Nursing students' perception of the professional nurse's role in four European countries.

BACKGROUND: Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students' perceptions of their future profession could help in the design of education and the retention of nurses. AIM: To compare nursing students' perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden. METHOD: A cross-sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse. RESULTS: A total of 392 final-year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse. CONCLUSIONS: Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries. IMPLICATIONS FOR NURSING POLICY: The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students' perceptions of their future professional role.

Platelet aggregation and risk of stent thrombosis or bleeding in interventionally treated diabetic patients with acute coronary syndrome.

BACKGROUND: Platelet aggregation monitoring in diabetic patients treated with coronary interventions (PCI) for an acute coronary syndrome (ACS) is a promising way of optimizing treatment and outcomes in this high risk group. The aim of the study was to verify whether clopidogrel response measured by Multiplate analyzer (ADPtest) in diabetic ACS patients treated with PCI predicts the risk of stent thrombosis or cardiovascular mortality and bleeding. METHODS: Into this prospective, observational study 206 elective PCI patients were enrolled. Two cutoff points of ADPtest were used in analysis to divide patients into groups. One (345 AU x min) was calculated based on ROC curve analysis; this cutoff provided the best ROC curve fit, although it did not reach statistical significance. The other (468 AU x min) was accepted based on the consensus of the Working Group on On-Treatment Platelet Reactivity. The risk of stent thrombosis and mortality was assessed using Cox regression analysis and Kaplan-Meier curves. RESULTS: The risk of stent thrombosis was higher in the group of patients with impaired clopidogrel response for either cutoff value (for >354 AU x min - HR 12.33; 95% CI 2.49-61.1; P = 0.002). Cardiovascular mortality was also higher in the impaired clopidogrel response group (for >354 AU x min - HR 10.58; 95% CI 2.05-54.58; P = 0.005). We did not find a clear relation of increased clopidogrel response to the risk of bleeding. CONCLUSIONS: The results of this study show that in diabetic ACS patient group treated with PCI an impaired platelet response to clopidogrel measured by the Multiplate analyzer results in increased risk of stent thrombosis and cardiac death.

Changing 14-year trends in the epidemiology of hepatitis B virus infection in rural and urban Central-Eastern European areas.

In Poland, the prevalence of HBV infection constitutes an emerging public health concern. The aim of the study was to analyse changes in hepatitis B incidence rate by age, gender and place of residence in Poland between 1999 and 2012. The data were obtained from Polish state statistics institutions such as the National Institute of Public Health and State Sanitary Inspection. Relationships of hepatitis B incidence with age, gender and rural/urban areas were investigated using χ(2) and tests for two proportions with Bonferroni adjustment. The incidence of hepatitis B in rural and urban populations was compared using Wilcoxon's signed-rank tests. Joinpoint regression was used to analyse trends in hepatitis B incidence rate. In Poland, a total of 26 660 cases of hepatitis B were reported in the studied period and 31.6% of these cases occurred in rural areas. There was significantly declining tendency in the hepatitis B incidence rate in the initial period of the study. However, there were periods of significant increase of HBV incidence rate in women from rural areas aged 15-24 years (9.4%/year) and in women from urban areas aged 15-24 years (10.9%/year) and 25-64 years (3.8%/year) in the final years of the observation. Despite the success in controlling this infection, a significant increase in the incidence of hepatitis B among young women living in rural and urban areas, as well as in adult women in urban areas, has been noted.

Index of clinical consequences of untreated dental caries (pufa) in primary dentition of children from north-east Poland.

PURPOSE: The purpose of this study was to evaluate the prevalence and experience of clinical consequences of untreated dental caries in primary dentition in 5 and 7 year-old children from north-east Poland and to find whether there is a correlation between dmft and pufa indices. MATERIAL/METHODS: Two hundred fifteen children aged 5 and 7 years living in the Podlaskie region were examined in the course of the Polish National Oral Health Survey 2011. Caries prevalence and experience in primary dentition was evaluated according to WHO criteria (dmft index). The clinical consequences of untreated dental caries were assessed by pufa index. RESULTS: The dmft index was 5.56 ± 4.45 in 5-years-old children and 6.69 ± 3.14 in 7-years-olds. The prevalence/experience of pufa index was 43.4%/2.20 ± 3.43 and 72.4%/2.44 ± 2.22, respectively. Children living in rural areas presented a worse dental condition. A statistical analysis revealed a strong relation between dmft and pufa in both age groups. CONCLUSION: The present study revealed negligence in the dental treatment of children from north-east Poland resulting in the high prevalence and experience of the pufa index in primary dentition. This index is a valuable measurement tool to record the clinical consequences of untreated dental caries.

Fractures during growth: potential role of a milk-free diet.

