Volume 131 (2021): Edition 1 (January 2021)

In connection with medical services provided, many patients are exposed to harm that may lead to permanent health impairment, hospitalisation, extended hospital stay or even death. Adverse events are reported and are the result of a complex nature of current healthcare systems, in which effective therapy and treatment outcomes of every patient depend on numerous factors, and not only on competencies of individual healthcare professionals.

Individual healthcare professionals can contribute to improving the safety of care by establishing respectful relationships with patients, following procedures, learning from mistakes, and communicating effectively with other members of the therapeutic team. This also decreases costs associated with reduction of harm sustained by patients. Reporting and analysis of errors may help identify major factors that have contributed to their occurrence. In order to consider changes that could prevent errors, at first it is necessary to learn about factors that led to them. An operating theatre is the heart of every hospital. It is where complex and highly specialized surgical procedures are performed in line with state-of-the-art procedures and applicable standards. It is also where employees of various wards meet to perform their crucial tasks that save lives.

Patient’s well-being is a paramount value for a therapeutic team working in the operating theatre. The main goal of surgical nurse is, in turn, to ensure a holistic and individual approach to the patient in accordance with applicable law, procedures and recommendations.

Introduction. There are a few statistical approaches to estimate health impacts of the ambient air pollution concentrations. Air health effects are often studied in short-term exposure. In this context two main techniques are used; time-series and case-crossover (CC). This work focuses on the CC methodology. In the standard method risk is estimated using log-linear models.

Aim. This work proposes other types of the models.

Material and methods. The CC design is applied with various transformations of air pollution concentration. The mortality data are used for the period from 1987 to 2015 for Toronto, Canada. Daily concentration level of ambient ozone is considered as an exposure. The ozone concentration is transformed and used in the statistical models. The transformation is a product of two parts; a simple function such as logarithm and a logistic function as a weight. The transformed concentration is used in the CC statistical models. The models estimate the coefficient related to transformed concentration. It allows to construct the concentration-response function. The generated models are assessed using the Akaike information criterion (AIC).

Results. The relative risks (RR), reported at 75th percentile of the concentration (55 ppb) are different. The standard CC model gives RR=1.0195 with the 95% confidence interval (1.0035, 1.0358), whereas the model with the transformation gives better fit and estimates RR=1.0054 (1.0026, 1.0082).

Conclusions. The proposed methodology allows to construct an accurate approximation of the concentration-response functions. These functions provide adequate approximations and also identify a potential threshold.

Introduction. Due to coronavirus disease 2019 (COVID-19) many people give up exercises. International physical activity guidelines recommend 150 minutes per week of moderate- to vigorous-intensity physical activity or 75 minutes at high intensity per week. Healthy adults should take 10,000 steps per day. Wearable devices (smartwatches, step counters, physical activity monitoring applications) have the potential to promote a healthy lifestyle at the time of COVID-19 pandemic. They are accepted by the youth.

Aim. The aim of the study was to find out if using step counting devices affects the level of physical activity and body mass index (BMI) in students.

Material and methods. A total of 303 participants (227 women, 76 men) studying in Lublin, Poland of mean age 19.5 years participated in the study conducted with use of an internet questionnaire.

Results. Before the COVID-19 pandemic their mean BMI was 22.17 kg/m2 and after 9 months of COVID-19–related restrictions it was 22.57 kg/m2. Among the respondents 204 (67.3%) did a physical activity for 50 min 3 times a week in 2019 and 99 (32.7%) did not. In December 2020 there was a significant decrease in the number of students doing physical activity to 128 (42.2%) (p<0.05) and an increase in the number of students who did not do any physical activity to 175 (57.8%) (p<0.05). In 2019 as many as 110 (36.3%) of the respondents used to use step counting devices and 192 (63.7%) did not. In 2020 the number of students using activity tracking devices significantly decreased to 58 (19.2) (p<0.05). The number of students who did not use any step counting device in 2020 was 245 (80.8%).

Conclusion. Due to the COVID-19 pandemic the number of students who don’t do enough physical activity significantly increased. The use of step counting devices helps students in continuing physical activity despite COVID-19-related restrictions.

Introduction. Vaccines are one of the greatest achievements of modern medicine. The compulsory vaccination schedule was introduced in Poland in the 1950s. Vaccinations are sometimes followed by adverse effects (ARV). The most common symptoms of ARV are swelling, redness and soreness at the injection site, usually lasting up to 24 hours after vaccination.

