Level and determinants of physical activity among school adolescents in Poland.

The recognition of adolescents' physical activity has become one of the serious challenges of the modern times, as a concern about the future health of societies. The major goal of the presented study was to discover the level of physical activity among Polish adolescents aged 16-18, and the factors which condition this level. The investigations were carried out in 2011, among 2,974 school adolescents from various locations in Poland - 1,790 girls (60.2%), and 1,184 boys (39.8%). As a study method, a short version of the IPAQ was applied. The results of the study indicated that a larger number of girls than boys show a low level of physical activity. With respect to activity among boys, higher values of intensive and moderate efforts are noted, while in girls, higher values of activities related to walking. It was confirmed that the level of physical activity does not depend on the place of residence. However, the number of physical exercise classes attended is a significant factor, both among boys and girls. It was also found that adolescents who more frequently lead a sedentary style of life are characterized by a lower level of total physical activity. Sedentary lifestyle (time spent sitting) does not differ among the level of physical activity of girls and of boys, neither with respect to the scope of the total physical activity nor to its three levels (low, moderate, high).

Tooth loss among adult rural and urban inhabitants of the Lublin Region.

Dental diseases and tooth loss result in various health, psychological, and even social problems. The objective of the study was determination of the number of missing teeth among adult rural and urban inhabitants of the Lublin Region, and whether or not there is a relationship between missing teeth and place of residence, and other socio-economic factors, such as: gender, age, education level and the occupation performed (farmer/non-farmer). Data concerning the number of missing teeth were collected from 3,388 individuals. The mean number of missing teeth among the respondents in the study was 13.6. This mean value was significantly higher among the rural than urban inhabitants. Tooth loss was significantly more often found among females than males, this relationship being statistically significant only in the subpopulation of rural inhabitants. According to expectations, the largest number of missing teeth was found in respondents aged over 60, among those aged 31-60 this number was nearly 2.5-fold smaller, while the smallest number of missing teeth was observed among respondents aged 18-30. The largest number of missing teeth was noted among respondents who possessed incomplete elementary or elementary education, followed by those with elementary vocational and secondary school/post-secondary school education, whereas this number was the smallest among respondents who had university education level. Farmers had a significantly larger number of missing teeth, compared to respondents who performed non-agricultural occupations. Using an analysis of regression, the relationship was confirmed between the number of missing teeth, and the respondents' gender, age, education level, place of residence, and occupation performed. Discrimination analysis was applied to show the relationship between the occurrence of total edentulism and the respondents' age, gender, education level and place of residence. It was observed that age was the variable which most strongly discriminated the occurrence of this characteristic, followed by education level, as well as gender and place of residence, which were the weakest discriminatory variables.

Are we helping or harming our insulin-treated diabetic patients during ambulatory treatment?

INTRODUCTION: Correctness of insulin treatment depends on both the experience and skills of the doctor and knowledge and behaviour of the patient. OBJECTIVE: Evaluation the adequacy of insulin doses administered to diabetes patients in ambulatory conditions. MATERIAL AND METHODS: The treatment of 59 patients hospitalized in the Diabetology Ward was evaluated at admission, discharge and 3 months after hospitalization. RESULTS: The mean daily doses of insulin significantly differed at times of evaluation and were: 53.90, 39.31 and 43.34 units, respectively (p≈0.000001). A significant reduction of body weight, 90.86 vs. 88.25 kg (p≈0.000001), was obtained only during hospitalization, and was maintained 3 months after discharge (87.86 kg). Significant differences were also noted in the body mass index (33.44 vs. 32.48 vs. 32.37 kg/m(2), p≈0.000001). The change in waist circumference was not statistically significant (107.87 vs. 104.89 cm; p≈0.06). A decrease in the number of hypoglycaemia episodes was observed, but were statistically insignificant (25 vs. 23; p≈0.7). Three months after hospitalization an insignificant decrease of HbA1c level was noted (8.41% vs. 8.03%; p≈0.07). CONCLUSIONS: During treatment in the Diabetology Ward the procedure of choice was more frequently a reduction than an increase in insulin doses. This management led to the reduction of the patients' body weight, improvement of glycaemia, without any significant effect on the diabetes control determined by the HbA1c level.

