ISSN: 0044-2011 e-ISSN: 2083-4829 Yearbook (from 2020) SUBMISSIONS - The authors should submit papers for the journal Polish Journal of Public Health via the internet platform. Click to log in. The Polish Journal of Public Health (formerly Public Health) is a scientific journal published by the Medical University of Lublin. It covers articles in the field of public health, including: lifestyle diseases, epidemiology, disease prevention and health promotion, health policy and health care organization, health psychology and sociology, bioethics and medical law, medical technologies and telemedicine. The journal is devoted to broad audience of scientists and practitioners in the field of public health, addressing contemporary health challenges from a national and international perspective. This is a peer-reviewed open access journal, meaning all content is available free of charge to the user or their institution. Users may read, download, copy, distribute, print, search, or link to the full text of articles in this journal without prior permission from the publisher or author. This is consistent with DOAI definition of open access. Authors publishing in Polish Journal of Public Health receive 40 points MNiSW. Purchase of the archival edition (2017-2019) in paperback: online via e-mail: journals@umlub.edu.pl
Patient rights and self-assessment of their application by physicians employed in public healthcare facilities
Aim. Patient rights are a set of rights granted to healthcare recipients. They include objective standards which inform patients about what they can expect from public authorities and institutions directly providing healthcare services. The main objective of the study was to assess the knowledge of physicians employed in public healthcare facilities about patient rights. Material and methods. The study was conducted in the period between October 2022 and March 2023. The diagnostic survey method was employed, using a self-developed questionnaire. One hundred respondents employed in hospitals and primary health-care facilities took part in the study. Microsoft Excel (Microsoft Office) was used to compile the data. The statistical analysis was conducted with the use of the Statistica 13.1 PL statistical software. Results. 61% of physicians reported their knowledge of patient rights to be satisfactory, while 39% found it unsatisfactory. 33% of respondents were familiarized with patient rights in the course of their higher education, while 67% learned about them only in the workplace. Meanwhile, 51% of respondents were familiar with the Patient Rights and the Patient Rights Ombudsman Act. 79% indicated that they complied with patient rights in their professional practice, while 33% of respondents confirmed that they had witnessed violations of patient rights in their workplace. Conclusions. Based on research, it can be concluded that there is a need to develop and implement a training program for medical personnel on patients’ rights. Doctors’ lack of knowledge about patients’ rights influences the exercise or violation of these rights.
Copyright (c) 2025 Authors https://creativecommons.org/licenses/by-nc-nd/4.0/
Probiotics – a blessing for some, a burden for others. The positive and negative effects of their use among different groups of patients – journal review
Introduction. The increasing interest in the use of bacterial cultures and complex microbial products in medical treatment has become more and more noticeable. Each year, a growing number of such products are introduced to the pharmaceutical market. With the development of methods for isolating and culturing specific bacterial strains, numerous concepts have emerged on the potential benefits of supplementation. We agree that probiotic supplementation yields scientifically proven positive effects in certain medical conditions. However, our attention is drawn to the tendency to expand the use of probiotics to vulnerable populations. This raises important questions concerning the safety, efficacy, and potential risks associated with probiotic use among the most sensitive patient groups. In our work, we focused on reviewing the current scientific literature, and we would like to propose several insights into safe probiotic administration among different groups of patients. Materials and methods. We reviewed the literature from early 2000 to 2025 for articles on the probiotics in different groups of patients. The review of the available literature was conducted by searching official databases such as PubMed and Google Scholar using the following keywords: probiotics, prebiotics, antibiotics, microflora, sepsis, acute diarrhea, preterm infants, SIBO, IBS, acute pancreatitis etc.. We also queried references cited from original research, meta-analyses, and reviews in both Polish and English language, published in scientific journals and articles. Results. Probiotics demonstrate therapeutic benefits in preventing antibiotic-associated diarrhea and reducing necrotizing enterocolitis in preterm infants. They may also support treatment of ulcerative colitis, pouchitis, travelers’ diarrhea and acute childhood diarrhea, as well as possibly prevent atopic dermatitis when taken maternally. However, the evidence remains inconclusive for several other conditions, including IBS and Crohn’s disease. Probiotic use remains not recommended in immunocompromised states, such as ICU settings, due to the risk of sepsis. Safety concerns include antibiotic resistance and microbiota disruption, which requires thorough data from high-quality clinical trials, including strain-specific assessments. Finally, the available data suggests that synbiotics may offer enhanced benefits, while postbiotics are emerging as safer alternatives. Conclusions. The available data and existing studies do not provide sufficient grounds to unequivocally support the use of probiotics and related products in clinical treatment. There is a lack of robust evidence based on well-designed clinical trials. Current recommendations regarding the use of probiotics for the management of travelers’ diarrhea and antibiotic-associated diarrhea remain in place, as do contraindications for their use in individuals with sepsis or compromised immune function. However, for other medical conditions, stronger evidence and formal guidelines from scientific societies are still awaited.
