Complying with the smoking ban by students before and after introducing legislative intervention

Objectives: More and more countries introduce a total ban on smoking tobacco in public places. The aim of this work was to evaluate the effectiveness of “The Act of 8 April 2010 on amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and act on National Sanitary Inspectorate” and assess the frequency of complying with the smoking bans by the students of the Medical University of Lodz, Poland. Material and Methods: Between 2007–2011, at the Social Medicine Institute of the Medical University of Lodz, a study using random survey was carried out involving students who were starting their studies at the Health Department of the Medical University of Lodz. The analysis of the collected material showed that 1038 people reported being smokers at the time of the study. Among that group, 530 students were included in the study prior to, and 508 after the introduction of the amendment. In order to verify their compliance with the smoking ban, the respondents were asked whether they smoked only in designated areas or wherever they wanted to. Results: The ratio of people claiming they smoked anywhere they wanted to, disregarding the smoking ban, was 60% (N = 318) and after the amendment had been introduced, this ratio was 62.2% (N = 316), it increased by 2.2 percentage points. The observed difference was statistically irrelevant (Chi2 = 0.530, p > 0.05). Conclusions: The Act ”On amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and Act on National Sanitary Inspectorate” in Poland did not result in the expected changes in the frequency of complying with the smoking ban by the 1st year students

Morbidity and financing cancer therapies in Poland between the years 2002 and 2011 based on the National Health Fund data

Wstęp. Choroby nowotworowe stanowią poważny problem ze względu na ciągle wzrastającą liczbę zachorowań oraz wysokie koszty rozpoznawania i leczenia. Zwiększenie odsetka osób w starszym wieku w połączeniu z większym narażeniem na działanie szkodliwych czynników środowiskowych, jak również rozwój metod diagnostycznych powodują wzrost liczby wykrywanych nowotworów. Celem pracy było określenie populacji chorych z rozpoznaniem nowotworów w Polsce, oszacowanie wydatków płatnika publicznego związanych z leczeniem przeciwnowotworowym oraz oszacowanie kosztów wprowadzenia nowoczesnych metod leczenia chorych na nowotwory.Materiał i metody. W celu wykonywania analiz informacji sprawozdawczych w bazach danych NFZ został wykonany moduł analityczny o nazwie „Rejestr Leczenia Chorób” (RLC), który umożliwia pobieranie informacji z bazy danych oraz prezentację danych w czasie rzeczywistym. W analizie przyjęto metodę oszacowania kosztu wprowadzenia innowacji. Przyjęto założenie, że kosztem innowacji staje się wartość środków wydatkowanych przez płatnika publicznego w danym roku, jakie pozostają po ekstrapolowaniu kosztów terapii z roku poprzedniego na liczbę chorych w danym roku. W analizie nie zostały wzięte pod uwagę wartości wskaźnika inflacji. Niepowtarzalnym identyfikatorem danego chorego został uznany numer PESEL. W analizie danych został wykorzystany arkusz kalkulacyjny Excel. Analizę dokonano z wykorzystaniem wszystkich istniejących w bazie pozycji, nie różnicując stopnia wiarygodności potwierdzenia rozpoznania.Wyniki. Liczba wszystkich wykazywanych chorych z rozpoznaniami nowotworowymi w latach 2002–2012 rosła corocznie i osiągnęła w roku 2011 ponad 1 milion osób leczonych z powodu nowotworów. Dynamika średnioroczna liczby pacjentów względem roku poprzedniego wyniosła ok. +11%. Rozpoznania, których koszty na przestrzeni całego badanego okresu przekroczyły 10% budżetu na rozpoznania onkologiczne, obejmują: nowotwór złośliwy sutka (C50) — 14,41% budżetu i przekroczenie średniorocznego kosztu dla rozpoznań onkologicznych o blisko 1400% oraz nowotwór złośliwy oskrzeli i płuca (C34) — 10,5% budżetu i przekroczenie średniorocznego kosztu dla rozpoznań onkologicznych o 1018%. Rozpoznaniami o najwyższych kosztach średniorocznych w analizowanym okresie były nowotwór złośliwy sutka (C50) — 566 944 649 PLN oraz nowotwór złośliwy oskrzeli i płuca (C34) — 412 877 994 PLN. Wyżej