 heterosexual women aged 18-55 years were included in a cross-sectional study: 74 women diagnosed with female sexual dysfunction (FSD) based on DSM-5 criteria and 100 non-dysfunctional women. The description of sexual response models was used to divide subjects into four subgroups: linear (Masters-Johnson and Kaplan models), circular (partial Basson model), mixed (linear and circular models in similar proportions, reflective of the composite Basson model), and a different model. Women were asked to choose which of the models best described their pattern of sexual response and how frequently they engaged in each model. Results showed that 28.7% of women endorsed the linear models, 19.5% the partial Basson model, 40.8% the composite Basson model, and 10.9% a different model. Women with FSD endorsed the partial Basson model and a different model more frequently than did non-dysfunctional controls. Individuals who were dissatisfied with a partner as a lover were more likely to endorse a different model. Based on the results, we concluded that the majority of women endorsed a mixed model combining the circular response with the possibility of an innate desire triggering a linear response. Further, relationship difficulties, not FSD, predicted model endorsement.

Sexual dysfunction and distress--development of a Polish version of the female sexual distress scale-revised.

INTRODUCTION: The concept of sexually related personal distress, central to the diagnosis of all female sexual dysfunction (FSD), is currently a subject of scientific debate. Several psychometric instruments have been used to measure sexually related personal distress in women, including the Female Sexual Distress Scale (FSDS) and its revised version (FSDS-R). AIM: To develop a Polish version of the FSDS-R (PL-FSDS-R). METHODS: In total, 210 women aged 18-55 years were included in the study. Seventy-five were diagnosed with hypoactive sexual desire disorder (HSDD), 31 were diagnosed with another FSD, and 104 were control. All subjects completed the PL-FSDS-R at baseline (day 0), day 7, and day 28. Internal consistencies were evaluated by Cronbach's α. Intraclass correlation coefficient was used to assess test-retest reliability. Discriminant validity was assessed by comparing mean scores of the FSD and control groups in a between-groups analysis of variance. Receiver operating characteristic (ROC) analysis was performed to determine optimal cutoff values of the PL-FSDS-R. MAIN OUTCOME MEASURES: To measure the validity and reliability of the PL-FSDS-R and to determine optimal cutoff values. RESULTS: Mean total PL-FSDS-R score was statistically higher in women with HSDD and other FSD compared to healthy individuals, showing the test had discriminant validity. The frequency of sexual intercourse and quality of relationship with sexual partner but not other sexual behaviors were statistically correlated with the PL-FSDS-R score. ROC analysis confirmed these findings. All domains of the PL-FSDS-R demonstrated satisfactory internal consistencies, with a Cronbach's α-value of >0.70 for the entire sample. Test-retest coefficients were between 0.86-0.92, with the best reliability for a 7-day recall period. CONCLUSIONS: The PL-FSDS-R is a reliable questionnaire with good psychometric and discriminative validity, and can be used to measure sexually related personal distress in Polish women with FSD with a cutoff score of ≥13.

Development and validation of the Polish version of the Female Sexual Function Index in the Polish population of females.

INTRODUCTION: Unlike male sexual function, which is relatively easy to assess, female sexual function is still a diagnostic challenge. Although numerous new measurements for female sexual dysfunction (FSD) have recently been developed, the Female Sexual Function Index (FSFI) remains the gold standard for screening. It has been validated in more than 30 countries. The FSFI has been used in several studies conducted in Poland, but it has never been standardized for Polish women. AIM: The aim of this study was to develop a Polish version of the FSFI (PL-FSFI). MATERIALS AND METHODS: In total, 189 women aged 18-55 years were included in the study. Eighty-five were diagnosed with FSD as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) criteria; 104 women did not have FSD. All subjects completed the PL-FSFI at baseline (day 0), day 7, and day 28. MAIN OUTCOME MEASURES: Test-retest reliability was determined by Pearson's product-moment correlations. Reliability was tested using Cronbach's α coefficient. Construct validity was evaluated by principal component analysis using varimax rotation and factor analysis. Discriminant validity was assessed with between-groups analysis of variance. RESULTS: All domains of the PL-FSFI demonstrated satisfactory internal consistencies, with Cronbach's α value of >0.70 for the entire sample. The test-retest reliability demonstrated good-to-excellent agreement between the assessment points. Based on principal component analysis, a 5-factor model was established that explained 83.62% of the total variance. Domain intercorrelations of the PL-FSFI ranged from 0.37-0.77. The optimal PL-FSFI cutoff score was 27.50, with 87.1% sensitivity and 83.1% specificity. CONCLUSION: The PL-FSFI is a reliable questionnaire with good psychometric and discriminative validity. Therefore, it can be used as a tool for preliminary screening for FSD among Polish women.

Current views on etiology, diagnosis and the treatment of pain connected with sexual intercourse at women.

Painful intercourse at women is a diagnostically and therapeutically difficult issue, but most of all there is no accordance to the etiology of this health problem. At present there are six classification systems by menas of which one tries to describe this issue. The layout of presented work is based on International Classification on Female Sexual Disorders, which in point four, includes Sexual Pain Disorders--dyspareunia, vaginismus and pain disorders not connected with sexual intercourse, but caused by other type of sexual stimulation. In context of current views on painful intercourse seen as the pain unit not as the sexual dysfunction, the crucial role of a gynaecologist in the diagnosis of this affliction has been underlined.