Is the advancement of diabetic angiopathy evaluated as ankle-brachial index directly associated with current glycaemic control?

INTRODUCTION AND OBJECTIVE: Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischemia. Measurement of ankle-brachial index (ABI) has emerged as the diagnostic tool of choice, because it is relatively simple, non-invasive and inexpensive. It is also an independent marker of increased morbidity and mortality from cardiovascular diseases. The aim of the presented study was to assess the relationship between current glycemic control defined by glycated hemoglobin (HbA(1c)) level, and quantitative changes in the arteries of the lower limbs in patients with type 2 diabetes. MATERIALS AND METHODS: 175 patients with type 2 diabetes hospitalized in the Diabetology Ward were studied. VENO Doppler and a sphygmomanometer were used to assess blood flow. RESULTS: The average level of HbA(1c) was assessed at 8.48%. Although the average level of ABI indicator was 1.20 (normal), only 45% of evaluated patients had their individual index within the normal range. Signs of ischemia were found in 17.7% of examined subjects. There was no conclusive correlation between ABI and HbA(1c) levels. CONCLUSIONS: The current level of glycemic control evaluated as HbA(1c) has no direct impact on the advancement of diabetic angiopathy evaluated as ABI.

Alcohol-related Developmental Origin of Adult Health--population studies in Poland among mothers and newborns (2010-2012).

Alcohol related harm is a global problem for public health where frequent consumption of large amounts of alcohol constitutes a serious health risk, particularly to vulnerable groups such as adolescents, pregnant women and newborns. The epidemiological study on health-lifestyle behaviour, especially alcohol consumption, was performed on a randomised group of post-partum women's health behaviour during pregnancy, covering drinking habits, was undertaken in 2010, 2011 and 2012, (n=8,237) according to the PRAMS model including effects on the foetus and newborn; women being selected from obstetric and gynaecological wards. In this Polish study, only 14% of women did not consume alcohol before becoming pregnant while 15% of women drank alcohol throughout the entire period of pregnancy. In addition, awareness of the harmful effects of alcohol consumed, especially of small amounts, before and during pregnancy is low among Polish women. It is also alarming that more than 55% of physicians who provide care for pregnant women do not discuss with them the harmful effect of alcohol on the organism of the mother and foetus, whereas over 2% of doctors even recommend the consumption of alcohol in pregnancy. With reference to the Barker's Foetal Origin of Diseases Hypothesis, the authors suggest such alcohol drinking behaviour of women during their reproductive ages and while pregnant may exert negative health effects on offspring, mainly in the form of susceptibility to contracting chronic diseases. Such findings pose a risk to future generations in Poland and require remedial/educational action targeted on health care professionals and public like.

Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations - adaptation of the hypothesis development origin of health and diseases.

It is recognized that the levels of women's physical activity during pregnancy has a direct bearing on the method of delivery and health of the newborn. The main objective of the study was investigation of the level of physical activity of women during pregnancy according to the Pregnancy Physical Activity Questionnaire (PPAQ). The subjects of this study were n=2852 post-partum women surveyed together with their newborns, representing all obstetric hospital departments throughout Poland. The questionnaires were completed on a single day during the second week of November 2011. The women were also asked about the amount, range and type of physical activity they performed before becoming pregnant. The Pregnancy Physical Activity Questionnaire was used for precisely measuring physical activity according to the standard metabolically equivalent (MET). In addition, comparisons were made between the weight of the infant and newborn status using the APGAR scale with the amount of physical activity performed by the mothers. There were decidedly low physical activity levels observed in pregnant women compared to those before becoming pregnant. Appropriate interventions can therefore now be targeted through remedial action in Poland. It is important to perform intervention studies intended to test this hypothesis and attempt to identify the most appropriate levels for intensity, duration and frequency of physical exercise during pregnancy. The studies should consider the four domains of daily physical activity and utilize tools that reliably measure exposure variables. Such studies would provide valuable information for recommendations about physical activity during pregnancy.

Physical activity of Polish adolescents and young adults according to IPAQ: a population based study.

