Association between symptoms of depression and inflammatory parameters in people aged over 90 years.

BACKGROUND: Old age is a period of life that presents many health and social challenges, resulting in a greater vulnerability to the development of mental disorders, including depression. There has been a growing interest in the relationship between depression and inflammatory factors, because of its potential clinical and therapeutic implications. Inflammatory processes, which were originally understood as a response to infection and trauma, appear to play an important role in the pathogenesis of depression in the elderly. The aim of the study was to analyse the relationship between the severity of depressive disorders and inflammatory parameters in people over 90 years of age. METHODS: The study was conducted in Poland in 2017. The study population consisted of long-lived individuals, both living at home and staying in residential care homes. The participants were 90 people of both sexes (69 women and 21 men), aged between 90 and 103 years (mean = 92.36; SD = 2.98). The study was conducted using the diagnostic survey method with a questionnaire technique. The Geriatric Depression Scale (GDS) was used to carry out the analysis. The levels of selected inflammatory factors were determined using relevant laboratory tests. RESULTS: In the study group, the highest percentage of people had symptoms of moderate depression (n = 36;40%), followed by those without depression (n = 35;38.9%). There was a weak negative correlation between GDS scores and fibrinogen levels (p ≤ 0.05). The logistic regression model showed no significant relationship between inflammatory parameters and the development of depressive disorders. CONCLUSIONS: Inflammatory parameters do not appear to predict the development of depressive disorders in people over 90 years of age.

Patience with foster children as a major problem for grandparents in the role of kinship carers aged 60 + and the psychosocial determinants of this deficit.

Kinship care represents the most prevalent form of foster care in Poland. Most commonly, the role of kinship carers is taken on by grandparents, who may struggle with various problems, needs and deficits in this role. The aim of this study was to investigate the problem of patience in kinship carers aged 60 + and its impact on deficits in the performance of roles and duties.Methods Seventy-five foster grandparents (63 female, 84%) aged from 61 to 97 years (M = 69,12; SD = 6.22) were investigated in north-western Poland in 2018 and 2019. The study was based on the diagnostic survey method.Results Psychological disposition, functioning, health problems and parental needs and deficits were assessed using standardised psychometric scales and tools self-constructed for this research study. A lack of patience with foster children was reported by 46.7% (n = 35) of the respondents. Patience deficits corresponded with a significantly lower sense of coherence, especially in the manageability domain (p < 0.001) and such stress coping strategies as lower positive reappraisal (p = 0.016) and seeking of emotional support (p = 0.025), as well as a greater tendency for suppression of activities (p = 0.014) and venting of emotions (p = 0.035). Relatively permanent personality traits and general self-efficacy were not differentiated by patience with children.Conclusions The results suggest that patience - so important for biological and foster parents - is related to psychological competencies that can be improved through psychoeducation and skills-training, which may be beneficial for improving foster carers' effectiveness.

The Involvement in Domestic Violence and the Severity of Legal, Moral and Social Consequences for the Perpetrators in the Perceptions of Students in Poland and Belarus.

Domestic violence is sequential, developmental and dynamic. The aim of this study was to examine whether, in the perceptions of students in Poland and Belarus, there is a relationship between involvement in violence and the legal and social consequences for the perpetrators. A total of 482 university students took part in the study, including 251 students from Poland and 231 students from Belarus. Statistically, Polish respondents were more frequently involved in domestic violence as witnesses and victims, which was confirmed by χ2 test. Based on the 95% confidence interval (CI), it can be concluded that the largest number of respondents from both countries surveyed who have been involved in violence as witnesses (85.2-94.8) indicated that an adequate punishment for perpetrators of violence is imprisonment. Students who have never been involved in domestic violence indicated social consequences as appropriate punishment for the use of violence more often than those who have been involved in violence as witnesses, victims or perpetrators. Witnesses and victims were not found to be in favour of more severe punishment or more serious moral and social consequences than perpetrators. The largest number of respondents indicated that the appropriate consequence of using violence should be imprisonment, followed by a restraining order and eviction from the place of residence.

Comparison of US and EU Prices for Orphan Drugs in the Perspective of the Considered US Orphan Drugs Act Modifications and Discussed Price-Regulation Mechanisms Adjustments in US and European Union.