Blue light from screen and depression – A review
Introduction. The growing prevalence of screen time in modern societies has significantly increased exposure to blue light,especially from smartphones and computers. While blue light is crucial for circadian rhythm regulation and mood enhancement during the day, its excessive evening exposure may negatively impact sleep quality and emotional stability. Recent studies have pointed toward its potential link with the development of depressive symptoms. Aim. This review aims to explore the relationship between exposure to blue light particularly from screen-based devices and the development or exacerbation of depressive symptoms, with a focus on biological mechanisms, epidemiological data, and the therapeutic potential of light in mood disorders. Material and methods. A narrative review of 113 articles retrieved from PubMed and open-access sources (published up to May 2025) was conducted. The included literature covered neurobiological mechanisms (e.g., melanopsin, ipRGCs), circadian rhythm alterations, clinical trials on light therapy, and epidemiological studies linking screen time with depression. Emphasis was placed on studies investigating adolescent and adult populations, blue light wavelength sensitivity, and melatonin suppression. Conclusions. Blue light influences human physiology through melanopsin-expressing retinal ganglion cells, affecting melatonin secretion and circadian rhythms. While daytime exposure supports mood and cognitive performance, evening exposure is associated with sleep disturbances and an increased risk of depressive symptoms. Bright light therapy shows promising efficacy in treating seasonal affective disorder and may support mood regulation in broader populations.
Copyright (c) 2025 Authors https://creativecommons.org/licenses/by-nc-nd/3.0/
Endocrine disruptors in male fertility – a review
Introduction. Endocrine-Disrupting Chemicals (EDCs) have an impact on health and disease. We are exposed to EDCs from the earliest years of life, from children’s products, personal care products, food containers, pesticides, and herbicides. These chemicals often bind to endogenous receptors (e.g., estrogen receptor, steroid receptor) and disrupt normal brain function, reproductive organs, development, immune system, and many other organs. Recent studies indicate a potential link between exposure to EDCs and male infertility. In this review we also provide practical public health implications, prevention strategies and policy recommendations aligned with the WHO and the EU frameworks for reducing EDCs exposure. Aim. This review aims to explore the relationship between exposure to Endocrine-Disrupting Chemicals, we can find in items used on a daily basis and male reproductive health focusing on mechanisms of action, exposure timing and substance specific consequences. Materials and methods. A narrative review of 62 articles retrieved from PubMed and open access sources (published up to May 2025) was conducted. The included literature covered molecular mechanism, function of Leydig and Sertoli cells, testosterone synthesis, semen analysis. Emphasis was placed on studies investigating adolescent and adult populations as well as animal models. Conclusions. EDCs interfere with hormonal homeostasis and spermatogenesis through numerous often very subtle mechanisms. Alarming is high sensitivity of the male reproductive system during prenatal development and puberty, while even lowdose exposures can lead to lasting or even transgenerational effects.
From strength to cognition: The expanding role of creatine supplementation in health and disease
Introduction and aim. Creatine monohydrate is one of the most extensively studied and widely used nutritional supplements, primarily recognized for its role in the improvement of skeletal muscle energetics and physical performance. However, mounting amount of evidence now supports its broader physiological impact beyond exercise, particularly in domains such as neuromuscular aging, cognitive function, and post-viral fatigue syndromes. The purpose of this narrative review is to comprehensively evaluate the effects of creatine supplementation across various domains of human health, including sports performance, cognitive function, aging-related outcomes, and post-viral fatigue syndromes such as long COVID. Particular attention is given to the impact of creatine on muscle strength, power output, recovery from exercise-induced muscle damage, neuroprotective mechanisms, and quality of life in different populations. By synthesis of findings from randomised controlled trials and recent clinical studies, this review seeks to clarify both the efficacy and safety profile of creatine, as well as its potential role as an adjunctive therapeutic strategy beyond traditional athletic contexts. Description of the state of knowledge. Creatine augments intramuscular phosphocreatine stores, thereby optimising ATP resynthesis during high-intensity exercise and promoting anabolic adaptations. Neuroprotective mechanisms involve mitochondrial stabilisation, antioxidant activity, and modulation of neurotransmitter systems. These effects are mediated by systemic and cellular alterations in energy metabolism, hormone profiles, and inflammatory pathways. Material and methods. This review was conducted following a narrative approach. Scientific publications were identified through a structured search of electronic databases including PubMed, Scopus, and Google Scholar, focusing on studies published between 2000 and 2025. Search terms included “creatine supplementation”, “exercise performance”, “cognition”, “aging”, “long COVID”, “muscle recovery”, and related keywords. Only peer-reviewed articles written in the English language were considered. The selection included randomised controlled trials, meta-analyses, and clinically relevant pilot studies. Additionally, to provide a comprehensive context for creatine use, related review articles, official regulatory documents, market reports, and position statements from authoritative organisations were also included. Conclusions. Clinical trials demonstrate significant improvements in muscular performance parameters, cognitive processing speed, depressive symptomatology, and markers of muscle damage andregenerative capacity. . The collective evidence supports creatine as a pleiotropic agent with potential applications extending beyond traditional sports nutrition into therapeutic domains addressing neurodegeneration, mood disorders, and post-viral fatigue syndromes. Given its broad applicability and favorable safety profile, creatine may hold value as a low-cost, scalable intervention in public health strategies aimed at promoting healthy aging, physical resilience, and cognitive well-being.