Aim. The aim of our study was to check the attitude of students of Lublin universities to vaccination in the COVID-19 period.

Material and methods. In December 2020 we conducted an anonymous and voluntary survey. It was uploaded and shared on the Google online survey platform. A total of 75 students participated in the study.

Results. The respondents were 56 women and 19 men. Out of them 30 (40%) were from Medical University of Lublin (MUL), 15 (20%) from University of Life Sciences (ULS), 21 from University of Marie Sklodowska-Curie (UMCS) (28%) and 9 from Lublin University of Technology (LUT) (LP) (12%). Their mean age was 22 years ± 1.1 (SD). More than half of the respondents were not interested in compulsory vaccinations before the COVID-19 pandemic. Only about 35% (18 persons) of people expressed a positive opinion about vaccines and they were students of MUL. Although 80% of respondents answered that the anti COVID-19 vaccine is necessary, but 81% thought that Poles had not enough knowledge about the vaccine. Students themselves most often obtained information about vaccines and ARVs from Internet.

Conclusion. Students of MUL were the most enthusiastic about mandatory vaccinations and anti COVID-19 immunization. Poles need more reliable information about vaccine to change their attitude towards it.

Introduction. Selenium (Se) is a trace element found mainly in meat, seafood, nuts and grains. Se is found in selenoproteins such as selenocystein or selenomethionin. A well balanced diet provides enough Se. Many regulatory and metabolic enzymes contain Se as their component, which is why Se supplementation is used in the treatment as well as prevention of multiple disorders. Se may, however, be toxic if overdosed.

Aim. The aim of this review is to summarize the data about functions of Se in human body and to discuss its use in treatment and prevention of diseases.

Materials and methods. The search was conducted using the PubMed and Google Scholar databases in March and April 2020. The key words used were: ‘selenium’, ‘cardiovascular disease’, ‘selenium supplementation’, ‘Keshan disease’, ‘source of selenium’. A total of 68 articles were analysed.

Results. The first cases of chronic Se deficiency cases were documented 85 years ago in China. The patients with cardiomyopathy, extensive fibrosis and degenerative changes in the heart were diagnosed with Keshan disease. Human selenoproteonome consists of at least 25 selenoproteins. Se plays a role in immunity and metabolism via its role in functioning of numerous enzymes: glutathione peroxidase, thioredoxine and methionine sulfoxide reductase, methionine-sulfoxide reductase B1. Se plays a role in glucose homeostasis, Alzheimer’s disease, thyroid disorders, infectious, inflammatory diseases, vascular diseases and fertility.

Conclusion. Se deficiency increases the risk of Keshan disease, but there is not enough evidence to recommend its supplementation for prevention of cardiovascular disease. However, Se status is important part of health assessment. Se supplementation should not exceed the dose of 55μg/day.

Sleep impacts our functioning, both on a physical and mental level. This study aimed to assess the officials’ sleep using objective (actigraphic examination) and subjective evalutation methods (self-administered questionnaire and sleep diary).

The analysis revealed that among the officials, sleep deprivation was common. The average actual sleep time in this group was 1-hour shorter than recommended. Officials holding managerial positions more frequently presented worse sleep outcomes affecting their sleep efficiency than lower-level office workers. Workplace stress was associated with reduced sleeping hours and household stress with more frequent night waking.

Introduction. Numerous authors have undertaken research on the coexistence of mental health disorders and thyroid disease. They have not been able to clearly demonstrate which illness came first.

Aim. The main purpose of this work is to asses the coexistence of thyroid disease with mental health conditions and disorders in behaviour. This work is based on a retrospective study and has shown frequent coexistence of thyroid disease with mental health or behaviour disorders.

Material and methods. The research method was a retrospective study carried out on the basis of medical records of patients of primary care clinics in the city of Lublin. The criterion for qualifying patients for the study was having a diagnosis, according to ICD 10, from at least one of the following groups: thyroid diseases E03-E07, mental health conditions F00-F 99 and behavioral disorders R44-R46.