The 2019 worldwide sales of Orphan Drugs were estimated at $136 billion USD, which constituted 16% of the global pharmaceutical prescription market and is expected to grow by 12% in the next 5 years. A better understanding of Orphan Drug pricing may contribute to on-going discussions on Orphan Drug Act (ODA) corrections in US or modifications of price setting mechanisms in EU. The objective of the study was comparison and analysis of the prices of Orphan Drugs in US and EU. All drugs with Orphan Drug status were compared in the US and EU. For the US prices, the US Department of Veterans Affairs (VA) was sourced. The EU List Prices came from six EU countries: Denmark, France, Germany, Greece, Poland, Spain. We found US prices to be higher than the six selected EU countries. The average Price Ratio was 1.64. The prices across EU countries were more homogeneous, while the number of the reimbursed and therefore available to patient medicines varied and was correlated with GDP per capita r = 0.87. Considered implementation of the External Reference Price system in US may generate significant savings in the US but may result in upward pressure on pricing of Orphan Drugs in EU. Centralization of the Orphan Drugs pricing negotiations in EU may prevent such development and offer a win-win opportunity for all involved parties.

Existential and Spiritual Attitudes of Polish Medical and Nursing Staff towards Death.

Issues related to death are difficult areas of human existence and are most often considered in terms of ethical or non-ethical behaviour. The aim of the research was to examine the attitudes of Polish medical and nursing personnel towards death. The research was conducted among medical (110 people) and nursing staff (110 people) working in Polish hospitals and representing 16 regions. The Questionnaire About Attitudes to Death (DAP-R-PL) was used. The attitude of medical staff, taking into account the holistic approach to the patient in his existential-spiritual dimension, is an extremely important element of professional care. The study outlines the attitudes of medical and nursing staff towards death. Medical personnel under examination demonstrate a mature attitude towards death. In light of this research, health care workers show great commitment to helping dying people with existential and spiritual needs.

Problematic Internet Use, health behaviors, depression and eating disorders: a cross-sectional study among Polish medical school students.

BACKGROUND: Problematic Internet Use is defined as a use of the Internet which leads to various difficulties. The aim of this study was to check whether Problematic Internet Use is associated with health risks, such as: anti-health behaviors, depressive symptoms, abnormal body weight or eating disorders. METHODS: This cross-sectional study included 540 medical school students of Polish descent (83.5% females; 16.5% males), whose mean age was 22.49 years (SD = 5.20). The participants were asked to complete a questionnaire set, including the Problematic Internet Use Test, Juczynski's Health-Related Behavior Inventory, the Beck Depression Inventory, the Eating Attitudes Test and a self-designed demographic survey. RESULTS: Increased Problematic Internet Use scores were observed in male, full-time students, persons who use the Internet on the computer (compared to those who mostly use it on the phone), and those who go online mainly for entertainment purposes (compared to those who indicated another main purpose of using the Internet). 47.6% of the sample reported poor health behaviors, while 27.1% met the criteria of a depressive episode and 6.9% of an eating disorder. High risk of Problematic Internet Use was observed in 2.8% of the sample, particularly those who reported having more free time during the day, engaged in fewer health protective behaviors, manifested more severe depressive symptoms and scored higher on the Eating Attitudes Test. CONCLUSION: Such results indicate that students with Problematic Internet Use lead an unhealthy lifestyle and more often show symptoms of depression and eating disorders than students without Problematic Internet Use.

Learning Curve for Metastatic Liver Tumor Open Resection in Patients with Primary Colorectal Cancer: Use of the Cumulative Sum Method.

