'Difficult Conversations with Patients'-A Modified Group Objective Structured Clinical Experience for Medical Students.

This study presents a modified Group Objective Structured Clinical Experience (GOSCE) focused on difficult conversations, in which, due to limited time and financial resources, only some students could actively participate in scenarios. We aimed to evaluate the intervention, including differences between them and observers. The intervention was organized for sixth-year medical students at a Polish medical university. The study protocol assumed a pre-post analysis of students' attitudes and self-efficacy of communication skills and their opinions about the intervention. Complete questionnaire pairs were returned by 126 students. The pre-post analysis revealed a significant improvement in their self-efficacy levels of almost all skills as well as their affective attitudes and belief in outcomes of communication learning. The improvement was significant among both the active participants and observers. It also showed a decrease in the motivation score, significant only in females. Regardless of their roles, students had positive opinions about the course and its particular aspects. The modified GOSCE may be an enjoyable and effective learning experience for students, especially in the light of limited resources. However, changes in their motivation score suggest the necessity to increase the importance of communication learning in the curriculum.

Structure and Thermal Properties of 2,2'-Azobis(1H-Imidazole-4,5-Dicarbonitrile)-A Promising Starting Material for a Novel Group of Energetic Compounds.

A high-nitrogen compound, 2,2'-azobis(1H-imidazole-4,5-dicarbonitrile) (TCAD), was synthesized from commercially available 2-amino-1H-imidazole-4,5-dicarbonitrile. It was characterized with infrared and nuclear magnetic resonance spectroscopy. Its structure was determined by single crystal X-ray diffraction. The crystal of TCAD tetrahydrate is monoclinic, with space group P21/c with crystal parameters of a = 10.2935(2) Å, b = 7.36760(10) Å, c = 20.1447(4) Å, V = 1500.27(5) Å3, Z = 4, and F(000) = 688. Computational methods were used in order to fully optimize the molecular structure, calculate the electrostatic potential of an isolated molecule, and to compute thermodynamic parameters. TCAD has very high thermal stability with temperature of decomposition at 369 °C. Kinetics of thermal decomposition of this compound were studied and apparent energy of activation as well as the maximum safe temperature of technological process were determined.

Coping with loss of ability vs. emotional control and self-esteem in women after mastectomy.

AIM: Does coping with the loss of ability depend on self-esteem and emotional control? BACKGROUND: Persons who experience losses in two dimensions, i.e. health and ability can deal with the loss by physical therapy, and also by mental and socio-professional rehabilitation. But far and foremost, it is the personality of the person who experiences the loss that matters most. MATERIALS AND METHODS: The study included 37 patients after mastectomy. They were divided into two groups according to the time elapsed from cancer diagnosis. The study was conducted using the Questionnaire on Coping With Ability Loss (P. Wolski), Self-Esteem Loss (M. Rosenberg,) and the Courtauld Emotional Control Scale - CECS. RESULTS: In Group I, the higher level of acceptance in the QCAL test, the higher self-esteem. The more depression experienced by individuals, the lower is their level of self-esteem or the less depression experienced, the higher the self-esteem. In Group II, the higher the level of depression, the lower the level of anger. The greater the struggle, the lower level of anger. The lower the level of depression and struggle, the higher the level of emotion control. CONCLUSIONS: Women diagnosed no longer than five years back do not differ from those diagnosed further back in terms of copying with the loss of ability, self-esteem and emotional control.

Vaccine Effectiveness against Influenza in 2015/16 in Hospital and Ambulatory Medical Care Facilities: Polish Results of the European I-MOVE+ Multicenter Study.

Influenza vaccination is the best measure available to prevent seasonal influenza infection. The majority of studies on vaccine effectiveness in the 2015/16 season conducted in the European I-MOVE+ Project, show that a match between the circulating influenza strains in the general public and those included in the vaccine for the Northern Hemisphere was low to moderate. As part of I-MOVE+, Poland has implemented a case control negative study design and molecular biology methods, such as real time RT-PCR, to assess the vaccine match and effectiveness. The research described herein consisted of two major influenza vaccine effectiveness investigations conducted in Poland in the 2015/16 season. The general practice part of the study included 228 cases consisting of 159 type A, 65 type B, and 4 coinfections (types A + B), and 312 negative control cases. The hospital study part included 26 cases consisting of 21 type A, 2 type B, and 3 coinfections, and 13 negative control cases. The data were collected from patients of all ages recruited by 46 volunteering doctors in 15 Poland's provinces and three hospitals, respectively. In both study parts, only were seven patients and 12 control subjects vaccinated. Low vaccine coverage, a major limitation of the Polish study, makes the calculation of vaccine effectiveness for the Polish population hardly applicable statistically. Despite the crudeness of data, they were included into the common European analysis. The overall vaccine effectiveness amounted to 21.0% (95% CI: 74-122). It was somehow better for type B virus: 53.9% (95% CI: 47-87) and type A virus: 23.6% (95% CI: 83-185). A larger sample size is needed to achieve a desired interpretation of results on influenza vaccine effectiveness in Poland.

Contamination with explosives in analytical laboratory procedure.