Results. In total, 243 patients were qualified for the study. In this group 193 people are women and the remaining 50 are men. Among patients with isolated diseases, 28% of them have only diagnosed thyroid disease; every third patient (30%) has diagnosed mental health illness or behavioural disorders. The Fisher test showed a relationship between thyroid diseases and mental health conditions including behavioural disorders (p=0.0000). A group of people with hypothyroidism in the course of Hashimoto’s disease has been identified. The results of the prevalence of the disease were observed dividing by gender and age. Hashimoto’s disease occurs in the group of 15% women and 4% men. Pearson’s Chi² test showed a relationship between the incidence of Hashimoto’s disease and gender (p=0.037). The quota coefficient showed that this relationship is weak (0.13). The disease is more common in women.

Conclusions. There is a close relationship between the incidence of thyroid disease and mental health illness, including behavioural disorders. Patients with co-morbidity are significantly more likely to present mental illnesses and disorders. The dominance of mental illnesses and disorders is three times higher compared to thyroid diseases.

Introduction. The issues of dental office accessibility, professionalism of the service as well as treatment reimbursement often determine geriatric patients’ decision regarding treatment. In the era of an aging society, struggling with the intensification of disease processes of the entire system, the belief of the elderly about the value and availability of dental treatments is the key to the wide use of the achievements of modern dental medicine. Thanks to this, there is a chance to improve oral health, which will directly improve the overall health condition of this age group.

Aim. The aim of the study was to know the opinions of senior patients about the quality and availability of dental care for this age group.

Materials and methods. The study was conducted during the Lublin Seniors Meeting LUB-SENIOR 2019 among 100 randomly selected people of both sexes aged 60-75 living in Lublin, who are not residents of retirement homes. An anonymous direct questionnaire with 7 questions regarding dental care was used.

Results. After analyzing the answers given by the respondents (n=100), it was found that 84% of them showed satisfaction with the dental care available to them. Among the surveyed seniors, 81% declared having their own dentist, while 25% expressed the willingness to change him. As much as 80% of the respondents declared that dentists pay attention to seniors dental health problems. A friendly approach of the dental team to a senior patient was declared by 61% of the respondents. Preferences concerning the use of dental treatment in private offices were reported by 44% of thepeople, and within the procedures provided by the NHF – by 45%.

Conclusions. The surveyed senior patients show attachment to their dentist, while expressing a positive opinion on dental care and the treatment. Few people in the studied age group show the willingness to change dentists, which is directly influenced by the doctors’ interest in health problems of the elderly.

Introduction. Women in Poland suffer from and die of cervical cancer more often than women from other European countries. The reason for this phenomenon is the fact that women in Poland are reluctant to perform Pap smear tests. Reluctance to undergo a Pap smear is due to low awareness of its course. Numerous studies show that women do not know much about the course of illness, risk factors and prevention of cervical cancer. In its prevention, health behaviors are important from the moment of sexual initiation, so it is important that young women have sufficient knowledge about it.

Aim. Determining the state of knowledge of the respondents, comparing social awareness to previous research and proposing new preventive solutions.

Material and methods. An anonymous questionnaire survey was conducted in electronic form among women aged 16-25 from all over Poland. The study was conducted using a proprietary questionnaire (Google form) completed online. The questionnaire contained closed questions verifying the knowledge of the topic under study and personal information. The following computer programs were used for statistical analysis of data: Statistica and Microsoft Excel.

Results. Almost half of the surveyed women believes that the use of oral hormonal contraception does not increase the risk of developing cervical cancer. One in ten women does not know about the existence of an HPV vaccine. Nearly one third of the respondents do not see a gynecologist at all. Nearly two-thirds of women do not perform a Pap smear.

Conclusions. The surveyed women have some knowledge concerning cervical prophylaxis, but they rarely use it in practice. However, the knowledge of women about the symptoms and risk factors of cervical cancer is small. Too few women know about the existence of a cervical cancer prevention program in Poland.

Introduction. Breast cancer is the most common malignant neoplasm among women in Poland. Many factors, both non-modifiable and modifiable, are involved in the development of this cancer, so it is important that women know the risk factors and the principles of cancer prevention. Numerous studies show that the knowledge of women in this area is small.

Aim. Determining the state of knowledge about breast cancer of young women in Poland, comparing the analysis of social awareness on this subject with previous research, and identifying the most important preventive measures in this area.

Material and methods. An anonymous questionnaire survey was conducted in electronic form among women aged 16-25 from all over Poland. The study was carried out using a proprietary questionnaire (Google form) completed online. The questionnaire contained closed questions verifying the knowledge of the topic under study and a certificate. The following computer programs were used for statistical analysis of data: Statistica and Microsoft Excel.