BACKGROUND: Liver resections have become the first-line treatment for primary and metastatic tumors and, therefore, are considered a core aspect of surgical training. This study aims to evaluate the learning curve of the extent and safety of liver resection procedures for patients with metastatic colorectal cancer. METHODS: This single tertiary center retrospective analysis includes 158 consecutive cases of small liver resection (SLR) (n = 107) and major liver resection (MLR) (n = 58) procedures. A cumulative sum control chart (CUSUM) method was used to investigate the learning curve. RESULTS: The operative time, total blood loss level, and incidence of adverse effects showed a learning curve. For SLRs, the CUSUM curve for operative time and blood loss level peaked at the 19th and 17th case, respectively, while for MLRs, these curves peaked at the 28th and 24th case, respectively. The CUSUM curve for minor adverse effects (MAEs) and severe adverse effects (SAEs) showed a downward slope after the 16th and 68th procedures in the SLRs group and after the 29th and 39th procedures in the MLRs cohort; however, it remained within the acceptable range throughout the entire study. CONCLUSION: SLR procedures were performed faster with less intraoperative blood loss and shorter postoperative stays than MLRs, and a higher number of completed procedures was required to gain stabilization and repeatability in the operating time and intraoperative blood loss level. In MLR procedures, the reduction of SAEs was accomplished significantly later than the stabilization of the operative time and intraoperative blood loss level.

Co-occurrence of adult abuse and child abuse: analysis of the phenomenon.

BACKGROUND: The purpose of this study was to analyze the co-occurrence of adult and child abuse based on the reports collected from the Polish police and social welfare institutions. METHODS: The study involved data concerning 468 households in Szczecin (Poland) inhabited by children where acts of violence between adults took place. The presented data refer to the years 2012-2103. The data came from so called Blue Card files, i.e. documents issued by the police and social workers in cases of domestic abuse, providing information about its forms, perpetrators, and victims. RESULTS: Domestic violence usually occurs between spouses and cohabitees (78%). The perpetrator was usually a man (88%). Violence usually lasted from 1 up to 3 years (30.0%). The most common forms of physical abuse against adults and children included pushing (79.5% of adults, 22.4% of children) and hitting (64.7% of adults, 16.6% of children), and psychologically abusive behaviors were mostly insults (91.9% of adults, 27.5% of children) and criticism (79.1% of adults, 21.5% of children). This work has shown that the longer the psychological abuse between adults lasts, the greater probability is that it will also be used against children. Child abuse is also associated with putting up resistance to the police by perpetrators. CONCLUSIONS: Summing up, in households where violence between adults is observed, actions should be taken to prevent violence against children.

Attitudes of Palestinian and Polish Medical Students Towards Death.

Attitudes of students of health-related subjects towards the death are an important issue showing the behaviour and values ​​that guide young people in everyday interactions. The study was conducted using the Questionnaire About Attitudes Against Death (DAP-R-PL) among 309 students, including 150 Palestinian from the Faculty of Nursing and Health Sciences and 159 Polish from the Faculty of Health Sciences. It was noticed that the attitude of Death Avoidance is higher in Palestinians than in Poles. The biggest difference between correlation indicators is for the factors fear of death and death avoidance (FD and DA). This value is positive for Palestinian respondents and negative for Polish respondents. The study confirms that the attitudes of students towards death from both universities in the perspective of 5 factors are positive and in future contacts with dying patients they will cope with this challenge.

Attitudes of Polish Priests and Laymen Towards Death During the Covid-19 Pandemic.

The Covid-19 pandemic has generated a situation where death is the most commonly used term by humans. The attitudes adopted towards the phenomenon of death are the result of existential life and the presented axiology. Looking at the death of a secular and spiritual person makes it possible to notice the existential and spiritual attitudes of two different social groups, interpenetrating one another and fulfilling different roles. The study used a diagnostic survey method using a standardized research tool in the form of the Attitude Profile Questionnaire for Death (DAP-R-PL) and an author's questionnaire. In the light of the conducted research, it can be observed that priests experience the phenomenon of death more existentially and religiously. Laymen consider the problem of death in an existential way and are more afraid than priests. Both attitudes are part of everyday life because each of the groups participating in the research maintains its identity.

Microbiome Metabolites and Thyroid Dysfunction.

Thyroid diseases are common conditions that have a negative impact on the health of all populations. The literature sheds light on the differences in the composition of the intestinal microbiota in patients suffering from thyroid diseases compared to healthy individuals. The microbiome affects the proper functioning of the thyroid gland, and the existence of the gut-thyroid axis is discussed in the context of both thyroid diseases and intestinal dysbiosis. The purpose of this review is to describe associations between the microbiome and its metabolites and thyroid dysfunction. We try to explain the role of the microbiome in the metabolism of thyroid hormones and the impact of thyroid autoimmune diseases. In addition, we raise issues related to the influence of bacterial metabolites, such as short-chain fatty acids or secondary bile acids, in the functioning of the thyroid gland. Last but not least, we explored the interactions between the gut microbiota and therapeutics and supplements typically administered to patients with thyroid diseases.