The alarming problem of a decline in physical activity among children and adolescents and its detrimental effects on public health has been well recognised worldwide. Low physical activity is responsible for 6% of deaths worldwide and 5-10% of deaths in the countries of the WHO European Region, according to country. Within the last decade, many initiatives have been launched to counteract this phenomenon. The objective of presented study was analysis of the level of physical activity among adolescents and young adults in Poland, according to the IPAQ questionnaire. The study group covered 7,716 adolescents: 5,086 children attending high school and secondary schools and 2,630 university students. Low physical activity was noted among 57% of schoolchildren and 20.84% of students. Analysis of the level of physical activity according to the IPAQ indicated that it was lower among girls, compared to boys. An additional analysis, with the consideration of the place of residence, showed that the highest percentage of the population with low physical activity was noted in the rural areas (29.30%), while among the urban inhabitants of cities with a population above 100,000 it was on the level of 23.69% and 20.57%. Median for weekly physical activity by respondents" gender was on the level of 1,554.00 MET*min. weekly among females, and 2,611.00 MET*min. weekly among males (p<0.000). The highest weekly physical activity expressed in MET*min. was observed among the inhabitants of towns with a population less than 100,000, whereas among the rural population and inhabitants of large cities with a population of over 100,000 the weekly physical activity was on a similar level (1,830.50 and 1,962.00 respectively). An extended analysis of respondents' physical activity showed that during the day students spend significantly more time in a sedentary position, compared to schoolchildren. The presented results of studies indicate the necessity to continue and intensify actions to promote various forms of physical activity among students and schoolchildren. A constant decrease in physical activity observed among children and adolescents suggests that it is necessary to pay greater attention to this social group while developing health programmes.

Tobacco-related Foetal Origin of Adult Diseases Hypothesis--population studies in Poland.

Epidemiological studies in Poland show that tobacco smoking by adolescents at reproductive age is still frequently observed. This concerns both boys and girls. The study was based on all-Polish population studies of health behaviours of adolescents aged 14-24 (Youth Behavioural Polish Survey--YBPS) conducted in 2011, and the Pregnancy-related Assessment Monitoring Survey (PrAMS). More than 12% of pregnant women do not discontinue smoking in association with becoming pregnant and expose the foetus to tobacco smoke, despite being aware of the hazardous effect of smoking on the health of the mother and child. Smoking in pregnancy is mainly observed among mothers with a low education level and those aged under 23. According to the Baker's Foetal Origins of Adult Health and Diseases Hypothesis, exposure of the foetus to the components of tobacco smoke results in many perturbations in the form of a lower birth weight, prematurity, worse state of neonates after birth, and higher susceptibility to contacting civilization diseases at the age of adulthood. The results of studies confirm some observations. Polish studies clearly confirmed a lower birth weight of babies delivered by mothers who smoke; however, earlier termination of pregnancy and worse status of neonates after birth were not observed. According to the Baker's hypothesis, a lower birth weight of babies delivered by smoking mothers during the further life cycle exposes the offspring to the risk of contracting civilization diseases. The efforts undertaken by public health authorities should be biased towards education of the population at reproductive age about the hazardous effect of smoking on the health of the foetus and the offspring born. Women at reproductive age should be encouraged to discontinue smoking in association with the planning of pregnancy and in pregnancy.

Current glycaemic control has no impact on the advancement of diabetic neuropathy.

UNLABELLED: The aim of the study was to assess the association between glycemic control understanding as a glycated haemoglobin level and indices of diabetic neuropathy. METHODS: We evaluated 204 patients with diabetes (type 1 - 29; type 2 - 175). Glycated haemoglobin was determined using The Diabetes Control and Complications Trial/ National Glycohemoglobin Standardization Program method. Evaluation of complaints from the lower extremities was based on the Neuropathy Syndrome Total Score questionnaire. We used a mono lament for evaluation of touch sensation (Semmes-Weinstein 5.07-10 g), a 128 Hz calibrated tune-fork for the vibration perception test, Tip-Therm to assess temperature sensation. RESULTS: The mean glycated haemoglobin level was assessed on 8.53±1.87%. The mean Neuropathy Syndrome Total Score: 11.45±6.37. Decreased sensation of touch on both sides was determined in 30% of cases, decreased sensation of temperature in 59% and decreased sensation of vibration in 30%. For Neuropathy Syndrome Total Score and glycated haemoglobin the Pearson's correlation test was 0.00910 (p≈0.99), Spearman's rank correlation test was 0.00523 (p≈0.95). Persons with sensation deficits and neuropathy symptoms had not significantly higher (Neuropathy Syndrome Total Score, temperature sensation disturbances) and not significantly lower (vibration and touch) glycated haemoglobin level compared to patients without neuropathy. CONCLUSION: There is no correlation between prevalence and advancement of sensorial neuropathy and current diabetes control in patients with long-term established diabetes.

