Towards optimal use of antithrombotic therapy of people with cancer at the end of life: a research protocol for the development and implementation of the SERENITY shared decision support tool Thrombosis Research

Background: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. Methods: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.Results: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. Conclusions: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers

The reinforcement elements corrosion threat of the reinforced concrete operated long-term in extremely different exposure conditions

Procesy korozyjne występują w konstrukcjach żelbetowych z różnym nasileniem, w zależności od środowiska eksploatacyjnego. Jedną z metod pozwalających na ustalenie występowania korozji oraz stopnia jej zaawansowania jest elektrochemiczna nieniszcząca metoda pomiaru impulsu galwanostatycznego. W artykule zaprezentowano wyniki badań pomiaru korozji zbrojenia słupów żelbetowych eksploatowanych w różnych warunkach środowiska uzyskane metodą impulsu galwanostatycznego przy użyciu aparatury GP -5000 GalvaPulseTM.Corrosion processes occur in reinforced concrete structures with varying intensity depending on operating environment. One of the methods to determine the existence of corrosion and its severity is electrochemical non-destructive method to measure the galvanostatic pulse. The article presents the surveys measuring reinforcement corrosion results of the reinforced concrete columns operated in various environmental conditions generated by the galvanostatic pulse using the GP -5000 GalvaPulseTM device

Stress at intellectual work and cardiovascular diseases in women at non-mobility working age

Introduction and objective. Stress at the work place reduces efficiency, as well as increasing accidents and absences, which may cause various diseases, including cardiovascular diseases. The aim of the study is an analysis of the prevalence and causes of stress in intellectual work, and its correlation with the prevalence of cardiovascular diseases in women at non-mobility working age. Materials and method. The study was conducted in 2016–2017 in a group of 300 women aged 45–60 in non-manual employment. A questionnaire for subjective job evaluation was used. Logistic regression models for the occurrence of CVDs versus frequency of occurrence of individual causes of work stress among the respondents were estimated. Results. Women at non-mobility working age with non-manual employment are especially exposed to stress, half of them experience high level of stress at work, most often caused by social contacts and lack of rewards and support. Cardiovascular diseases were found in 26.5% of the women studied who were also significantly higher exposed to the occurrence of health hazards due to exposure to harmful factors, or due to an accident at work, changes in the workplace, the need to compete with others,and the need to perform the task despite the lack of appropriate material resources, compared with women without such diseases. Conclusions. The study revealed a high prevalence of occupational stress in non-manual employment, indicated its main causes that correlated with the alence of cardiovascular diseases. Actions are needed to reduce the level of stress in the work of women at non-mobility working age, to maintain their work ability and quality of life

Changes in interregional migration of patients hospitalized in Poland - 2013–2017

Objectives. The aim of the study is to determine the scale of interregional migrating patients’ hospitalizations in Poland in 2013–2017, as well as their demographic and medical factors, total costs and time changes. Materials and method. Data from the NHF (National Health Fund) regarding hospitalizations in a given province of patients registered in another province in Poland in 2013–2017 were statistically analyzed. Times series analyses as well as coefficients of correlation, determination and variation were used. Results. The number of patients hospitalized outside their regional registration and the cost of their hospitalization increased from year-to-year during 2013–2017. There was a large variation in provinces in terms of inflow of patients and costs of their hospitalization, while there was only a small variation in terms of outflow of patients and costs of their hospitalization in the analyzed years. Among the patients hospitalized outside the province where they were registered, there were more women then men, while the age group was dominated by 60-year-olds and their share in the subsequent years increased, while the share of other age groups remained unchanged or decreased. The most and increasingly more from year-to-year hospitalizations outside the regional registration were due to neoplasms and diseases of the circulatory system. Conclusions. The results of the study may significantly contribute to the proper planning of securing the health needs of the inhabitants of particular regions, and to improving the quality and economic efficiency of health services in individual NHF branches

Background ionizing radiation and semen parameters of men with reproductive problems

Introduction and objective. The male reproductive system constitutes a set of tissues which are particularly sensitive to external factors. The aim of the study was to analyze the relationship between background radioactivity and the quality of the semen of the men who have reported to the infertility treatment facility in 2000–2016 in the Lublin region of eastern Poland. Materials and method. The radioactivity of the ground-level air layer obtained from the Institute of Meteorology and Water Management in Włodawa in the Lublin region was analysed. 4,250 spermiograms of patients who reported to the treatment facility for the first time due to infertility were analysed and correlated to background radioactivity in the Lublin region in 2000–2016. Results. A long-term decrease in the percentage of morphologically normal spermatozoa of the patients was observed (r=-0.970; p<0.001 in 2000–2009 and r=-0.925; p=0.003 in 2010–2016). Men’s age correlated negatively with sperm motility (r=-0.164; p=0.009) and morphology (r=-0.186; p=0.009). The percentage of spermatozoa with normal morphology was lowered by beta-isotopes of artificial origin in the air in 2000–2009 (r=-0.655; p=0.040) and by the exposure to gamma radiation of the ground-level atmosphere in 2010–2016 (r=-0.676; p=0.048). The percentage of sperm vitality was lowered by gamma radiation in the atmosphere (r=-0.636; p=0.006), but improved by beta isotopes in precipitation (r=0.686; p=0.002) in the whole of the analyzed period. Conclusions. The percentage of morphologically normal spermatozoa in patients who reported to the infertility treatment depends not only on the age of patient, but also on beta-isotopes of artificial origin and gamma radiation in the atmosphere. Beta isotopes in precipitation affect the improvement of sperm vitality

Atherogenic lipid profile and health behaviours in women post-menopause working in agriculture

Introduction and objective. There is a significantly higher risk of lipid disorders occurrence, including atherogenic dyslipidemia in women after menopause than it is in general population. The aim of the work was to investigate the correlation between health behaviours and the occurrence of lipid disorders in women after menopause working in agriculture. Material and methods. The study was conducted in years 2015–2016 and included 843 post-menopausal women working in agriculture. The following were used: a questionnaire including socio-demographic data, laboratory lipid tests, inventory of health behaviours. The following were estimated: logistic regression models for serum lipids concentration versus frequency of health behaviours in the examined women. Results. Adverse lipid profile was found in over a half of post-menopausal women working in agriculture, whereas the frequency of health behaviours were estimated at the average level, although the frequency of correct eating habits and health practices was significantly lower than preventive behaviours and positive psychological attitudes. A correlation was found between the frequency of health behaviours and the occurrence of lipid disorders in women after menopause working in agriculture: more frequent health practices co-existed with the lower concentration of total cholesterol and a higher concentration of HDL-cholesterol, more frequent preventive behaviours co-existed with lower concentration of LDL-cholesterol. Women with higher concentration of triglycerides undertook pro-health practices relatively more often. Conclusions. The study revealed a high prevalence of lipid disorders in postmenopausal women working in agriculture. More effective health education programmes are necessary in the area of reduction the risk factors of CVD in the population of women working in agriculture