Subjective Feelings of Polish Doctors after Receiving the COVID-19 Vaccine.

The COVID-19 pandemic has caused enormous confusion around the world in our daily existence. The security measures taken, such as physical distance, wearing a mask, quarantine or closing shopping malls, and even isolating large groups of the population, did not contribute to the complete overcoming of the problem. Information on the positive results of research into the COVID-19 vaccine and, finally, its administration offered hope that the pandemic would be overcome. The undertaken problem of research concerning the subjective analysis of the feelings of doctors in Poland after receiving the COVID-19 vaccine shows an important area of the medical world, which is directly responsible for their own health and the patients entrusted to them. In addition, 149 people participated in the study (8-13 February 2021), including 57% of women and 43% of men. The minimum and maximum age of the respondents are 26 and 69 years old. Furthermore, 85% of respondents took two doses of the vaccine and 15% took one. The authorial questionnaire was completed by the participants in the study online in February 2021. The results obtained indicate that the COVID-19 vaccine generates hope for stopping the pandemic. In addition, 96% of research participants think so. Doctors in middle and mature age are the most optimistic, while the youngest ones are less optimistic. In addition, 57% of respondents do not worry about side effects after taking the vaccine. Fear at the time of vaccination was experienced by over 9% of doctors. The most frequently reported post-vaccination reactions are injection site pain, fatigue and headache. Increased temperature occurred in older female respondents. From a psychosocial perspective, men are more likely to fear being infected personally with the virus, and women are more likely to be infected with their loved ones. The presented subjective assessment presents the physicians' view captured at the moment in terms of existential and emotional. The presented feelings of the research participants reflect their personal satisfaction, responsibility for their own health, care for their relatives and patients.

Epidemiological factors for type 2 diabetes mellitus: evidence from the Global Burden of Disease.

BACKGROUND: The United Nations acknowledged diabetes as an epidemic of the 21st century. Global trends demonstrate a continuing growth in its prevalence at approximately 2.5 % per year. The aim of the study was to analyse selected epidemiological factors for type 2 diabetes mellitus in Poland, Central Europe and the World. METHODS: This study presents Global Burden of Disease (GBD) data. Study describes the type 2 diabetes burden in the studied populations based on years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs). RESULTS: Type 2 diabetes has been demonstrated to be a determinant of reduced life expectancy, as in the analysed period the condition presented an increasing trend, compared to other diseases. CONCLUSIONS: In recent years the observed YLL, YLD and DALY values for type 2 diabetes have been comparable to the expected ones. Thus the prognosis presented by GBD may be used as a reliable source of information and a basis for a health policy that reduces the number of patients with diabetes and related complications, comorbidities or mortality.

Analysis of the levels of inflammatory parameters in persons over the age of 90.

Chronic inflammatory conditions resulting from elevated levels of circulating proinflammatory mediators are common in the elderly. The aim of the paper was to analyze the balance between proinflammatory and anti-inflammatory markers in longevous individuals. The study was conducted in persons aged >90 years old, residents of Poland living either at home or staying at residential care facilities. The study included 90 persons (69 women and 21 men) aged between 90 and 103 years. Persons with abnormal CRP presented with a statistical tendency toward higher fibrinogen and lower IL10 and IL-1α levels compared to patients in whom CRP level was within the normal range. IL-6 concentration predicted abnormality within CRP. Inflammation in persons above the age of 90 years old might be linked to abnormal fibrinogen and IL-6 levels.

Telemedicine services in the work of a doctor, dentist, nurse and midwife - analysis of legal regulations in Poland and the possibility of their implementation on the example of selected European countries.