Smoking during pregnancy--hematological observations in pregnant women and their newborns after delivery.

Cigarette smoking is a global public health problem. According to the current estimations, more than one billion people worldwide smoke tobacco. The highest prevalence of smoking is observed in Europe and Central Asia. In Poland, nearly a half of males and 1/3 of females are smokers. Information concerning an increase in the prevalence of tobacco smoking among women is alarming. It is estimated that tobacco smoking is the cause of approximately 10% of deaths worldwide. If the present trend maintains itself, in the present 21(st) century nearly one billion people will prematurely loose their lives due to tobacco smoking. Tobacco smoking by pregnant women additionally exerts a negative effect on the developing foetus. The objective of the study was analysis of haematological parameters of the erythropoietic system in pregnant women and their newborn babies after delivery according to the number of cigarettes smoked daily by the mothers in pregnancy. The studies were based on the questionnaire forms. The studies were carried out in all hospitals in Poland where pregnant women were hospitalized with their newborns on one day in 2010 and 2011. The material for the study were replies to the questions concerning the results of blood tests of mothers and newborns. No significant changes concerning haematological parameters of the erythropoietic system were observed in women after delivery. With respect to newborns, an increase was noted in the level of haemoglobin in the babies of women who, in the third trimester of pregnancy, smoked more than 6 cigarettes daily. The hematocrit value and amount of erythrocytes did not change. The results of the studies showed that tobacco smoking in pregnancy exerts a negative effect on the environment in which the foetus develops, and consequently, on the health of newborn babies.

Cigarette smoking among a sample of PONS study subjects: preliminary assessment.

AIM: To evaluate the prevalence, socio-demographic patterns and behavioural characteristics of tobacco smoking in a pilot group of PONS respondents. MATERIALS AND METHODS: Open-ended prospective cohort study conducted in Swietokrzyskie Province. A pilot group of subjects aged 45-64 years was examined. Data on smoking were collected with the use of the Health State Questionnaire administered by the CAPI method. RESULTS: 62.6% of males and 45.5% of females participating in the PONS study were ever smokers. In the male population, the percentage of current and former smokers were 19.8% and 42.8%. In females, these percentages were at the lower level of 15.3% and 30.3%, respectively. Self-reported data on smoking prevalence seem to be consistent with objective assessment of exposure to tobacco smoke (measured by carbon monoxide level in exhaled lung air), especially for non-smokers. CONCLUSIONS: The analysis found substantial differences in the level of current and former smoking between PONS study and nation-wide surveys conducted in the adult Polish population. Percentages of current smokers in the PONS study are two or even more times lower, and the prevalence of former smoking is almost two times higher than among adult Poles. The above differences may result from social characteristics of the fi rst group of PONS subjects and their health behaviours. PONS subjects who decided to take pat in the fi rst phase of the study are proportionally better educated than a comparable age group of the adult Polish population, and therefore may be more health-oriented than respondents from the general population. Therefore, it is recommended that the next phase of the PONS study should promote and focus on the less educated inhabitants of the study areas, especially males.

Prevalence of obesity - baseline assessment in the prospective cohort 'PONS' study.

OBJECTIVE: The aim of the study was to evaluate the prevalence of overweight and obesity in the population of Swietokrzyskie Province in Poland. METHODS: Body mass index (BMI), waist to hip ratio (WHR) and waist circumference (WC) in the Polish-Norwegian Study (PONS) was measured in 2,567 females and 1,287 males. Anthropometric measurements included fat mass, height, weight, waist and hip circumference. BMI and WHR were calculated. RESULTS: Data showed that 52% of males and 42% of females were overweight (25.0 ≤ BMI<30.0 kg/m2), and the prevalence of obesity (BMI ≥ 30.0 kg/m2) was 35% in both genders. The average BMI was higher in males (28.5 kg/m2) than in females (28.2 kg/m2). Analysis of WC showed that 36% of males and 45% of females had abdominal obesity, whereas measurements of WHR showed abdominal obesity in 64% of males and 79% of females. Generally, the prevalence of obesity was higher in the older age group (55-64 years) and in rural inhabitants. The prevalence of overweight increased with educational level, but the prevalence of obesity decreased with level of education in both males and females. CONCLUSIONS: Almost 80% of the PONS population were either overweight or obese; therefore, the PONS population is at increased risk of developing obesity-related diseases.