Quality of care for pregnant and postpartum women in randomly selected hospitals in Poland
Aim. The purpose of the study was to determine the degree of satisfaction of women giving birth in hospitals in Poland with the quality of perinatal care. Factors such as choice of hospital, possibility of obtaining an epidural, participation of people accompanying women during labor and others were taken into account. The study examined how complications and procedures (such as perineal incision) affected women’s satisfaction with perinatal care. Material and methods. The survey was conducted online among patients giving birth in facilities across Poland, both public and private. Participation in the survey was offered to a random sample of 309 women who gave birth between 2014 and 2024. A self-administered questionnaire, consisting of closed and open-ended questions, was used for evaluation. Results. The perinatal care was rated positively by 70.8% of the women surveyed. Among the Polish women surveyed, only 8.3% rated the level of care as bad and 2.1% as very poor . Most respondents gave birth in public hospitals, and only a small percentage in private hospitals (3.2%), so the conclusions drawn in this study apply mainly to public facilities. Conclusions. The most significant factors in assessing the satisfaction of mothers with the standard of care were the attitude of medical personnel toward patients and the lack of availability of epidural anaesthesia for labor. The quality of perinatal care in Polish hospitals seems satisfactory for most patients, but some issues still need improvement. Care of the pregnant woman should be multilevel and include both physical and psychological aspects, for the overall well-being of mother and child.
The impact of passive tobacco smoke exposure on the disease course and frequency of exacerbations in pediatric inflammatory bowel disease
Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease, are an increasing health problem in the pediatric population, with rising incidence globally. Environmental factors are crucial in the etiology and progression of these disorders. A key modifiable risk factor is exposure to tobacco smoke, both active and passive. This study aimed to analyse current knowledge on the impact of passive smoking on the risk and course of IBD in children. The literature review shows that although a direct link between passive smoking and pediatric IBD etiology is not conclusively proven, there is strong evidence suggesting its negative effect on disease activity and prognosis. Prenatal and early childhood exposure, in particular, may influence immune mechanisms and predispose children to disease development and exacerbations. Children with IBD exposed to secondhand smoke have more frequent flare-ups, require more hospitalizations, and often need intensified immunosuppressive treatment. The importance of preventive actions is also emphasised, especially education of parents and caregivers to limit children’s exposure to tobacco smoke. Effective strategies to reduce passive smoking at home and at the legislative level are necessary. A comprehensive interdisciplinary approach covering medical, social, and legal aspects is essential to improve the quality of life among children with IBD and reduce related health and economic burdens. This analysis highlights the need for further research and preventive measures to minimise the harmful impact of passive smoking on the course of IBD in the pediatric population.
Mobile health technologies as a tool supporting mental health and physical activity in adolescents – a review of current practices
In the era of rapid development of mobile health technologies, tools supporting mental health have become an integral part of modern health promotion among adolescents. In Poland, there is a growing interest in and use of solutions that offer access to personalised training programs, mood monitoring, and real-time psychological support. This article provides a comprehensive review of the latest trends and technological solutions with the potential to improve mental health and to increase physical activity among young people. A narrative literature review methodology was applied. Publications from 2015 to 2025 in Polish and English, related to the use of mobile health technologies in promoting mental health and physical activity among adolescents, were included. The review indicates a dynamic development of artificial intelligence and machine learning enabling the creation of increasingly advanced and individualized health solutions foradolescents.. The analysis highlights various challenges faced by users and developers of applications,from the need to tailor interventions to individual needs and motivation levels, through digital fatigue limiting engagement, to concerns regarding privacy and data security. Integration of mobile applications with healthcare systems opens new possibilities for health monitoring and early intervention. Further research on the effectiveness of these tools is recommended, along with the necessity to strengthen digital competencies of adolescents and their families through educational programs.
Management of hepatic echinococcosis: Should surgical intervention be the first-line therapeutic option?
Introduction. Echinococcosis is a serious zoonotic disease, especially in endemic regions. Its treatment remainsthe subject of debate,, including pharmacotherapy, percutaneous techniques, and surgery. Without intervention, mortality can reach 90%. Common symptoms include weight loss, right upper quadrant discomfort, and, less frequently, jaundice with cholangitis. Materials and methods. This unsystematic literature review covers studies from PubMed and Google Scholar (2020-2025) focused on echinococcosis treatment. Keywords included: echinococcosis, treatment outcomes, diagnostic methods, surgery, cystic echinococcosis (CE). Results. Thechoice of therapy depends of thedisease stage. The most effective strategy is radical surgical resection combined with benzimidazole-based therapy, which has a low recurrence rate. However, surgery carries risks such as bleeding, bile leakage, infections, and bowel obstruction. Despite these complications, it remains the gold standard, offering favorable long-term results. In cases with hydatid cyst abscess, non-radical surgery is preferred to reduce postoperative complications. Albendazole monotherapy is suitable only for lesions under 5 cm, extending 10-year survival in 80% of cases. Due to the long latency and nonspecific early symptoms, surgery is required in most cases. Conclusions. Pharmacotherapy alone is rarely sufficient. Surgery remains the most effective approach, ensuring parasite removal and lowering recurrence risk. The best outcomes are achieved with a combined approach: initial albendazole therapy, followed by surgery after cyst shrinkage, and continued albendazole use postoperatively.