Results. Less than a third of women knows the typical age at which breast cancer develops and is aware of the relationship between the use of oral hormonal contraceptives and the development of this cancer. Few of the respondents are able to correctly identify the risk factors for breast cancer, practically every tenth respondent knows the principles of breast cancer prevention, and nearly one third of them correctly indicated its symptoms.

Conclusions. There are gaps in the knowledge of young women about breast cancer that need to be filled. Education in the field of breast self-examination and risk factors for breast cancer development is a priority, which in the future may contribute to increasing the detection of breast changes and reducing the number of breast cancer cases.

Introduction. People with mental illness can be restricted in certain constitutional rights only in the manner and within the limits that are established by the laws of a particular country. Such restrictions of the rights and interests of persons with mental health defects are possible only by court decision and to the quantities that are determined by the nature of the disease and the degree of public danger of the diseased. Defining a list of such restrictions and criteria for their application is one of the complex problems of public practice.

Aim. The essence of the problem is revealed and the grounds, possibilities and procedure for interfering in the sphere of rights and interests of persons suffering from certain mental illnesses are indicated in the given research, based on results of the analysis of legislative acts and practice of rendering of psychiatric help to patients in Ukraine.

Methodological framework. The authors of the article have applied scientific theoretical methods, which are analysis, synthesis, concretization, generalization, analogy, as well as empirical method of studying the normative sources, the methodical documentation, and method of system approach for forming conclusions to reveal the essence of the problem.

Results. Interference in the sphere of personal rights and interests of human is possible only in the manner that is determined for this by the legislation of the country. Such are the requirements regarding the restriction of certain rights of persons who show signs of mental illness or suffer from certain mental illnesses. Restrictions of the rights of people suffering from mental illness have long been applied in society and it is based on the stigmatization of mental illness. However, certain restrictions for such persons are important primarily for the protection of their personal interests and the interests of society in general and other people, who are located near them. This relates to the application, in the court manner, of coercive measures of a medical nature not as a form of punishment, but as a system of treatment, medical-prevention and rehabilitation measures, the provision of psychiatric care in accordance with the general principles of treatment. Separate problems are the issues of provision of the rights of persons with mental disorders, who belong to the category of witnesses, victims, plaintiffs, defendants. Here the legislation of Ukraine and departmental documents, by which the issues of protection of the rights of the person with defects of mental health have been regulated, has certain inconsistencies or insufficient clarity of the wording of regulations.

Conclusion. Standards and principles of the providing of psychiatric care in Ukraine are in line with modern European approaches. Judicial manner for making decisions on temporary restriction of the rights of individuals with psychiatric disorders serves as a guarantee of fairness in the application of legal requirements, and the restrictions themselves must be exclusive and minimal in nature. The disadvantage is that there are no rules for conducting psychiatric assessment of victims, witnesses, plaintiffs, defendants today in Ukraine. At the same time, all these measures require the awareness-building among the population and the education of humane treatment of those whose mental sphere of life needs help.

Introduction. Postpartum depression (post-natal depression, pure postpartum depression, PPD) is one of three types of post-natal mood disorders. The degree (severity) of this disorder may be defined as moderate or severe. A milder form of depression is postpartum sadness (baby blues), while the untreated depression can develop into a very severe form of depression called postpartum psychosis

Aim. The aim of the work was to analyse the incidence and severity of postpartum depression symptoms in women in the first year after giving birth, evaluated by the Edinburgh Postnatal Depression Scale, and the social support received and expected by them.

Material and methods. This paper presents the severity of depressive symptoms in 150 women measured by the Edinburgh Postnatal Depression Scale in the first year after their giving birth as well as the support received by them and the demand for it.

Results. More than half of the women filling in the Edinburgh Postnatal Depression Scale achieved a result indicating a high risk of postpartum depression (more than 12 points). The severity of postpartum depression symptoms depended on the place of residence of women, was related to attendance antenatal classes, breastfeeding and the support received.

Conclusions. It would be advisable to initially assess the risk of postpartum depression in women immediately after childbirth and the social support available to them.

Introduction. This study investigates associations between air pollution and emergency department (ED) visits for urticaria in Toronto, Canada.

Aim. To verify the hypothesis that urticaria are related to air pollution.

