Determinants and disparities in access to paediatricians in Poland.

BACKGROUND: The purpose of this study was to identify the factors that determine the differences in the distribution and workload of paediatricians in Poland. This research, specific to conditions found within Poland, will help further advance knowledge in this area. Data were derived from the database of Statistics Poland. The level of convergence of the phenomenon studied was analysed. The paediatricians' accessibility index was ascertained and its spatial diversity examined. The level of correlation of patients treated per paediatrician was analysed in relation to indices of urbanisation, availability of paediatricians and disposable income. RESULTS: A moderate variation of patients treated per paediatrician was found and the conditional convergence of the investigated phenomenon observed. A close negative association between the number of patients treated and access to paediatricians (-0.686, p = 0.005) was revealed. CONCLUSIONS: The research suggests that socioeconomic factors may affect the uneven spatial distribution of the workload of paediatricians in Poland and cause differences between the provinces in the equal access to paediatricians. This research may thus provide implications for policy and practice as well as lead to a better understanding of the problem.

Socio-economic development, level of urbanization and consumption of selected food products as factors in the prevalence of overweight and obesity among youths and young adults in Poland.

INTRODUCTION AND OBJECTIVE: Obesity and overweight among teenagers and young adults pose serious problems for the Polish health care system. The aim of this study was to assess the relationships between the prevalence of overweight and obesity and the level of urbanization, consumption of selected food products and socio-economic development in the provinces in Poland. MATERIAL AND METHODS: The material used in this study is based on data published by the Central Statistics Office (GUS) for population, components of the Human Development Index (HDI), urbanization level (URBI), average monthly consumption of selected food products per person, and the percentage of obese and overweight people in the Polish provinces. The prevalence of overweight and obesity in all 16 provinces was analysed in the context of the URBI, HDI, and the average monthly consumption of selected food products. RESULTS: There was no a statistically significant correlation between the number of overweight and obesity cases and the levels of HDI and URBI. The negative correlations were found between the consumption of sugar and URBI (-0,710, p=0.002), bread and grain product consumption (-0.642; p=0.007) and fresh milk consumption (-0.594; p=0.015). Fish consumption correlated with URBI at a moderate level (0.550; p=0.027). The consumption of oils and fats strongly correlated with HDI (-0.788; p < 0,001). In the group of overweight woman, a moderate negative correlation was noted (-0.511; p=0.043) in cheese and curd consumption. CONCLUSIONS: The high level of economic development and urbanization have no direct impact on the prevalence of overweight and obesity in Poland. The results of the study indicate existing dependencies of the consumption of some of selected products with respect to the level of urbanization.

Chemical meningitis in children as a risk factor following craniopharyngioma resection - a case report.

BACKGROUND: Craniopharyngiomas are defined by the WHO as "benign" tumours, but their location and surgical treatment may be associated with major complications, one being chemical meningitis. Although rare, especially in children, it should be taken into account when worrying symptoms appear after surgery. CASE PRESENTATION: The aim of this study is to present the case of chemical meningitis in a 7-year-old girl. She was admitted to the Department of Neurology with the following symptoms: headache, vomiting and balance disorders. Brain magnetic resonance imaging showed a tumour in the sellar and suprasellar region, which was diagnosed as a craniopharyngioma. Due to acute hydrocephalus the patient underwent emergency surgery. Conventional surgery was preceded by an endocrinological consultation to determine pituitary hormone levels. The first 6 days post-surgery, during which the patient started substitution therapy for pituitary insufficiency, were uneventful but on the seventh day she presented with seizures, fever, severe headache, weakness, irritability, stiffening of the neck and a gradual degradation of consciousness. This clinical presentation suggested meningitis, which was confirmed by examination of cerebrospinal fluid. CONCLUSIONS: The conventional and/or endoscopic resection of a craniopharyngioma poses a risk of postoperative complications in the form of chemical meningitis. Although this is a rare occurrence in children with craniopharyngioma, physicians should be aware of this complication and its clinical presentation as it may facilitate earlier diagnosis, appropriate treatment and a faster recovery of their patients.