Repair vs replacement of composite restorations with secondary caries: A narrative review of current clinical strategies
Secondary caries remain a leading cause of restoration failure and replacement in contemporary dental practice. The aim of this paper is to review current clinical criteria guiding the decision-making process between repair and replacement of composite restorations affected by secondary caries. Additionally, the paper assesses the effectiveness of surface conditioning techniques and prepares a repair protocol for recurrent caries. The electronic database search was carried out using PubMed and Google scholar databases with the keywords: “secondary caries”, “repair”, “replacement”, “surface conditioning”, “minimally invasive dentistry”. The reference lists of selected articles were manually searched for appropriate studies. The literature search included publications from 01/01/2015 to 15/05/2025 and was limited to English language. Studies show that it is preferable to perform a repair rather than a replacement whenever possible. Surface conditioning techniques like bur roughening, air abrasion, acid etching, and the use of salinizing and adhesive agents can enhance the success of the repair method. However, evidence on how effective these methods are is less certain. When deciding between repair and replacement, clinicians should consider restoration material properties, patients caries risk, their personal experience, and the decay advancement. The currently obeyed rules of minimally invasive dentistry favour the decision of repair. Many methods of increasing the effectiveness of a restoration repair have been introduced. This study presents an exemplar repair protocol using air abrasion.
Transformation of the Italian healthcare system
The Italian healthcare system is based on the National Health Service (Servizio Sanitario Nazionale; SSN), which provides free healthcare mainly to citizens and legal foreigners. The decentralization of the Italian healthcare system has led to the argument that it is now undergoing a fundamental transformation that must be adequately reflected in the operation of the National Health Service (Servizio Sanitario Nazionale; SSN). The current fundamental transformation of the Italian healthcare system is also a consequence of the changes that scientific and technological progress is introducing into almost every activity of the National Health Service (Servizio Sanitario Nazionale; SSN).
decentralization of the Italian healthcare system
scientific and technological progress in the Italian healthcare system
Copyright (c) 2025 Author https://creativecommons.org/licenses/by-nc-nd/3.0/
The comparison of the dental needs of patients from Poland and Ukraineaged 21-30 years old based on panoramic radiographs
Introduction. Oral diseases are a serious problem of today’s population. Amongst the leading causes of oral health diseases, untreated dental caries, edentulism and severe periodontal disease are identified. The condition of the oral cavity in patients aged 21-30 years varies depending on multiple factors, such as diet, lifestyle, hygiene of the oral cavity, availability of dental care and many others. Aim. The aim of this study was to compare the dental treatment needs of young adults from Poland and Ukraine based on panoramic X-rays. Materials and methods. The material was derived from the database of panoramic radiographs taken in the years 2017-2022 at the Department of Dental and Maxillofacial Radiodiagnostics. Results. Mean number of teeth in patients from Ukraine and Poland was comparable. The mean number of teeth with fillings was higher in Polish patients. The number of carious cavities in patients from Ukraine and Poland was similar. Both periapical lesions and teeth qualified for extraction were more frequently observed in Ukrainian patients. The average number of impacted third molars per person was higher in Polish patients. The study took into account gender differences. Discussion. The authors studied the intensity of caries in different age groups, the condition of periodontal tissues, and the incidence of retained third molars. Epidemiological studies were conducted to assess the oral health of patients of different nationalities and to analyze their attitudes toward oral health through a questionnaire. Conclusions. The dental status of the studied Ukrainian and Polish patients shows no significant differences, unsatisfactory level of treatment and comparable dental needs.
Patterns and correlates of smoking among randomly selected former athletes
Introduction. The relationship between smoking and inactivity or moderate physical activity is well documented, but little is known about the relationship between smoking and participation in competitive sports. Aim. The objectives of our investigation were to present prevalence data for cigarettes smoking among athletes, describe the direction of changes in smoking habits after finishing their sports career, and examine the independent risk factors of smoking among female and male former athletes. Material and methods. Randomly selected Polish former athletes (n=351, aged 18-66 yr) responded to an anonymous questionnaire regarding smoking during their sports career, period and level of participation in competitive sports in the past, and current smoking status, level of leisure time for physical activity, and socioeconomic status. Wilcoxon`s signed rank test was used to determine changes in smoking behaviours during and after finishing respondents` sports career. Risk factors of smoking were identified through the logistic regression analysis. Results. The prevalence and intensity of smoking among men and women during their sports career were low. The increase in prevalence of smoking after finishing sports career was observed among both men (p<0.001) and women (p<0.01). However, the intensity of smoking among former athletes was generally low. The multifactorial analysis showed that low risk of smoking was associated with older age among men (p<0.05), being non smoker during sports career among both men and women (p<0.0001), and participation in competitive sports for many years among women (p<0.01). Conclusion. Our results suggest that promotion of participation in competitive sports can be a part of strategies against smoking.