UNLABELLED: Dietary calcium deficiency may increase fracture risk. In girls, 29.4% of fracture cases and 11.8% of controls without fracture had a history of milk-free diet. The odds ratio (OR) for fracture with a milk-free diet in girls was 4.6, p < 0.01. In boys, 23% of cases and 19% of controls had a history of a milk-free diet; OR = 1.3, NS). A milk-free diet due to cow's milk allergy is associated with increased fracture risk in girls. INTRODUCTION: An intake of calcium below the reference daily intake (RDI) of 800-1200 mg/day during growth is thought to increase fracture risk even though convincing evidence for this view is scarce. The paucity of evidence may be partly due to many trial participants being calcium replete. Children and adolescents with cow's milk allergy (CMA) avoid milk and have a calcium intake below the RDI. The aim of this study was to examine the association between consumption of a milk-free diet and fracture risk. METHODS: In this case-control study conducted in Poland, 57 boys and 34 girls aged 2.5-20 years with fractures (cases) were randomly matched by age and sex with 171 boys and 102 girls without fractures (controls). Weight and height were examined using standard methods. Bone mineral density (BMD) and body composition were measured using dual-energy X-ray absorptiometry. Conditional logistic regression and Bayesian analyses were used to determine the proportion of the fracture risk attributable to a milk-free diet. RESULTS: In girls, 29.4% of cases and 11.8% of controls had a history of milk-free diet producing an odds ratio (OR) for fracture associated with a milk-free diet of 4.6 (95% confidence interval [CI]: 1.4-15.5, p < 0.01). In boys, 23% of cases and 19% of controls had a history of a milk-free diet; OR = 1.3 (95% CI: 0.6-2.7, NS). If the prevalence of CMA in the population is 5%, only 6.7% of the fractures occurring are attributable to CMA and the associated nutritional deficit. CONCLUSIONS: Cow's milk allergy is associated with increased fracture risk in girls. Whether this association is due to the illness, calcium deficit or a deficit in other milk nutrients is uncertain. These data suggest that the contribution of milk-free diet to fracture liability among children and adolescents is modest.

Comparative analysis of the effect of preparations used in professional fluoride prophylaxis on the chosen parameters of human saliva.

UNLABELLED: Regular supply of fluoride ions to the oral environment is one of the prophylactic actions against dental caries. Fluorides, whose exogenous action combines with saliva properties, condition the anticariogenic effect. Fluoride ions exhibit high chemical activity, can alter the oral environment parameters and inhibit the activity of enzymes. PURPOSE: In the current study, the effect of fluoride preparations used in professional caries prophylaxis on chosen saliva parameters was studied. The levels of pH and fluoride ions, and the activity of cathepsin D in human saliva were determined. MATERIAL AND METHODS: Material for analysis contained resting mixed saliva collected before and 1, 4 and 24 hours after the application of Duraphat, Elmex Gel, Fluor Protector, Fluormex Gel and Fluoro-Gel. RESULTS: The fluoride-containing preparations inhibited the activity of cathepsin D in the way depending on the time that had passed since the application and altered the pH level of human saliva.

Effect of fluoride preparations on the activity of human salivary cathepsin C.

Preparations containing organic and inorganic fluorine compounds are used for oral hygiene. Fluoride ions contained in these preparations display high bioactivity and can alter the environment of the mouth. The aim of the study was to determine the effect of preparations containing aminofluorides, commonly used in oral hygiene, on the activity of salivary cathepsin C (EC 3.4.14.1). The research material included mixed saliva, collected at rest before and after the application of the following preparations: Elmex gelee, Elmex red fluid, Elmex green fluid, Fluormex rinse. The salivary pH, concentration of fluoride ions and activity of cathepsin C were determined. Fluoride preparations inhibit the activity of cathepsin C and cause changes in human salivary pH. Saliva can serve as a diagnostic material in the examination of the environmental exposure to fluorides.

Dietary habits of men from Podlasie region of Poland in the years 1987-1998 analysed with self-organizing neural networks.

The study was conducted on a group of 556 men. Their dietary habits were evaluated 3 times in the years 1987-1998 by the frequency of consumption of 41 food items during last three months. Obtained frequencies were processed by self-organizing Kohonen neural network, allowing to group persons of similar dietary habits into 3 clusters. After analysing frequencies of consumption of each food item in each cluster, in view of health value, one model was described as appropriate, while remaining were described as two different inappropriate models. In three studies during 11 years, statistically significant increase in frequency of appropriate model was observed. That increase was linked with decrease of occurrence of inappropriate models. Additional verification of described models revealed significant differences between them in nutritive ingredients intake, and also in concentrations of HDL cholesterol in the blood serum of men assigned to those dietary patterns.

Overweight and obesity and their determinants among men from Podlasie region in the years 1987-1998.

The goal of the study was to determine the frequencies of occurrence of obesity and overweight among men from Podlasie region of Poland, as well as nutritional and environmental factors related to these conditions. During 9-year period (1987-1998), dietary habit of each of 556 men was evaluated three times using 24-hour consumption questionnaire. At the same time body mass index (BMI) was also calculated. BMI increased significantly from 26.2 kg/m2 to 27.6 kg/m2 during discussed period, while percentage of overweight grew up from 62.7% to 73.2% and percentage of obesity rose from 14.5% to 22.5%. Executed multiple regression analysis revealed a variety of predictors of obesity and overweight. Among nutritional factors, the increase of energy and carbohydrates (especially saccharose) in diet were the reasons of increasing BMI. Considering psychological, sociological and economical features, multi-shift work provoked increase of BMI, while decrease of BMI was induced by smoking. Observed increase of spread of overweight and obesity among men, had its nutritional and environmental reasons.