Regional differences in access to health care in Poland from the perspective of health care resources.

OBJECTIVE: To examine disparities in access to the public in Poland, in association of the resources of health care, socio-economic development of Provinces and their level of urbanization. MATERIAL AND METHODS: The Provinces were divided into four groups, using the quartile method, according to the urbanization and level of socio-economic development. The socio-economic development level was identified by the Human Development Index (HDI) for each Province. The urbanization level of each Province was determined by the Index of Urbanization (URBI). Disparities level to access to public health care was identified by taxonomic measure of accessibility (TMA), calculated using resources of health care data. TMA index was compared in the different regions, depending on the level of HDI and URBI. RESULTS: There was no linear relationship between accessibility to public healthcare and socio-economic development of each tested region, nor between accessibility to public health care in the Provinces and their urbanization level. During the study, the correlation between the TMA and HDI and URBI alsdo produced a negative result. CONCLUSIONS: An insufficient number of physicians and the limited value of contracts within the public health service may cause a drop in the availability of the public medical service sector, regardless of regional level of urbanization and socio-economic development.

Concentration of Selected Metals in Whole Blood, Plasma, and Urine in Short Stature and Healthy Children.

The short stature in children is defined as height below the third percentile from the mean for age and gender. This problem affects about 3% of young people. More than 20,000 children in Poland have problems with short stature. There is not much information available in the literature on the study of metals in blood, plasma, and urine in children with short stature. The study was conducted on a group of 56 short stature Polish children and 35 healthy children. The content of metals was determined using high-performance ion chromatography and inductively coupled plasma mass spectrometry methods. The study revealed significant differences between the content of selected metals in body fluids between a short stature group and healthy children. There were significant differences in the Fe, Cu, and Ni concentrations between the groups with respect to the hormonal therapy. There were no significant differences between the groups with respect to the area where the children lived. The results showed no statistically significant differences between metal concentration and age, body weight, and height. The study demonstrated statistically significant differences between the content of metals in body fluids in short stature children compared with the healthy children. It seems that the difference in the concentration of certain elements may also be the result of growth hormone therapy and the interaction between various metals. Both the alterations in the content of metals and their mutual interactions may play an important role in the pathogenesis of short stature children.

Influence of urbanization level and Gross Domestic Product on the prevalence of adolescent obesity in Poland.

INTRODUCTION: Obesity is considered as a major disease of twenty-first century civilization. Its occurrence in Poland and worldwide has been increasing steadily for many years. Several factors play an important role in the development of overweight and obesity. In addition to the genetic factors and those associated with diseases of the endocrine system and nervous system, the rapidly growing number of obese people is due to improper nutrition. OBJECTIVES: In this paper, authors attempt to justify the prevalence of obesity in Poland among the population of adolescent and young adults aged 15 - 29 years of age, depending on the urbanization level and Gross Domestic Product (GDP) per capita of voivodeships. METHODS: Voivodeships, as an entity of regional autonomy, were divided into two groups according to urbanization level and GDP per capita. From the total population of each voivodeship population, groups of overweight and obese people aged 15-29 were selected. The population group aged 15-29 was divided into male and female subgroups. Each subgroup was compared in the different voivodeships, depending on the urbanization level and GDP per capita. RESULTS: The study shows that there is a strong linear relationship between the prevalence of obesity and GDP per capita of each examined region. During the study, the correlation between the level of prevalence of obesity and urbanization level produced a negative result. CONCLUSION: The high level of regional economic development in the economic transformation states has a significant impact on the increase in the percentage of people with overweight and obesity in the population aged 15-29. Gender and place of residence (urban or rural areas) did not show significant correlation with the occurrence of overweight and obesity in the study group of the population.