Copyright (c) 2009 Polish Journal of Public Health
Occupational and paraoccupational diseases of the locomotor system in dentists
The work of a dentist is related to exposure to a number of burdensome and harmful factors that constitute a potential health threat. The commonest hazards include: locomotor system overload, exposure to infections and allergies, and the risk of sight and hearing damage. The problem of occupational hazards resulting from the work of a dentist concerns a population of over 12,000 practitioners. The most frequent complaint in dentists are spinal pain syndromes, as well as diseases of the musculoskeletal and peripheral nervous systems. Humeral epicondylitis and the carpal tunnel syndrome are recognized as occupational diseases related to the locomotor system; spinal pain syndromes, however, are considered paraoccupational diseases, where work conditions are one of many possible factors making the disease manifest. The musculoskeletal system overload in the dentist’s workplace should be minimized by adopting a variety of measures. Firstly, dentistry students should be taught ergonomics and occupational diseases prophylactics, and form correct working habits, while active practitioners should develop their skills in this area by participating in postgraduate training. Secondly, the dentist’s workplace should be properly designed and equipped according to the principles of modern ergonomics, while ergonomic work procedures, i.e. four-handed dentistry with horizontallypositioned patients, should be adopted; work organization should include rational time management. Thirdly, dentists should do simple physical exercises during work breaks and participate in various forms of physical activity in their free time. Fourthly, periodic prophylactic examinations of dentists should be adjusted to the specificity of their work and oriented towards early diagnosis of locomotor system overload, produce a detailed documentation and result in a systematic, periodic rehabilitation of the dentist’s musculoskeletal system.
Cancer chemoprevention – application perspectives in prophylactics and therapy
Cancer chemoprevention is defined as the use of natural, synthetic, or biological and chemical agents to reverse, suppress, or prevent either the initial phase of carcinogenesis or the progression to invasive cancer in high-risk populations. Several chemopreventive agents (including tamoxifen) are proved to be effective in preventing the development of cancer, while several remain just as dietary restrictions. Chemopreventive agents have been reported to interfere with a specific stage of the carcinogenesis and different mechanisms involved in anticancer activity have been described. This article summarises agents that have a chemopreventive potential against cancer, as well as these ones which are already in clinical use against cancer. This review will also highlight current clinical research in chemoprevention.
Tick-transmitted diseases. Part II. Pathogens Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti
Ixodes ricinus ticks are a reservoir and vector for numerous viruses, bacteria and protozoa, including species of medical and epidemiological significance. The bacteria Borrelia burgdorferi and Anaplasma phagocytophilum as well as the protozoa Babesia microti are among the pathogenic microorganisms transmitted by Ixodes ricinus ticks. The mentioned pathogens are etiological factors of tick-borne diseases that constitute an important public health problem: diagnostic, clinical and prophylactic. This concerns the most frequently occurring borreliosis which has many forms and multi-organ symptoms, the less frequent anaplasmosis with a non-characteristic clinical picture, and babesiosis – with the clinical picture similar to that of malaria. However, due to co-infections of Ixodes ricinus ticks with the pathogens: Borrelia burgdorferi, Anaplasma phagocytophilum and Babesia microti, mixed infections are possible. In the case of co-infection with the mentioned pathogens, patients may experience a mosaic of symptoms and a more severe course of disease. The paper presents the current knowledge on epidemiology and pathogenicity of Borrelia burgdorferi, Anaplasma phagocytophilum and Babesia microti. It also describes methods used in diagnostics of tick-borne diseases to detect infections with this pathogens: both in ticks and in humans.
Tick-transmitted diseases. Part I. Ixodes ricinus as a reservoir and vector for pathogens
Ixodes ricinus ticks play the key role as a reservoir and vector for numerous pathogens, including species of medical and epidemiological signifi cance. They are a reservoir and vector of many viruses, bacteria and protozoa. As a result of changes in climate and land use, these parasitic arthropods found new habitats. They are increasingly often observed in cities (parks, private estates, gardens) and industrial areas, where the risk of infecting humans with various pathogens is comparable to that in forest biotopes. Active pastimes, recreation, dog walking in the areas overgrown with bushes or in meadows are conducive to a more frequent contact with ticks. Additionally, an increasing number of tick co-infections with several different pathogens found in recent years, points to a growing probability to infect a host, including a human one, with more than one pathogen. Ixodes ricinus is one of the three-host ticks whose instars, before transforming into the subsequent developmental stage, must feed on the blood of a different host. Mechanisms facilitating infection of the host are: pathogen transfer with the saliva of a feeding tick, regurgitation (a backflow of the intestine contents), excretion of the infected faeces or rubbing the infected secretions in through a broken skin of the host. The paper presents the current knowledge on the occurrence and activity of Ixodes ricinus ticks and their role as a reservoir and vector for pathogenic microorganisms.