Physical activity among women at reproductive age and during pregnancy (Youth Behavioural Polish Survey - YBPS and Pregnancy-related Assessment Monitoring Survay - PrAMS) - epidemiological population studies in Poland during the period 2010-2011.

Physical activity is among the basic human needs and is the key precondition for the maintenance and enhancement of health throughout all periods of life. Physical inactivity is now identified as the fourth leading risk factor for global mortality. Physical inactivity levels are rising in many countries, with major implications for the prevalence of non-communicable diseases and the general health of the population worldwide. An adequate level of physical activity among young women at reproductive age is especially important because it is one of the preconditions affecting their capability for procreation which, to a great extent, aff ects their activity during pregnancy and conditions the course of pregnancy and labour. Unfortunately, many scientific reports indicate a decrease in physical activity among adolescents, especially girls. The primary cause of this alarming phenomenon are changes in behaviours, including an increasingly greater amount of time devoted to so-called sedentary activities. Such negative health behaviours of women may have negative health eff ects on the functioning of their organism and, in the future, on the development of their off spring. The objective of the presented study was analysis of the level of physical activity among women at reproductive age (prior to conception), and pregnant women in Poland. The study group covered 3,940 women, (730 girls aged up to 15, and 3,210 women aged over 15), and 6,252 pregnant women. The survey was conducted among schoolchildren and students during the last quarter of 2011, while the survey among pregnant women was carried out twice: in the second quarter of 2010, and in the third quarter of 2011. The results of the study revealed a relatively low level of physical activity among young women and pregnant women. The analysis showed an alarming downward tendency in the physical activity of women related to age. Such a decrease in physical activity among girls already during the period of puberty may be of key importance during the period of maturity, especially when they become pregnant. It is highly recommended, therefore, that effective actions should be taken in the area of public health; this would enhance the social awareness, especially among females, concerning the importance of physical activity for the normal development of the organism and an adequate course of pregnancy and labour.

Haematological parameters in postpartum women and their babies in Poland - comparison of urban and rural areas.

Anaemia is a serious health problem in the contemporary world which aff ects 24.8% of the total human population. It is especially frequent among pregnant women and children. Anaemia is considered as a risk factor of an unfavourable outcome of pregnancy. More than a half of the cases of anaemia, especially among pregnant women, are caused by iron deficiency. The prevalence of anaemia worldwide is especially high among the rural population. It is estimated that the incidence of anaemia after delivery is 4-27%. Anaemia occurring in pregnant women is the cause of anaemia in newborns after birth. The objective of the study was analysis of the haematological parameters of postpartum women and newborns, with particular consideration of the comparison between urban and rural areas. The studies were conducted with the use of questionnaire forms based on the project undertaken in the USA: Pregnancy Risk Assessment Monitoring System (PRAMS). The survey was carried out on a single day, during the period 9-13 August 2010, in all hospitals in Poland where mothers were hospitalized with their newborns. The presented study was based on the replies concerning the results of whole blood count tests in mothers and their babies. The results of the study did not confirm any significant differences between Hct, Hb and RBC values between urban and rural mothers. In both cases, the Hct levels were at the lower limit of normal. Also, no differences with respect to the above-mentioned values were noted among the newborns, although the babies of urban mothers had a higher Hb level. The results of the studies indicate the lack of differences in the health of mothers and their newborn babies with respect to the urban or rural place of residence. Despite this, anaemia is associated with complications which are life-threatening for the mother and the baby; therefore, efforts should be undertaken in order to minimize this problem.

Prevalence of cigarette smoking among adult population in eastern Poland.