Material and methods. The National Ambulatory Care Reporting System database is used to draw the daily ED visits. The L50 section of the International Classification of Disease 10^th Revision is applied to extract ED visits whose primary causes was urticaria-related skin condition. Statistical models (condition Poisson regression) using daily counts of ED visits are constructed for urticaria (health response) with ambient air pollution concentrations and weather factors as independent variable. Two air quality health indexes and six ambient air pollutants: fine particulate matter PM_2.5, O₃, CO, NO₂, SO₂, and maximum 8-hour average ozone are considered as an exposure.

Results. A total of 176 statistically significant (P-Value <0.05) positive correlations were identified over the 15 day lag period (0-14 days). For daily average of ambient ozone, 74 positive correlations were observed with the following relative risks (RR) for a one interquartile range (IQR=12.8 ppb) increase: RR=1.361 (95% confidence interval: 1.302, 1.404), 1.359 (1.299, 1.401), 1.351 (1.281, 1.404) in the warm season (April-September), lag 0, and RR=1.019 (1.013, 1.025), 1.023 (1.016, 1.030), 1.014 (1.007, 1.021), lag 1, in the cold period (October-March), for all, females, and males, respectively. 10, 45 and 45 positive correlations were also obtained for sulfur dioxide, fine particulate matter, and daily maximum 8-hour average ozone concentrations, respectively.

Conclusions. The results indicate that urban ambient air pollution could influence the numbers of ED visits for urticaria. Ambient ozone was determined as the main environmental factor contributing to these associations.

The COVID-19 epidemic has negatively affected all spheres of life, leading to the deterioration of health and quality of life. Although it has affected both men and women, it has had an extraordinary impact on the latter, exposing and exacerbating the existing health inequalities among those groups.

There is increasing evidence that both sex and gender-related factors make women more prone to the harmful effects of SARS-CoV-2. Therefore, it is expected that the crisis caused by coronavirus will have long-term severe medical, social, and economic consequences in this population. This paper aimed to investigate the key factors contributing to the different outcomes of COVID-19 in men and women and present multi-dimensional effects of coronavirus pandemic from the perspective of women.

Sex and gender differences must not be ignored in analyzing the impact of COVID-19. Sex/gender-oriented approach should be implemented in all public health actions: from collecting sex-disaggregated data to designing tailored repair post-COVID policies.

Introduction. Secondary traumatic stress (STS) is a consequence of the indirect experience of trauma. The symptoms of STS are similar to those experienced by people who directly experience traumatic events in the form of posttraumatic stress disorder (PTSD).

Aim. The aim of the study was to determine the frequency of the symptoms of PTSD and to establish the role of coping strategies in the development of PTSD symptoms among Polish nurses. The study was conducted before the COVID-19 pandemic.

Material and methods. The study was conducted in the Podkarpackie Province (Poland) in clinical hospitals and hospital out-patient clinics. The results of studies conducted among 509 nurses were analyzed. The mean age of the respondents was 35 years, and the mean work seniority was 11 years. The IES-R scale and Mini-COPE were used in the study.

Results. At least moderate PTSD symptoms were found in 42.4% of the surveyed nurses. The results showed that maladaptive stress coping strategies played a major role in the development of PTSD symptoms in the group of nurses.

Conclusion. Nurses are a professional group exposed to a high risk of traumatic encounters that may result in PTSD/STS, therefore this professional group should be targeted at prophylactic programs and training in dealing with traumatic stress. The COVID pandemic and the related restrictions, organizational chaos, constant fear and a sense of danger are serious traumatizing factors and can seriously contribute to the increase in stress disorders among nurses and other medical professionals.

Breast milk banks are specialized hospital-located laboratories. Their role is to provide breast milk to newborns and infants who, for various reasons, cannot be fed with their mother’s milk. They are an inseparable part of intensive neonatal care units and an element of the mother and child care system. They are financed by hospitals in which they operate. Milk is obtained from donors, thoroughly examined, pasteurized and passed directly to children in need. Food recipients are mainly premature babies in the neonatal intensive care unit. As proven by numerous scientific studies, breast milk is the most appropriate food for newborns and infants. Breast milk is also recommended by Polish, foreign and international organizations and institutions involved in nutritional problems of children.

There are 226 Breast Milk Banks in Europe (first organized in 1909 in Vienna) and the organization of additional 16 is planned. In Poland there are only 9 banks and two more are in the organizational phase. Breast milk banks in Poland operate on the basis of in-hospital regulations. The European Association of Milk Banks strives to unify the procedures of conduct in all units, including Poland.