The Obesity Epidemic in the 21st Century
Obesity is now considered a global civilization disease. Studies confirm its causal relationship with the occurrence of cardiovascular diseases, namely hypertension and coronary heart diseases, as well as type 2 diabetes, lipid disorders and some cancers. According to estimates about 200 million (50-65%) of Europeans are over-weight, a problem that increasingly affects children and adolescents. The development of civilization, and the change in human lifestyle, resulting in reduced physical activity, combined with the introduction of high-energy diet seem to be the most important causes of obesity, followed by genetic or environmental factors. Therefore, the need for the development of good health habits from early childhood should be particularly emphasized. Based on the review of the literature the following issues are presented in the work: Epidemiological characteristics of obesity, Forecasts for its prevalence in selected countries of the world, Methods for assessing obesity in epidemiological studies, Factors determining its presence in contemporary societies, The correlation between the prevalence of obesity, with particular emphasis on visceral obesity, and other civilization diseases. Recommendations for prevention.
Healthcare information technology (IT) and management systems Part 4 – suggestions for solutions in Poland for Patient Internet Account
Basing on national and foreign experiences and by analysing the ways in which the projects were developed in other European countries to offer patients Internet Account as well as the functionality of the account, one can notice the regularity that the evolutionary approach to information technology issue in health care, is most effective. When subsequent functionalities are implemented in stages, starting from the simplest accessible then possibilities, next they allow for launching of new services and building up the system. In Poland there is an effectively functioning National Health Care System –OSOZ, which successfully realizes nowadays the functionality of patient internet account on the level permitted by Polish law. Complete functionality of the Patient Internet Account due to legislative reasons, is not possible at this stage in any of the systems. The present article is presenting the assumptions for further studies concerning the implementation of information technology system in health care in Poland. The project recommends the use of National Health Care System – OSOZ- as the solution that is best adapted to the currently functioning legal acts. This solution in the present form practically implements the best practices encountered in foreign projects with the proved functional effects. The solution implemented deliberately and systematically, with the support of health care decision-makers, has great chances to be one of the most comprehensive systems of this type in Europe.
Healthcare information technology (IT) and management systems. Part 3 – international experiences in e-prescription
One of the most important element in health care information system is the efficiently functioning e-prescription system. Basing on the international experiences, the paper is presenting the proven methods of communication between the project participants, the scope of transmission and the scope of information required for the correct functioning of e-prescription system. The achievements of the following countries in this field have been presented: Denmark, Spain, USA, Czech Republic, Germany, Great Britain, Bulgaria, Estonia, Gibraltar, Norway and Sweden. The analysis of the applied solutions in individual countries concerning e-prescription indicates many convergent elements in the individual projects, nevertheless it points to significant differences in functioning of health care in individual countries. The applied solutions are adapted to the specific character of the legislation of a given country, however many of the elements of good practice or concepts can be used in other countries. The mechanism of e-prescription allows for efficient buying of the prescribed drugs in a chosen drug stores, the analysis of the possible contraindications for dispensing a drug, efficient functioning of the system of prescriptions monitoring, allowing for detecting and eliminating of prescription forgery. This makes improvement of rationalization in financing of health care in a given country, possible.
Conditions, methods and principles of healthcare system records integration – part 1
The article is the explication of refl ections on the role and importance of records in the healthcare information system the author has taken up in the weekly “Służba Zdrowia” and monthly journals: “National Medical Outline” and “Health Manager”. The article covers the valid definitions of: public record, official record, administrative record, and next there is discussed an issue of inadequacy of public record definition that has been introduced by the act of information technology implementation in the healthcare system. This definition excludes from the public records many healthcare records which constitute important information technologyrelated infrastructural elements of the state on the one hand, and on the other hand, it affords a public status to the typical private records. The article points out to the considerable difference between the register, files and the specification. Their distinction is one of the key issues in the context of introducing information order in healthcare. The models of information system functioning in Polish and Scandinavian healthcare systems were discussed. The review of records classification used in the subject literature was made, as well as, an attempt of designing such a classification for healthcare records was made. The developed classification was used for designing of models for individual types of records: service providers, medical workers and the customers. In the models, among other things, the desired hierarchical and informational relationships between individual types of data sets in health protection were indicated, particularly between different types of administration records.
The healthcare system in Poland and the basket of guaranteed healthcare services
For many years the health care system in Poland has been struggling with same problems: poor funding of personnel, hospitals running into debts, limited access to medical services, long waiting lists, corruption and a decline in the value of the technical infrastructure. The main reason for this is the dissonance between the level of funds allocated to pay for medical services and the required volume of such services. The best solution to this situation (based on the experiences of other European countries) is to implement a package of guaranteed health care services. Successive governments have been working continuously on the creation of a package of health care services. Unfortunately, it should be noted, that this work depends to a large degree on political conditions, and the completion of many initiatives, founded on both theoretical and practical bases, is often impossible. The implementation of a new method of accounting for hospital use – Diagnosis Related Groups (JGP), which makes the registration and description of treatment processes possible both in the clinical sense and also in terms of cost categories, seems to be a good sign. It allows to determine the actual costs of medical procedures. The aim of this work is to show the progress of activities towards the implementation of a basket of guaranteed health care services in the Polish health care system, as well as to summarise the steps that have been taken as a part of this initiative.