Cigarette smoking is the strongest modifiable factor, which shortens the life span and deteriorates the quality of life. It increases the risk of development of cancer, cardiovascular and respiratory system diseases. The objective of the study was evaluation of the prevalence of cigarette smoking among the adult population of the Lublin Region, and investigation of the relationship between nicotinism and respondents? place of residence, and other selected socio-economic factors. Data concerning the cigarette smoking habit was obtained from 3,993 people - 2,447 females and 1,546 males; 23.0 percent of respondents in the study were smokers - 35.6 percent of males and 15.1 percent of females. The percentage of male smokers was similar in rural and urban areas. Urban females were smokers more often than those living in rural areas. A decrease was noted in the difference which has been observed to-date between the percentage of urban and rural female smokers. The highest percentage of smokers occurred among the population aged 41-50, while the lowest - among the youngest and the oldest respondents. The percentage of smoking farmers was lower than that of respondents performing non-agricultural occupations, also among rural inhabitants. Those who were occupationally active were smokers more frequently than those not engaged in occupational activity. The lowest percentage of smokers was noted among respondents who had the highest education level, while the highest percentage was observed among those who had vocational education.

Occurrence of overweight and obesity among adult rural population in Eastern Poland. Relationship between obesity and selected socio-economic factors.

The objective of the study was evaluation of the prevalence of overweight, obesity and abdominal obesity among adult rural population in the Lublin Region, and the relationship between the occurrence of obesity, and selected socio-economic factors. The study covered a random sample of 2,260 rural inhabitants - 1,390 females and 870 males; mean age 51.6. Overweight and obesity was diagnosed in 60% of the total number of the population examined (63.1% of males and 58% of females). Overweight was more frequently observed in males, while obesity more often occurred in females. The number of people with overweight and obesity increased with age. No statistically significant relationship was noted between the occurrence of obesity and abdominal obesity, and the occupation performed, occupational activity and source of maintenance of the people examined. Obesity and abdominal obesity was more often observed in those who were married.

Empirical first-line antibioticotherapy in adult rural patients with acute respiratory tract infections.

The objective of the study was the evaluation of the frequency of occurrence of acute respiratory infections among rural population from the Lublin Region, and verification of the appropriateness of the use of antibiotics in empirical first-line therapy of these diseases. The analysis covered medical records concerning 1,839 patients selected from 27 rural health centres within the period of one year (1 September 2005-31 August 2006). As many as 656 patient visits were recorded, the reasons for which were qualified by physicians as infections of the upper and lower airways. These disorders were diagnosed in 450 patients, which constituted 24.46% of the population examined. The following diagnoses were most frequently made: acute pharyngitis and tonsillitis (31.25% of the total number of diagnoses), acute upper respiratory infections of multiple and unspecified sites (22.25%), and common cold (21.64%). Antibiotics were used in empirical first-line therapy in as many as 82% of the total number of patients. The analysis showed that in the great majority of cases the use of antibiotics was inappropriate. If this situation persists, in the near future it will lead to an increase in the phenomenon of antibiotic resistance in Poland. In order to prevent this situation, it is necessary to carry out an extensive educational action concerning the hazardous effect of excessive use of antibiotics, both among physicians and the whole society.

Prevalence of obstructive respiratory disorders in the rural population of the Lublin region.

The subject of the study was to analyze spirometric data provided by comprehensive research programme of Institute of Agricultural Medicine in Lublin. Field research was conducted in the years 1999--2001 to evaluate the prevalence of selected respiratory system diseases. The basic measurements were forced expiration maneuver performed and interpreted on the strength of ATS recommendations, physical examination and medical history (especially lower respiratory airways obstruction symptoms). The two-stage random sample of population of 4 eastern part of Lublin region communes was the studied material (660 people). The aim was to evaluate the incidence of airways obstruction and then chronic obstructive pulmonary disease. Next, we wanted to asses--the main clinical symptoms of disease and what percentage of disease cases are diagnosed/treated by the health care system. Based on our results the incidence of airways obstruction in the population examined is excessive (11%), typical of populations exposed to respiratory risk factors. There were no clinical manifestations in the 50% of cases with spirometric diagnosed obstruction and incidence of severe, symptomatic forms of obstructive diseases was low. 75% of obstructive patients have never been diagnosed by health care system and a very low percent has been properly treated with personal drug inhalers. Our study confirms that chronic obstructive lung disease is an essential problem also in the Polish rural population. Patients belittle early symptoms of COPD and health care system is insufficient in detection and treatment of this disease.