The philosophy underlying the procedure with the trace from the moment of the securing of the evidence up to its ultimate inspection is of significance for the result achieved. Hands of the people who conduct investigative action or of the experts involved in examinations contaminated with explosives may adversely affect results of the analyses. The contamination effect is one of the most dangerous consequences of non-observance of the strict rules in handling the traces secured on the crime scene. The aim of this research work was to examine whether at all, and if so, with what an ease and at which stage of the analytical procedure there occurs a likely contamination of the evidence material with explosives such as TNT, RDX, PETN, NG. The analytical procedure employed consisted of the sampling stage, extraction from gauze swab, transfer of the extract and execution of an instrumental analysis based on gas chromatography with electron capture detector (ECD). The most significant contamination effect was observed during the analytical procedure for TNT, followed by a similar, yet less pronounced, for RDX and PETN. Contaminating the research material with nitroglycerin, known to be liquid under normal conditions, proved unsuccessful.

Coping with loss of ability vs. acceptance of disease in women after breast cancer treatment.

AIM: To answer the question: is there a correlation between copying with the loss of ability and the acceptance of disease? BACKGROUND: The loss of ability is the beginning of a process of dealing with a widely understood dysfunction and its consequences. This happens owing to the lifting of the barriers that emerged due to the loss of ability and through the acquisition of skills that help an individual find their way in the new reality. MATERIALS AND METHODS: The study included 90 patients with history of breast cancer. They were divided into two groups- I: up to five years from diagnosis, II: more than five years from diagnosis. The study was conducted using the Questionnaire on Coping With Ability Loss by P. Wolski, Acceptance of Illness Scale - B.J. Felton, T.A. Revenson, G.A. Hinrichsen, adapted by: Z. Juczynski. RESULTS: Group I: it is positive weak correlation, meaning that the higher level of acceptance in the QCAL test, the higher acceptance of illness. Group II: there is no relation between acceptance of illness and the QCAL test acceptance scale and no relation between depression and the level of acceptance. CONCLUSIONS: The more depressed a patient is and the less successful they are in dealing with the loss of ability, the lower their level of acceptance of illness. On the other hand, in time, it is struggle with the disability that plays more important role in the acceptance of the disease than the impact of negative emotions.

Professional psychological support and psychotherapy methods for oncology patients. Basic concepts and issues.

BACKGROUND: The essence of psychological support provided to oncology patients is to adjust its methods to the needs and expectations arising from the distressful experience of cancer and its treatment. AIM: The aim of this study is to present methods of professional psychological support to be used in work with oncology patients during the treatment and follow-up stages. MATERIALS AND METHODS: The article is a review of psychological and psychotherapy methods most often applied to oncology patients. CONCLUSION: Methods of psychological support depend on the current condition of a patient. The support will be effective if provided in adequate time and place with the patient's express consent and in line with their individual needs and expectations.

Styles of coping with stress of cancer in patients treated with radiotherapy and expectations towards medical staff - Practical implications.

BACKGROUND: It is essential to adjust oncological treatment to medical procedures but also to the expectations of patients themselves. Expectations of patients may depend on the way of coping with the stress of cancer. Many researchers have dealt with this issue. However, it is difficult to find studies concerning relations between the styles of coping and expectations of patients towards medical staff. AIM: To demonstrate the relationship between the style of coping with stress of cancer shown by patients undergoing radiotherapy at the Greater Poland Cancer Centre and the nature of their expectations towards the medical staff, and to present work of the Clinical Psychology Unit in response to the expectations of patients. MATERIALS AND METHODS: Questionnaire survey. The respondents filled in a questionnaire consisting of a patient request form (PRF), the mini-mental adjustment to cancer scale (Mini-MAC), and personal data. Obtained results were subjected to statistical analysis. RESULTS: SIGNIFICANT ASSOCIATIONS: the expectation to have the disease explained is associated with anxious preoccupation, fighting spirit, helplessness-hopelessness; the expectation of emotional support is associated with anxious preoccupation and helplessness-hopelessness; and the expectation of information on examinations and treatment is associated with anxious preoccupation and helplessness-hopelessness. CONCLUSIONS: Expectations of patients undergoing radiotherapy in the Greater Poland Cancer Centre towards the medical staff depend on their styles of coping with the stress of cancer.

[Causes and consequences of frequent hospitalization among schizophrenic patients]. / Przyczyny i skutki wielokrotnych hospitalizacji w szpitalu psychiatrycznym chorujacych na schizofrenie.

UNLABELLED: Schizophrenia is one of the most frequent mental diseases. The probability of being taken ill with this psychosis among the whole population is 1%. Frequent hospitalizations of schizophrenic patients prevent them from normal and effective functioning in a society. AIM OF THE STUDY: Conducted research had an aim to isolate and define the risk factors of rehospitalization among schizophrenic patients. MATERIAL AND METHODS: In the research, the authors used their own questionnaire which provided the demographic, social and medical data. The research was based on archival case histories of schizophrenic people who were the patients of a mental hospital. The research was conducted among 65 people (27 women, 38 men) who were hospitalized more than 15 times in the schizophrenic treatment. RESULTS: Psychiatric rehospitalizations in schizophrenia are conditioned not only by medical factors connected with the disease itself, but also by demographic and social factors. CONCLUSIONS: 1. The decisive role in rehospitalization of schizophrenia patients plays a small availability of alternative psychiatric care in the patients' dwelling place as well as the lack of regularity in the continuation on treatment after leaving the mental hospital. 2. Patients' family status, relationship with family and friends and the level of acceptance and understanding of their disease decline the risk of rehospitalization. 3. The greatest risk of rehospitalization is among people from the lowest class--lonely, young men with primary or vocational secondary education, having no permanent employment.