INTRODUCTION AND OBJECTIVE: The aim of the study is to discuss the legal framework for telemedicine services in Poland, and to present telemedicine solutions used in selected European countries. MATERIAL AND METHODS: The analysis of legal cts was chosen as a research method in order to determine legal possibilities for medical professionals to use telemedicine services. A literature review was undertaken to demonstrate the possibilities of telemedicine as used in the United Kingdom, Germany, Norway, The Netherlands and Sweden. RESULTS: The Act on the professions of a doctor and a dentist states that the doctor and the dentist can perform their profession via ICT systems or communication systems. The doctor is obliged to practice in accordance with current medical knowledge and available methods. 'Available methods' include considering information and communication measures that may allow prevention, recognition or treatment. The Act on the profession of a nurse and a midwife states that the nurse and midwife perform the professions using current medical knowledge and the mediation of ICT systems or communication systems. Thus, the legislator has clearly authorized persons performing these professions to provide services in the field of telemedicine. However, despite the existence of a legal basis for using telemedicine, its development in Poland is not as high as in the United Kingdom, Germany, Norway, The Netherlands or Sweden. CONCLUSIONS: The legislator gradually introduces legal solutions necessary for the development of telemedicine services, although the pace of these changes, as well as building the technical infrastructure that is the basis for the proper provision of telemedicine services, are too slow.

The Role of Iron Metabolism in Fatigue, Depression, and Quality of Life in Multiple Sclerosis Patients.

Multiple sclerosis (MS) is a chronic inflammatory disease of autoimmune origin for which there is currently no available cure. In the course of MS, next to neurological disorders, patients often present with chronic fatigue syndrome and depressive disorders, which impact on their daily function and quality of life. The aim of study was to analyse the relationship between serum parameters of iron metabolism and the severity of fatigue, depressive symptoms, and quality of life in MS patients. METHODS: The study sample consisted of 90 people with a diagnosis of multiple sclerosis, age range 19-67 years, whose functional status evaluated using the Expanded Disability Status Scale in 90% of the participants did not exceed 3.5 points. Venous blood samples were collected for blood cell count determination and for the purposes of obtaining serum analysed for the concentrations of iron, ferritin, transferrin, transferrin saturation, unsaturated iron binding capacity (UIBC), and total iron binding capacity (TIBC). The participants were also evaluated according to the Fatigue Severity Scale, Beck Depression Inventory, and Functional Assessment of Multiple Sclerosis. RESULTS: Ferritin levels were significantly correlated with the severity of depressive symptoms (r = -0.22; p = 0.04) and quality of life assessment (r = 0.22; p = 0.04) in the MS patients. Moreover, the severity of fatigue and depressive symptoms was significantly linked to a deterioration in quality of life. CONCLUSIONS: Ferritin deficiency in MS patients is associated with an exacerbation of depressive disorders and a decline in quality of life. Symptoms of fatigue in MS patients are inversely proportional to mood and quality of life.

The incidence of eating disorders among upper secondary school female students. / Wystepowanie zaburzen odzywiania wsród uczennic szkól ponadgimnazjalnych.

OBJECTIVES: The aim of the present study is to evaluate the incidence and prevalence of eating disorders in the population of Polish upper secondary school female students, while considering the type of school and living conditions. METHODS: The investigations of eating disorders were conducted between March and June 2017 and covered female students of the upper secondary schools of Szczecin. Selection for the survey was multistep. 1,750 questionnaires were included in the analysis. The study used a tool for screening for the occurrence of eating disorders - the Eating Attitudes Test (EAT-26). RESULTS: Lower scores were observed among higher grade students (EAT-26, EAT dieting) as well as those who did not receive pocket money (EAT dieting, EAT bulimia) (p < 0.05). CONCLUSIONS: (1) Age has proved to be an important prognostic factor for eating disorders. The risk decreased as the age of the examined girls increased. (2) The risk of eating disorders was almost 21 times higher among first and second grade girls.

Domestic violence in the perceptions of university students in Poland and Belarus.