wymienione nowotwory stanowiły również rozpoznania o największej liczbie zrealizowanych świadczeń na przestrzeni lat 2002–2011.Wnioski. Przeprowadzone analizy wykazały, że spośród ponad 100 grup rozpoznań nowotworów istnieje około 35, które są istotne z punktu widzenia epidemiologii społecznej. Świadczy to o tym, że Narodowy Program Zwalczania Nowotworów właśnie te choroby powinien potraktować priorytetowo i dla nich powinna być opracowana szczegółowa strategia postępowania. Istnieje około 20 grup rozpoznań, w których obliczony koszt innowacji przekroczył na przestrzeni trzech lat 50 milionów złotych (nowotwory, w leczeniu których wprowadzono nowe leki). Istnieje duża i utrzymująca się w badanym okresie rozbieżność (około 50%) między wykazywanymi rozpoznaniami i rozpoznaniami potwierdzonymi lub chorymi leczonymi, co wymaga przeprowadzenia odrębnych i bardziej szczegółowych analiz.Introduction. Cancer related illnesses are a serious problem due to the always increasing number of such illnesses and the high cost of diagnosis and treatment. The increase in the ratio of elderly people together with the higher risk of exposure to harmful environmental factors and the development of diagnostic methods result in an increased number of diagnosed cancers. The aim of the work was to determine the population of the persons diagnosed with cancer in Poland, evaluate the tax payers’ expenses connected with anti-cancer treatment and evaluate costs related to the introduction of the state-of-the-art treatment methods of the ill diagnosed with cancers.Material and methods. In order to carry out analyses of report information in the NHF data bases, an analytical module was created called the Illness Treatment Register (ITL). This enables downloading of information from the database and presenting it in real time. In the analysis, a method of evaluating the cost of introducing the innovation was assumed. Namely it was assumed that the cost of innovation is the value of funds expended by the public tax payers in a given year that remain, after extrapolation of therapy costs from the previous year per number of ill persons in a given year. The analysis did not consider the value of the inflation index. The PESEL number was considered to be the uniqueidentity number of the ill person. An excel calculation sheet was used in the data analysis which was carried out with the use of all items existing in the database, not differentiating the degree of credibility of diagnosis confirmation.Results. The number of all the established persons diagnosed with cancer between the years 2002 and 2011 increased annually and reached over 1 million people in 2011 who were treated because of cancers. The average yearly dynamics of the patient numbers compare to the previous year, oscillated around +11%. Diagnosis that throughout the whole tested period exceeded 10% of the budget allocated for the oncological diagnoses, included breast cancer (C50) — 14.41% of the budget and exceeded the average annual cost for oncological diagnoses by nearly 1400%, and bronchi and lungs cancer (C34) — 10.5% of the budget and exceeded the average annual cost for oncological diagnoses by 1018%. Diagnosis with the highest annual average in the anaysed period were breast cancer (C50) — 566 944 649 PLN and bronchi and lungs cancer (C34) — 412 877 994 PLN. The above mentioned cancers were alsothe diagnoses of the highest number of health services between the years 2002 and 2011.Conclusions. The analyses showed that from over 100 groups of diagnosed cancers, there are around 35 that arerelevant from the point of view of social epidemiology. This indicates that the National Cancer Prevention Programme should treat these illnesses with a high priority and it is for them that a detailed strategy of action ought to be worked out. There are about 20 groups of diagnoses where the calculated cost of innovation exceed 50 million PLN throughout the last three years: for cancers where new medicines were introduced. There is a great and sustaining hiatus in the analysed period (around 50%) between the reported diagnoses and the confirmed diagnoses for the ill persons that are treated. This requires more detailed analyses