Health care in the European Union – organization and functioning of health care systems
All of European health systems show some similarities with regard to legal, organizational and fi nancial issues, as well as how the system and its features are running. It is worth to mention that none of the European Union members has accepted common healthcare system policy. Key EU treaties including Maastricht Treaty (1992) and Amsterdam Treaty (1997) do not impose an obligation to do so. Main stipulations say: „The European Community will act in a way of securing high level of healthcare protection” and “High level of healthcare protection will be taken into account in development and implementation of European Community’s policies and activities”. Other stipulations in above mentioned treaties undoubtedly show no intention to intervene in organization and functioning within members’ healthcare systems. Therefore diversity of adopted solutions has been granted. The course of European Communities policy is to develop common standards and rules of healthcare systems with regard to public welfare as the biggest asset of each nation. This paper presents two main models that most of worlds healthcare systems are based on. Those models give background for the comparison of various healthcare systems run in the European Union.
Emigration of Polish healthcare system workers, especially to Great Britain
Introduction. European healthcare systems struggle with dynamic changes and demographic trends that impose growing demand for healthcare services in highly developed countries. Due to limited resources and funding, sound balance between demand and supply has to be found. Aim. The aim of the paper is to analyse migration of Polish health professionals with special attention paid to extensive migration to the United Kingdom. Results. The first part of the paper shows main factors inducing young Polish workers to look for a job in foreign countries as well as presents trends and diversion in migration due to access of Poland to the European Union. The key incentive to Polish healthcare professionals to start up working abroad are higher wages, therefore the second part of the paper presents a comparison of public health professionals’ salaries in Poland and UK. Conclusion. Taking into account great importance of healthcare professionals to provide societies with desired, high standard of living, grave problem arises due to expected shortages of healthcare professionals. Therefore, broad, negative consequences of brain drain in Polish healthcare system will be also analyzed.
High frequency electromagnetic field affecting living organism
Electromagnetic field (EMF) is the area in which penetration of electric and magnetic energy is mutual. It is taking part in practically every field of our life. Natural electromagnetic field is produced by The Sun or The Earth, however artificially it comes into being as an effect of present civilization. Every year development of the technology delivers new EMF’s sources increasingly. Among the most widespread are transmission lines, which boosting majority of home devices. These devices are mostly sources of 50/60 Hz electromagnetic fields. Some of them like television or radio emit radiation with higher frequency. Universally used at present microwave cookers or cellular telephones work in microwave range, that is frequencies above 300MHz. High frequency electric field has found use in medicine, as a short-wave diathermy, microwave diathermy or d’Arsonval’s electricity, applied to many orthopedic, rheumatic or muscular diseases treatment. EMF emitted from ubiquitous sources affects living organisms. Mechanisms of this interactions and its harmful effect is not totally known. It is known that electromagnetic field can affect metabolic processes in cells and disturb their working and functioning. High frequency radiation range can lead to overheat tissues, which cause thermal effect (the hyperthermia) and every stress reactions for organism. There are some coverages that long-term exposition on EMF causes the development of neoplastic disease. However investigations in this subject are not unambiguous.
Do health professionals care about their health? A comparative study of doctors and people with non-medical university education
Introduction. In general opinion doctors are considered to be paragons of proper health behaviour. The aim of our study was to assess if their lifestyles really fit to this image. Material and methods. The anonymous questionnaire distributed among group of 56 medicine doctors (42 females and 14 males) and control group of 62 people with non-medical university education (33 females and 29 males) was used to obtain data. Questionnaire consisted of 37 test and open questions considering alcohol and tobacco consumption, eating habits, sport activity and prophylactic examinations. The survey took place in January and February of 2008. Results. There was no significant statistical difference between the study and control group in: mean BMI values, awareness of own overweight, pattern and quality of meals, alcohol consumption and time spent weekly on sport activities and number of former and active tobacco smokers. More doctors declare to practice sport ‘regularly’ and “time to time’ than in the control group (Chi-squared test, p=0.032) and consume fruit and vegetables over 3 times a day (Chi-squared test, p=0.002). There are no differences both in awareness and practice of breast and cervix cancer prophylaxis between the groups of doctor and non-doctor women, also general poor participation in cervix and breast cancer prophylaxis was revealed. Conclusions. The survey proved that physicians’ lifestyle is not much healthier in comparison to people with nonmedical university education. The percentage of female doctors as well as women from the control group undergoing cytological examinations regularly and practicing breast self-examination is still too low. As doctors should be examples of proper health behaviours, teaching programs should put a higher emphasis on this problem among health professionals.