BACKGROUND: Domestic violence is a social phenomenon where a family member, husband, wife or another cohabiting person in the household tries to dominate, physically or mentally, the other partner, children, parents, grandparents, in-laws, etc., using their physical advantage, threats, blackmail, with the intention of harm. The aim of the study was find the perceptions of university students regarding the phenomenon of violence and to show similarities and differences in this respect between students from Poland and Belarus (PL and BY). METHODS: A total of 482 persons took part in the study, including 251 students from Szczecin (Poland) and 231 students from Grodno (Belarus). The method was a diagnostic survey using the authors' original questionnaire. The questionnaire consisted of two parts: the first, containing 6 demographic questions, and the second containing 25 mainly closed-ended questions. RESULTS: In the perceptions of the respondents from Poland and Belarus, women are statistically more likely to experience violence, and men are more likely to use it. The responses of students from Poland and Belarus show statistical connections regarding such behaviors as a single spank, shouting, refusing to talk - recognizing them mostly as a form of violence. The respondents from both countries also show a convergent position concerning quarrelling and forcing a person to drink alcohol or smoke cigarettes, recognizing them as violent behavior. Significant differences can also be observed with regard to such behaviors as throwing objects, name-calling and mocking, which do not indicate violence in the opinions of the majority of students from Belarus, in contrast to the Polish students, who perceive these behaviors as violent. CONCLUSIONS: Students from both countries acknowledge that the concealment of domestic violence by victims mainly results from fear of worsening their already difficult situation as well as from fear of retaliation by the perpetrator.

The Prevalence of Insomnia and the Link between Iron Metabolism Genes Polymorphisms, TF rs1049296 C>T, TF rs3811647 G>A, TFR rs7385804 A>C, HAMP rs10421768 A>G and Sleep Disorders in Polish Individuals with ASD.

Iron deficiency have been found to be linked to sleep disorders. Both genetic and environmental factors are risk factors for skewed iron metabolism, thus sleep disruptions in autism spectrum disorders (ASD). The aim of our study was to assess the prevalence of single nucleotide polymorphisms (SNPs) within transferrin gene (TF) rs1049296 C>T, rs3811647 G>A, transferrin receptor gene (TFR) rs7385804 A>C, and hepcidin antimicrobial peptide gene (HAMP) rs10421768 A>G in Polish individuals with ASD and their impact on sleep pattern. There were 61 Caucasian participants with ASD and 57 non-ASD controls enrolled. Genotypes were determined by real-time PCR using TaqMan SNP assays. The Athens Insomnia Scale (AIS) was used to identify sleep disruptions. There were 32 cases (57.14%) with insomnia identified. In the ASD group, the defined counts of genotypes were as follows: TF rs1049296, C/C n = 41 and C/T n = 20; TF rs3811647, G/G n = 22, G/A n = 34, and A/A n = 5; TFR rs7385804, A/A n = 22, A/C n = 29, and C/C n = 10; and HAMP rs10421768, A/A n = 34, A/G n = 23, and G/G n = 4. There were no homozygous carriers of the TF rs1049296 C>T minor allele in the ASD group. All analyzed SNPs were not found to be linked to insomnia. The investigated polymorphisms are not predictors of sleep disorders in the analyzed cohort of individuals with ASD.

Does functional assessment of individuals aged 80-plus give rise to scientific discussion - considerations based on literature review.

INTRODUCTION AND OBJECTIVE: For many years, Europe has been struggling with the problem of an aging society. It is obvious that everyone would like to live longer while retaining good psycho-physical health and social activity. This, however, is influenced by many factors, such as health, which may be a form of limitation in everyday life or in performing social roles in accordance with the norms. OBJECTIVE: The aim of the study was to analyze the use of scales for functional assessment of basic and complex daily living activities in individuals aged 80+ in various EU countries. MATERIALS AND METHOD: Potentially essential articles were obtained through review and analysis of the PUBMED (MEDLINE) database by entering the following keywords: functional activities of daily living, ADL, IADL, complex activities of daily living, basic activities of daily living. Article selection was based on the following inclusion criteria set by the authors and the appointed Advisory Board. RESULTS: Assessment of independence and fitness of elderly persons in the area of basic and complex activities of daily living provides information on the quality of life of senior individuals. Analysis of research data used for comparing functional independence of senior persons on the basis of ADL and IADL scales is difficult due to the discrepancies, which may be confusing for researchers studying this area. CONCLUSIONS: The use of different methodologies for assessing functional fitness of elderly individuals makes it difficult to interpret, compare and practically apply the outcomes. Standardization of research methods used for assessment of basic and complex daily living activities in 80+ persons would enable comparing the obtained data in an interdisciplinary perspective.