[Selected features describing sexuality among elderly married women--research results]. / Wyniki badania wybranych cech seksualnosci starszych kobiet w zwiazku malzenskim.

OBJECTIVES: Analysis of selected features describing sexuality and sexual behaviour of elder married women, without hormonal treatment, assessing their sexual life as either successful or unsuccessful MATERIAL AND METHODS: 170 women were examined with the help of a self-constructed questionnaire containing questions concerning sexual life. All interviewed women were married. The results have been submitted to the statistical analysis. RESULTS: Among 170 examined women, 124 (73,0%) described their sexual life as successful, 23 (13,5%) as unsuccessful, 23 (13,5%) did not have any sexual life, and therefore have been excluded from the statistical analysis. CONCLUSIONS: 1. Elderly women have active sexual life. 2. Elderly women describing their sexual life as unsuccessful are withdrawn and reluctant to have a conversation about their relationships, have hidden sexual expectations and dream about changing their lives. 3. In marriages with unsuccessful sexual life, women have intercourse in few (up to three) positions and do not use elements of foreplay. 4. In marriages with successful sexual life, women accept their nudity, as well as that of their husbands, and accept their physical appearance. 5. Elderly women who are sexually active use contraceptive methods, including hormonal pills. The type of used contraceptive does not have any influence on the assessment of the quality of the sexual life. 6. The age of an elderly woman and successful sexual life do not constitute a guarantee of faithfulness in a marriage.

[Selected sexuality features among married women--research results]. / Wyniki badania wybranych cech seksualnosci kobiet w zwiazku malzenskim.

OBJECTIVES: Analysis of features describing sexuality and sexual behavior of married women, deeming their sexual life 'successful' or 'unsuccessful'. MATERIAL AND METHODS: 217 women have been interviewed with the help of our original questionnaire about sexual life. All women in question had been married at the time of the interview. The results have been submitted for statistical analysis. RESULTS: Among 217 married women that had been interviewed, 190 (87.6%) described their sexual life as 'successful', while 25 (11.5%) as 'unsuccessful'. Two women were not sexually active and thus have been excluded from the study. CONCLUSIONS: 1. Women in failed marriages discuss the causes of their problems with their husbands less frequently, and more often have unrevealed sexual expectations and dreams, in comparison to the group of women in successful marriages. 2. Women who deemed their sexual life 'unsuccessful' have problems with accepting nudity, both theirs and their husbands. 3. Women describing their sexual life as 'unsuccessful' do not perceive sex as pleasure. 4. The belief that one has a 'successful' or 'unsuccessful' sexual life does not have influence on the attempts of undertaking sexual contacts, with or without the consent of a woman. 5. Almost a half of married women giving consent for intercourse against their will, both in 'happy' or 'failed' marriages, are of the opinion that a husband has the right to rape his wife. 6. 'Successful' sexual life in a marriage is not a guarantee of woman's faithfulness. 7. The type of contraceptive used does not have an influence on perceiving one's sexual life as 'successful' or 'unsuccessful'.

Human sexuality and sex steroids.

Studies on human sexuality are considered to be extremely difficult. Moreover, their results appear often unclear and contradictory. Sexuality is perceived as the identity, feelings and behavior associated with sex. Different assumptions concerning its mechanisms are made by researchers in the field of neuroendocrinology, endocrinology and psychology, and their tests' results help to describe human sexuality. Since the second half of the 20th century efforts of describing sexuality have been made, but they are still imperfect. There are no current research methods which allow for separation of sexual functions or sex-related behavior in a human, and for their description. It should be remembered, however, that the very awareness of taking part in such examination can have meaningful impact on the tests' results. What is more, the patient's emotional state can also alter the results. In this paper, current results on sexual steroids' place in forming human sexuality and its role in an adult human being life are presented. The cognition of the complete role of testosterone, estradiol and progesterone in forming human sexuality is considered to be the challenge for researchers in the following years.

[Assessment of painful sexual intercourse occurrence among women in gynaecological practice]. / Ocena wystepowania bolesnego wspólzycia u kobiet w praktyce ginekologicznej.

OBJECTIVES: Analysis of painful sexual intercourse occurrence among women who are patients of a gynaecological practice. MATERIAL AND METHODS: 104 women have been examined by means of self-constructed questionnaire consisting of parts A and B. All interviewees had had sexual intercourses. Part A of the questionnaire included questions concerning painful sexual intercourse and was completed by the interviewees, whereas part B included questions concerning the presence of symptoms of vulvar vestibulitis and was completed by the gynaecologist after the examination. Statistical analysis was performed by means of chi-quadrat test. RESULTS: Out of 104 examined women, 20 patients (19.2%) complained of painful intercourse occurrence. CONCLUSION: 1. Women at all ages experience painful intercourse, although there are different reasons for its occurrence. 2. Women may experience pain connected with sexual intercourse although they never experienced intercourse with vaginal penetration. 3. In case of 1/4 of women, coital pain occurs at the attempt of intercourse or "at the very thought of it". 4. Pain during sexual intercourse occurs in case of almost 50% of post menopausal women, experiencing vaginal dryness. 5. Since 30% women with visible features of vulvar vestibulitis, detected during gynaecological examination, experience painful sexual intercourse, gynaecological examination should constitute a constant element of diagnosis of painful sexual intercourse among women.