Health and life hazards related to aggressive behaviour of patients diagnosed with alcohol abstinence syndrome

Alcohol withdrawal syndrome is one of the most serious disorders resulting from alcohol addiction. Moreover, this disorder may cause complications such as hallucinations including delirium. Doctors and paramedics dealing with patients very often face aggressive behaviour. The aim of the study was to investigate the scale of that phenomenon and characterize it. The study included the analysis of patients’ medical documentation with diagnosed alcohol abstinence syndrome at the time of admission. Research confirmed that the aggressive behaviour occurred in 25% of cases. It occurred most frequently in case of delirium, and was directed to the patient’s environment. Conclusions: 1) Aggressive behaviour is quite a serious problem that affected every fourth patient being tested. The reasons can be different, but the crew of ambulances and doctors from hospital wards must be attentive and prepared for all kinds of violent behaviour, not only towards them, but to the patient himself also. 2) Aggressive behaviour was observed more frequently in the event of alcoholic delirium. 3) Aggression demonstrated by the patients with alcohol abstinence syndrome is addressed in almost ⅔ of the cases to the environment of the patient

Zagrożenia zdrowia i życia powiązane z agresywnym zachowaniem pacjentów ze zdiagnozowanym alkoholowym zespołem abstynencyjnym

Alcohol withdrawal syndrome is one of the most serious disorders resulting from alcohol addiction. Moreover, this disorder may cause complications such as hallucinations including delirium. Doctors and paramedics dealing with patients very often face aggressive behaviour. The aim of the study was to investigate the scale of that phenomenon and characterize it. The study included the analysis of patients’ medical documentation with diagnosed alcohol abstinence syndrome at the time of admission. Research confirmed that the aggressive behaviour occurred in 25% of cases. It occurred most frequently in case of delirium, and was directed to the patient’s environment. Conclusions: 1) Aggressive behaviour is quite a serious problem that affected every fourth patient being tested. The reasons can be different, but the crew of ambulances and doctors from hospital wards must be attentive and prepared for all kinds of violent behaviour, not only towards them, but to the patient himself also. 2) Aggressive behaviour was observed more frequently in the event of alcoholic delirium. 3) Aggression demonstrated by the patients with alcohol abstinence syndrome is addressed in almost ⅔ of the cases to the environment of the patient.Alkoholowy zespół abstynencyjny jest jednym z najpoważniejszych zaburzeń wynikających z uzależnienia od alkoholu. Dodatkowo w trakcie jego przebiegu może dojść do powikłań z wystąpieniem halucynacji oraz pełnoobjawowym majaczeniem alkoholowym włącznie. Lekarze i ratownicy medyczni w kontaktach z takimi pacjentami często spotykają się z agresywnym zachowaniem. Celem pracy było zbadanie skali wspomnianego zjawiska oraz próba jego scharakteryzowania. Badania polegały na analizie kart chorobowych pacjentów z rozpoznanym, w chwili przyjęcia, alkoholowym zespołem abstynencyjnym. Z badań tych wynikało, że zachowania agresywne występowały w 25% przypadków. Najczęściej agresja była skierowana na otoczenie pacjenta i dotyczyła majaczenia alkoholowego. Wnioski: 1) Agresywne zachowanie jest dość poważnym problemem, występującym u co czwartego badanego pacjenta. Przyczyny tego stanu bywają różne, a członkowie załóg karetek pogotowia i lekarze oddziałów szpitalnych muszą być uważni i przygotowani na różnego rodzaju gwałtowne zachowania, skierowane nie tylko na personel, ale także na samego pacjenta. 2) Agresywne zachowanie było obserwowane zdecydowanie częściej w przypadku majaczenia alkoholowego. 3) Agresja pacjentów z alkoholowym zespołem abstynencyjnym skierowana jest w blisko ⅔ przypadków na otoczenie pacjenta

Complying with the smoking ban by students before and after introducing legislative intervention

Objectives: More and more countries introduce a total ban on smoking tobacco in public places. The aim of this work was to evaluate the effectiveness of “The Act of 8 April 2010 on amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and act on National Sanitary Inspectorate” and assess the frequency of complying with the smoking bans by the students of the Medical University of Lodz, Poland. Material and Methods: Between 2007–2011, at the Social Medicine Institute of the Medical University of Lodz, a study using random survey was carried out involving students who were starting their studies at the Health Department of the Medical University of Lodz. The analysis of the collected material showed that 1038 people reported being smokers at the time of the study. Among that group, 530 students were included in the study prior to, and 508 after the introduction of the amendment. In order to verify their compliance with the smoking ban, the respondents were asked whether they smoked only in designated areas or wherever they wanted to. Results: The ratio of people claiming they smoked anywhere they wanted to, disregarding the smoking ban, was 60% (N = 318) and after the amendment had been introduced, this ratio was 62.2% (N = 316), it increased by 2.2 percentage points. The observed difference was statistically irrelevant (Chi2 = 0.530, p > 0.05). Conclusions: The Act ”On amendment of the act on protection of health against the consequences of consumption of tobacco and tobacco products and Act on National Sanitary Inspectorate” in Poland did not result in the expected changes in the frequency of complying with the smoking ban by the 1st year students

Assessment of the Health Behaviours and Value-Based Health Analysis of People Aged 50+ Who Were Hospitalized Due to Cardiovascular Disease

Introduction: The basic determinant of healthy behaviour—among other human behaviours—is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population. Objective: To assess the health behaviours and value-based health analysis of people aged 50+ who were hospitalized due to cardiovascular disease, depending on the selected descriptive variables. Materials and methods: The study was conducted between April 2018 and December 2018 among 411 subjects aged 50+ who were hospitalized due to cardiovascular disease at the Independent Public Health Care Unit in Sanok (Podkarpackie voivodship in Poland). The method used in the study was a diagnostic survey. The study used the authors’ survey questionnaire and two standardized tests: Inventory of Health-Related Behaviour (IHB) and List of Health Criteria (LHC). A statistical analysis was carried out in the R program, version 3.5.1. The obtained results were subjected to thorough statistical analysis using the following tests: Student’s t, Mann–Whitney U, ANOVA, Kruskal–Wallis, Fisher’s Least Significant Difference (LSD), Pearson, and Spearman. Results: The strongest correlation between health status and health behaviours (according to the IHB questionnaire) was in the area of ‘health practices’, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. Based on the LHC questionnaire, the most important health criteria according to the subjects were ‘not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. A positive correlation was found in the group of respondents where the ‘preventive health behaviours’ were more intense; herein, the more important criterion for the respondents was ‘eating properly’. Conclusions: Respondents aged 50+ and hospitalized for cardiovascular diseases indicated (based on the IHB questionnaire) that health behaviours in the area of ‘health practices’ had the strongest correlation with their health, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. According to the respondents, the most important criteria determining health (according to the LHC questionnaire) included ’not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. Based on the information collected from the respondents, it was found that the most important criteria determining health depended on selected descriptive variables, such as age, gender, place of residence, education, and marital status