Damage as premise for compensatory liability
The aim of the paper is to discuss ‘material’ and ‘nonmaterial’ damages as a condition for civil liability and fi nancial (pecuniary) compensation, arising from inappropriate actions of health-care workers. The concept of ‘damage’ is closely related to medical law and should be considered in the context of such law. Damage may be material (e.g. physical damage to a person or property) or non-material damage (e.g. mental suffering or physical discomfort). When considering compensation due to damages, it is necessary to determine its size and impact in the context of a patient’s natural rights or by comparing the situation in which the patient would exist if not for the improper conduct of health care employee with the situation in which the patient does exist as a result of the improper conduct. The paper identifi es examples of both material and nonmaterial damages, drawing on both Supreme Court jurisdiction and the literature. It also examines various forms of compensation, focusing on the conditions that must arise when either seeking compensation of an appropriate sum of money, or return to the state before the damages occurred. It is noted that fi nancial compensation may be in the form of a single reimbursement of costs incurred by the patient due to injury or to other health disorder. Other forms of fi nancial compensation are also described: single cash benefi t and cash compensation for the infringement of natural rights. In addition, the paper focuses on the conditions related to application for a pension by victims who experienced harm in the course of medical procedures, in connection with poor medical procedures, or in connection with poor performance by medical staff.
Hearing dysfunction as the factor influencing the body asymmetry in 13-15 year-old youth
Introduction. Physical development is one on the human development areas and lateralization is one of its aspects. Lateralization, with its consequences as an asymmetry, is considered to be a developmental regularity and the lateralization level decides on effective operation. Hearing is very important for social life. Many more lateralization disorders could take place in hearing-impaired children. It is related to the infl uence of deafness on neurological structures and hearing-impaired people’s behaviour. Aim. The cognitive aim of the study was to identify and compare functional asymmetry in a chosen group of 13-16 year-old hearing-impaired youth. The comparison with hearing peers and identification of a problem in the context of the subjects’ gender was also carried out. Material and method. The study was carried out in hearing- impaired students of a Hearing-Impaired Education Centre placed in the south of Poland and in hearing students of public secondary school in the same localisation. The Wroclaw Asymmetry Test by Koszczyc and Sekita was used during the study. Results. The right-sided functional asymmetry dominates in examined groups of hearing and hearing-impaired girls and boys. Both groups of examined girls and group of examined hearing boys have dominant uniform profile of functional asymmetry. In case of hearing-impaired boys the combined profile prevails. The same directions and profiles of functional asymmetry are observed in hearing girls and boys. Hearing-impaired students have different functional asymmetry profiles, but the same directions. Conclusions. One can reach the conclusion, that the hearing defects determine lateralization, what is observed especially in hearing-impaired boys. Hearing defects in girls infl uence the lateralization as well, but to the smaller extent. Significant dimorphic differences in body lateralization are not observed, either.
Evaluation of life quality of epileptic patients depending on selected clinical and demographic factors
Introduction. The assessment of quality of life has significance in case of neurological diseases, which often are protracted, causing a reduction of physical and mental functioning, worsening the functioning of an ill person in society. Epilepsy is a special disease with certain characteristics, which differs from many other chronic diseases. Basic effects occur irregularly, unpredictably, disturbing all areas of functioning. In the opinion of the patient, most harsh and handicapping is a sense of loss of control and full dependence on the disease. In case of rare attacks the anxiety against the unexpected occurrence of the attack is one of the major factors limiting the activity of patients. This feeling significantly impedes normal activities, causing a sense of depending on others and often preventing to continue work. Repeated attacks disturb lifestyle and are one of the major causes of ill-functioning of patients below their capabilities and expectations. Aim. The aim of this work was to assess rating relationship between quality of life of patients with epilepsy and selected demographic parameters and the parameters which set out the clinical status of patients depending on the degree of social functioning. Results. All patients were treated ambulatorily in Provincial Specialist Neuropsychiatric Health Care Centre. The tests were performed on 244 patients with epilepsy, including 114 women (53%) and 130 men (47%), aged from 19 to 65. In the tested group of patients, as well as in other studies conducted in our country, the quality of life was clearly reduced – 44.39. The quality of life of patients with epilepsy is affected by both demographic factors, as well as some of the factors determining the clinical status. Demographic factors, which, above all, in negatively affect the quality of life of patients with epilepsy are older age and restrictions in social life. The factors determining the status of the most important clinical significance for the quality of life is the type of seizures and the occurrence of side effects. In the analysed material up to 57% of respondents claimed that the attacks severely limited their activity and social life. The anxiety (77%) that the attack occurs in a public place is one of the major factors worsening the quality of life of patients with epilepsy.
Injuries due to accidents are the greatest health problem among children and adolescents. From the beginning of the 90s a systematic decrease has been observed in the number of deaths caused by accidents among children; however, this rate is considerably higher compared to that noted in West European countries. Accidents are the cause of approximately 70% of deaths among children and adolescents. Simultaneously, the percentage of accidents resulting in injuries requiring hospitalization remains high. In recent years, the number of these events has been increasing. In 2008, approximately 70,000 children aged 5-14 required hospital treatment due to accident injuries. Compared to 2003, the value of accident-related morbidity increased by 25%. An especially unfavourable situation was noted in the rural environment, where the accident rate increased by 33.3% - and among rural girls – by 42%. One of the causes of high accident rates among rural children is their engagement in work activities on family farms. Data by the Agricultural Social Insurance Fund (KRUS) indicates that every year about 1,400 children aged 15 are victims of accidents while performing agricultural work activities. It seems justifi able to monitor the accident rates among children.